{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T16:05:18Z","timestamp":1779725118406,"version":"3.53.1"},"reference-count":80,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Chronic neck pain is a prevalent condition linked to functional disability and maladaptive pain-related behaviors. Although the physical and psychosocial impairments have been extensively studied in the literature, the factors related to cognitive impairments are not fully understood. This study aimed to examine the physical, psychosocial, and cognitive impairments associated with chronic neck pain and examine the variables associated with cognitive performance in this population. Materials and Methods: This cross-sectional study included 87 individuals with chronic neck pain. Pain sensitivity, neck disability, physical capacity, cervical muscle strength, pain catastrophizing, kinesiophobia, and self-reported central sensitization were assessed in all participants. Within the scope of the neuropsychological assessment, global cognition, processing speed, attention, and executive functioning were evaluated. The relationship between physical, psychosocial, and cognitive impairments was assessed using Spearman correlation. Additionally, a multiple linear regression analysis was performed to assess the extent to which the independent variables were associated with cognitive performance. Results: Global cognition was moderately correlated with pain intensity (r = \u22120.427, p &lt; 0.001) and pain catastrophizing (r = \u22120.414, p &lt; 0.001). Difficulties in response inhibition were moderately related to age (r = 0.440, p &lt; 0.001). Cervical muscle strength (r = 0.384\u20130.233) and physical capacity (r = 0.332) were also weakly correlated with global cognition (p &lt; 0.05). Age exhibited the strongest relationship with global cognition (\u03b2 = \u22120.332, p &lt; 0.001), followed by pain intensity (\u03b2 = \u22120.291, p = 0.004) and pain sensitivity (\u03b2 = 0.253, p = 0.011), with an explained variance of 30.8%. Additionally, age showed the strongest association with difficulties in processing speed (\u03b2 = 0.448, p &lt; 0.001), followed by kinesiophobia (\u03b2 = 0.325, p = 0.001) and neck disability (\u03b2 = 0.262, p = 0.030), with an explained variance of 34.2%. Conclusions: These findings suggest that increased nociceptive sensitization and deficits in physical health may be associated with maladaptive pain-related coping strategies in individuals with chronic neck pain. Furthermore, cognitive impairments in these individuals may reflect a multidimensional association of demographic, physical, psychosocial, and sensorial mechanisms.<\/jats:p>","DOI":"10.3390\/medicina62050956","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T15:05:08Z","timestamp":1779721508000},"page":"956","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidimensional Analysis of Physical, Psychosocial, and Cognitive Impairment in People with Chronic Neck Pain"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1947-7100","authenticated-orcid":false,"given":"Zeynep","family":"Guven","sequence":"first","affiliation":[{"name":"Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1132-3660","authenticated-orcid":false,"given":"Ezgi","family":"Yetim Arsava","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet Ilkay","family":"Isikay","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayse","family":"Akyay","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erdem","family":"Karabulut","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7334-411X","authenticated-orcid":false,"given":"Songul","family":"Atasavun Uysal","sequence":"additional","affiliation":[{"name":"Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"ref_1","unstructured":"(2024). GBD 2021 Neck Pain Collaborators. Global, regional, and national burden of neck pain, 1990\u20132020, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol., 6, e142\u2013e155."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Kazeminasab, S., Nejadghaderi, S.A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M.J.M., Kolahi, A.A., and Safiri, S. (2022). Neck pain: Global epidemiology, trends and risk factors. BMC Musculoskelet. Disord., 23.","DOI":"10.1186\/s12891-021-04957-4"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1007\/s00586-004-0864-4","article-title":"The prevalence of neck pain in the world population: A systematic critical review of the literature","volume":"15","author":"Fejer","year":"2006","journal-title":"Eur. Spine J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"m791","DOI":"10.1136\/bmj.m791","article-title":"Global, regional, and national burden of neck pain in the general population, 1990\u20132017: Systematic analysis of the Global Burden of Disease Study 