Stroop test performance in individuals with chronic neck pain: Relationships with pain intensity, duration, and functional disability

Bulent Bozyigit

doi:10.5281/zenodo.19193303

Authors

Bulent Bozyigit Private Saglik Hospital, Department of Neurosurgery, Izmir, Turkey https://orcid.org/0000-0001-5038-2260

DOI:

https://doi.org/10.5281/zenodo.19193303

Keywords:

Chronic neck pain, Executive function, Stroop test, Cognitive inhibition, Selective attention

Abstract

Objective: Chronic neck pain (CNP) has traditionally been conceptualized as a predominantly sensory and musculoskeletal condition; however, growing evidence suggests that chronic pain may also influence higher-order cognitive processes. This study aimed to investigate executive function performance in individuals with CNP using the Stroop Test and to examine the associations between Stroop performance and clinical pain parameters.

Materials and methods: Twenty-five individuals with CNP and 25 age-, sex-, and education-matched healthy controls were included in this cross-sectional study. Pain intensity was assessed using the Visual Analog Scale (VAS), functional disability using the Neck Disability Index (NDI), and pain duration was recorded in months. Executive functions were evaluated using all five subtests of the Stroop Test. Group comparisons were performed, and correlations between clinical variables and Stroop performance were analyzed within the CNP group.

Results: Individuals with CNP demonstrated significantly longer completion times across all Stroop subtests compared to healthy controls (p<0.05), with moderate-to-large effect sizes (r=0.40-0.59). No significant associations were found between Stroop performance and pain intensity, pain duration, or disability level (all p>0.05).

Conclusion: The findings indicate that individuals with chronic neck pain exhibit impaired executive function, particularly in cognitive inhibition processes. However, this impairment does not appear to be directly explained by conventional clinical pain parameters. These results suggest that CNP may involve alterations in executive control–related neural networks and highlight the importance of incorporating cognitive assessment into the clinical evaluation of chronic neck pain.

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