Understanding the Experience and Impacts of Brain Fog in Chronic Pain: A Scoping Review 2023 Dass et al

Introduction
Approximately 15% to 40% of persons with chronic pain as a primary disorder experience brain fog. Prior research has investigated the etiology of “brain fog” in conditions in which pain presents as a key feature (e.g., fibromyalgia). However, it remains understudied in the context of chronic 10 musculoskeletal pain. Following current scoping review guidelines, we obtained stakeholder input from patient and health care professionals (HCPs) to define this phenomenon. Specific aims of this review were to (1) identify factors contributing to brain fog, (2) identify the functional correlates of brain fog and assessments used to measure them, and (3) establish a definition of brain fog that can be employed by researchers and HCPs to advance research and care.

Methods
A scoping review was conducted using recommendations of the Joanna Briggs Institute methodology of scoping reviews and the Levac et al methodology. Embase, Cinahl, PsycINFO, and Medline was searched to identify relevant sources. Findings were verified with patient and healthcare professionals.

Results
We identified four 15 key features of brain fog: perceived variability, subjective cognitive dysfunction, participation limitations, and changes in functional activities. We developed a model of brain fog illustrating the overlapping categories of contributors to brain fog in chronic musculoskeletal pain: (1) neuroanatomical and neurophysiological, (2) mental health/emotional, and (3) environmental/lifestyle.

Conclusion
The results of this scoping review conclude that the inconsistency in research regarding brain fog in 20 chronic musculoskeletal pain is obstructing a clear understanding of the phenomenon and therefore may be impeding persons with chronic pain and brain fog from receiving optimal care.

Open access, https://www.tandfonline.com/doi/full/10.1080/24740527.2023.2217865

 

I think it's not the inconsistency in research, it's the lack of clear definition and quantifiability of the symptoms. Questionnaires are inconsistent.

 

Yup. It's mostly an issue of garbage in garbage out.

And so far even in the context of LC making this far more known, it's still mostly garbage in. It's frankly looking to me like it's simply not possible to study subjective experience without heavy involvement from the subjects themselves. Not much surprise we are still no more advanced than any time in the past. They can't figure which questions to ask, and the questions they do ask rarely make sense in our context.

 

The questions are pretty much by definition leading, since there's no consensus on what to ask, or what the answers should be, or what they mean. "How many fingers am I holding up?" is straightforward, with three clear answers (right, wrong, or "I can't tell"). "How is your brainfog today?" is going to get various vague and inconsistent answers, even from just one subject. "Are your muscles feeling much stronger after 6 sessions of GET?" is leading.