2017","volume":"368","author":"Safiri","year":"2020","journal-title":"BMJ"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1097\/AJP.0000000000001115","article-title":"Differential structural brain changes between responders and nonresponders after physical exercise therapy for chronic nonspecific neck pain","volume":"39","author":"Berryman","year":"2023","journal-title":"Clin. J. Pain"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1136\/jech.2009.090720","article-title":"Risk factors for the onset of non-specific neck pain: A systematic review","volume":"64","author":"McLean","year":"2010","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Alhakami, A.M., Madkhli, A., Ghareeb, M., Faqih, A., Abu-Shamla, I., Batt, T., Refaei, F., Sahely, A., Qassim, B., and Shami, A.M. (2022). The prevalence and associated factors of neck pain among ministry of health office workers in saudi arabia: A cross sectional study. Healthcare, 10.","DOI":"10.3390\/healthcare10071320"},{"key":"ref_8","first-page":"E389","article-title":"Cognitive performance is related to central sensitization and health-related quality of life in patients with chronic whiplash-associated disorders and fibromyalgia","volume":"18","author":"Coppieters","year":"2015","journal-title":"Pain Physician"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Blomgren, J., Strandell, E., Jull, G., Vikman, I., and R\u00f6ijezon, U. (2018). Effects of deep cervical flexor training on impaired physiological functions associated with chronic neck pain: A systematic review. BMC Musculoskelet. Disord., 19.","DOI":"10.1186\/s12891-018-2324-z"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.math.2010.12.005","article-title":"Endurance and fatigue characteristics of the neck flexor and extensor muscles during isometric tests in patients with postural neck pain","volume":"16","author":"Edmondston","year":"2011","journal-title":"Man. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.jelekin.2010.11.011","article-title":"Reduced force steadiness in women with neck pain and the effect of short term vibration","volume":"21","author":"Muceli","year":"2011","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.2522\/ptj.20150501","article-title":"Effectiveness of global postural re-education in patients with chronic nonspecific neck pain: Randomized controlled trial","volume":"96","author":"Pillastrini","year":"2016","journal-title":"Phys. Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s00421-008-0696-8","article-title":"Alterations in cervical muscle activity in functional and stressful tasks in female office workers with neck pain","volume":"103","author":"Johnston","year":"2008","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1016\/j.clinph.2011.11.033","article-title":"Chronic trauma-induced neck pain impairs the neural control of the deep semispinalis cervicis muscle","volume":"123","author":"Schomacher","year":"2012","journal-title":"Clin. Neurophysiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.math.2010.07.006","article-title":"Association between neck muscle coactivation, pain, and strength in women with neck pain","volume":"16","author":"Schomacher","year":"2011","journal-title":"Man. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1111\/pme.12429","article-title":"Myofascial trigger points in patients with whiplash-associated disorders and mechanical neck pain","volume":"15","author":"Castaldo","year":"2014","journal-title":"Pain Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e1863","DOI":"10.1002\/pri.1863","article-title":"Progressive resistance exercise for improving pain and disability in chronic neck pain: A case series","volume":"25","author":"Cox","year":"2020","journal-title":"Physiother. Res. Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1016\/j.jpain.2020.02.007","article-title":"Comparing central pain processing in individuals with non-traumatic neck pain and healthy individuals: A systematic review and meta-analysis","volume":"21","author":"Xie","year":"2020","journal-title":"J. Pain"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Poenaru, D., Sandulescu, M.I., and Cinteza, D. (2023). Pain modulation in chronic musculoskeletal disorders: Botulinum toxin, a descriptive analysis. Biomedicines, 11.","DOI":"10.3390\/biomedicines11071888"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1242\/dmm.011502","article-title":"Pain hypersensitivity mechanisms at a glance","volume":"6","author":"Gangadharan","year":"2013","journal-title":"Dis. Model. Mech."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"15","DOI":"10.2174\/1570159X20666221012112725","article-title":"Central sensitization and pain: Pathophysiologic and clinical insights","volume":"22","author":"Curatolo","year":"2024","journal-title":"Curr. Neuropharmacol."