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However, the underlying mechanisms are still unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and analysis<\/jats:title><jats:p>This study protocol describes a cross-sectional study aimed at investigating the presence of self-rated mental fatigue, objectively measured cognitive fatigability and executive functions and their relation to other cognitive functions, inflammatory biomarkers and brain connectivity in patients with CP. We will control for pain-related factors such as pain intensity and secondary factors such as sleep disturbances and psychological well-being. Two hundred patients 18\u201350 years with CP will be recruited for a neuropsychological investigation at two outpatient study centres in Sweden. The patients are compared with 36 healthy controls. Of these, 36 patients and 36 controls will undergo blood sampling for inflammatory markers, and of these, 24 female patients and 22 female controls, between 18 and 45 years, will undergo an functional MRI investigation. Primary outcomes are cognitive fatigability, executive inhibition, imaging and inflammatory markers. Secondary outcomes include self-rated fatigue, verbal fluency and working memory. The study provides an approach to study fatigue and cognitive functions in CP with objective measurements and may demonstrate new models of fatigue and cognition in CP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ethics and dissemination<\/jats:title><jats:p>The study has been approved by the Swedish Ethics Review Board (Dnr 2018\/424-31; 2018\/1235\u201332; 2018\/2395\u201332; 2019\u201366148; 2022-02838-02). All patients gave written informed consent to participate in the study. The study findings will be disseminated through publications in journals within the fields of pain, neuropsychology and rehabilitation. Results will be spread at relevant national and international conferences, meetings and expert forums. The results will be shared with user organisations and their members as well as relevant policymakers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05452915\">NCT05452915<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2022-068011","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T17:23:31Z","timestamp":1680110611000},"page":"e068011","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Cognitive and mental fatigue in chronic pain: cognitive functions, emotional aspects, biomarkers and neuronal correlates\u2014protocol for a descriptive cross-sectional study"],"prefix":"10.1136","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct05452915","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8700-5186","authenticated-orcid":false,"given":"Marika C","family":"M\u00f6ller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1192-4527","authenticated-orcid":false,"given":"Nils","family":"Berginstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6396-5104","authenticated-orcid":false,"given":"Bijar","family":"Ghafouri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9058-7463","authenticated-orcid":false,"given":"Anna","family":"Holmqvist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8701-0206","authenticated-orcid":false,"given":"Monika","family":"L\u00f6fgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9685-8583","authenticated-orcid":false,"given":"Love","family":"Nordin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2916-0628","authenticated-orcid":false,"given":"Britt-Marie","family":"St\u00e5lnacke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,3,29]]},"reference":[{"key":"2024021703200807000_13.3.e068011.1","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1097\/AJP.0000000000000534","article-title":"The relationship between structural and functional brain changes and altered emotion and cognition in chronic low back pain brain changes: a systematic review of MRI and fMRI studies","volume":"34","author":"Ng","year":"2018","journal-title":"Clin J Pain"},{"key":"2024021703200807000_13.3.e068011.2","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.nicl.2015.08.004","article-title":"Normalization of aberrant resting state functional connectivity in fibromyalgia patients following a three month physical exercise therapy","volume":"9","author":"Flodin","year":"2015","journal-title":"Neuroimage Clin"},{"key":"2024021703200807000_13.3.e068011.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2008.04.003"},{"key":"2024021703200807000_13.3.e068011.4","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.ejpain.2009.05.010","article-title":"Co-occurrence and associations of pain and fatigue in a community sample of dutch adults","volume":"14","author":"Creavin","year":"2010","journal-title":"Eur J Pain"},{"key":"2024021703200807000_13.3.e068011.5","doi-asserted-by":"publisher","DOI":"10.1023\/A:1009020914358"},{"key":"2024021703200807000_13.3.e068011.6","first-page":"1407","article-title":"The prevalence and meaning of fatigue in rheumatic disease","volume":"23","author":"Wolfe","year":"1996","journal-title":"J Rheumatol"},{"key":"2024021703200807000_13.3.e068011.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2015.03.004"},{"key":"2024021703200807000_13.3.e068011.8","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1046\/j.1526-4637.2003.03008.x","article-title":"Is pain fatiguing? 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