},{"key":"ref_22","first-page":"338","article-title":"Differences between women with traumatic and idiopathic chronic neck pain and women without neck pain: Interrelationships among disability, cognitive deficits, and central sensitization","volume":"97","author":"Coppieters","year":"2017","journal-title":"Phys. Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1515\/sjpain-2020-0107","article-title":"Sensitization in office workers with chronic neck pain in different pain conditions and intensities","volume":"21","author":"Nunes","year":"2021","journal-title":"Scand. J. Pain"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"G\u00fcne\u015f, M., Turan, M., \u00c7ataloluk, D., and Apayd\u0131n, A.S. (2026). The relationship between neck and body awareness, pain, and proprioception with central sensitization in patients with chronic nonspecific neck pain. BMC Musculoskelet. Disord., 27.","DOI":"10.1186\/s12891-026-09628-w"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s11916-012-0317-4","article-title":"Psychological resilience, pain catastrophizing, and positive emotions: Perspectives on comprehensive modeling of individual pain adaptation","volume":"17","author":"Sturgeon","year":"2013","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1002\/ejp.1364","article-title":"Evaluating the novel added value of neurophysiological pain sensitivity within the fear-avoidance model of pain","volume":"23","author":"Uddin","year":"2019","journal-title":"Eur. J. Pain"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2447","DOI":"10.1016\/j.pain.2011.06.024","article-title":"A new direction for the fear avoidance model?","volume":"152","author":"Moseley","year":"2011","journal-title":"Pain"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Asiri, F., Reddy, R.S., Tedla, J.S., ALMohiza, M.A., Alshahrani, M.S., Govindappa, S.C., and Sangadala, D.R. (2021). Kinesiophobia and its correlations with pain, proprioception, and functional performance among individuals with chronic neck pain. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0254262"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"E1025","DOI":"10.36076\/ppj\/2017.7.E1025","article-title":"Decreased regional grey matter volume in women with chronic whiplash-associated disorders: Relationships with cognitive deficits and disturbed pain processing","volume":"20","author":"Coppieters","year":"2017","journal-title":"Pain Physician"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Rampazo, \u00c9.P., da Silva, V.R., de Andrade, A.L.M., Back, C.G.N., Madeleine, P.M., Arendt-Nielsen, L., and Liebano, R.E. (2021). Sensory, motor, and psychosocial characteristics of individuals with chronic neck pain: A case-control study. Phys. Ther., ahead of print.","DOI":"10.1093\/ptj\/pzab104"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1016\/j.jpain.2019.04.009","article-title":"Pain-related fear, pain intensity and function in individuals with chronic musculoskeletal pain: A systematic review and meta-analysis","volume":"20","year":"2019","journal-title":"J. Pain"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.cpr.2014.08.003","article-title":"Do people with chronic pain have impaired executive function? A meta-analytical review","volume":"34","author":"Berryman","year":"2014","journal-title":"Clin. Psychol. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1016\/j.pain.2013.03.002","article-title":"Evidence for working memory deficits in chronic pain: A systematic review and meta-analysis","volume":"154","author":"Berryman","year":"2013","journal-title":"Pain"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.2522\/ptj.20130597","article-title":"Chronic stress, cortisol dysfunction, and pain: A psychoneuroendocrine rationale for stress management in pain rehabilitation","volume":"94","author":"Hannibal","year":"2014","journal-title":"Phys. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.pain.2003.12.015","article-title":"Chronic pain patients are impaired on an emotional decision-making task","volume":"108","author":"Apkarian","year":"2004","journal-title":"Pain"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"307","DOI":"10.3233\/NRE-2003-18405","article-title":"Cognitive impairment in patients with chronic whiplash-associated disorder--a matched control study","volume":"18","author":"Antepohl","year":"2003","journal-title":"NeuroRehabilitation"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1016\/j.apmr.2012.05.013","article-title":"Validity and reliability of the perceived deficit questionnaire to assess cognitive symptoms in people with chronic whiplash-associated disorders","volume":"93","author":"Takasaki","year":"2012","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2082","DOI":"10.1016\/S0140-6736(21)00393-7","article-title":"Chronic pain: An update on burden, best practices, and new advances","volume":"397","author":"Cohen","year":"2021","journal-title":"Lancet"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1002\/ejp.1994","article-title":"A meta-analysis of the associations of elements of the fear-avoidance model of chronic pain with negative affect, depression, anxiety, pain-related disability and pain intensity","volume":"26","author":"Rogers","year":"2022","journal-title":"Eur. J. Pain"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.pnpbp.2018.01.017","article-title":"Evaluating psychosocial contributions to chronic pain outcomes","volume":"87","author":"Meints","year":"2018","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1002\/ana.23665","article-title":"Effect of lifestyle activities on alzheimer disease biomarkers and cognition","volume":"72","author":"Vemuri","year":"2012","journal-title":"Ann. Neurol."},{"key":"ref_42","first-page":"112","article-title":"Investigation of Turkish reliability of the Edinburgh Hand Preference Questionnaire","volume":"6","author":"Ekinci","year":"2019","journal-title":"J. Exerc. Ther. Rehabil."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/0028-3932(71)90067-4","article-title":"The assessment and analysis of handedness: The Edinburgh inventory","volume":"9","author":"Oldfield","year":"1971","journal-title":"Neuropsychologia"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1002\/pmrj.12732","article-title":"The effects of osteopathic manipulative treatment on pain and disability in patients with chronic neck pain: A single-blinded randomized controlled trial","volume":"14","author":"Cholewicki","year":"2022","journal-title":"PMR"},{"key":"ref_45","first-page":"409","article-title":"The Neck Disability Index: A study of reliability and validity","volume":"14","author":"Vernon","year":"1991","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"E362","DOI":"10.1097\/BRS.0b013e31817144e1","article-title":"The cultural adaptation, reliability and validity of neck disability index in patients with neck pain: A Turkish version study","volume":"33","author":"Aslan","year":"2008","journal-title":"Spine"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"J\u00f8rgensen, R., Ris, I., Falla, D., and Juul-Kristensen, B. (2014). Reliability, construct and discriminative validity of clinical testing in subjects with and without chronic neck pain. BMC Musculoskelet. Disord., 15.","DOI":"10.1186\/1471-2474-15-408"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.apmr.2014.10.006","article-title":"Two-minute walk test performance by adults 18 to 85 years: Normative values, reliability, and responsiveness","volume":"96","author":"Bohannon","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_49","first-page":"12","article-title":"Intra-rater and inter-rater reliability of the kinvent hand-held dynamometer in young adults","volume":"22","author":"Oliveira","year":"2023","journal-title":"Med. Sci. Forum"},{"key":"ref_50","unstructured":"Otman, A., Demirel, H., and Sade, A. (2014). Basic Evaluation Principles in Treatment Movements, Pelikan Publishing."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1080\/24750573.2017.1322672","article-title":"Validity of Turkish form of Pain Catastrophizing Scale and modeling of the relationship between pain-related disability with pain intensity, cognitive, and emotional factors","volume":"27","author":"Ugurlu","year":"2017","journal-title":"Psychiatry Clin. Psychopharmacol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Javdaneh, N., Saeterbakken, A.H., Shams, A., and Barati, A.H. (2021). Pain neuroscience education combined with therapeutic exercises provides added benefit in the treatment of chronic neck pain. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18168848"},{"key":"ref_53","first-page":"44","article-title":"Turkish version of the Tampa Scale for Kinesiophobia and its test-retest reliability","volume":"22","author":"Yilmaz","year":"2011","journal-title":"Fiz. Rehabil."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.pain.2006.07.016","article-title":"Fear of movement\/(re)injury in chronic pain: A psychometric assessment of the original English version of the Tampa scale for kinesiophobia (TSK)","volume":"127","author":"French","year":"2007","journal-title":"Pain"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"518","DOI":"10.46497\/ArchRheumatol.2022.8665","article-title":"Validity and reliability of the Turkish version of the central sensitization inventory","volume":"36","author":"Birtane","year":"2021","journal-title":"Arch. Rheumatol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1007\/s40122-024-00601-w","article-title":"Correlations of The Central Sensitization Inventory, conditioned pain modulation, cognitions and psychological factors in individuals with chronic neck pain: A cross-sectional study","volume":"13","author":"He","year":"2024","journal-title":"Pain Ther."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.jpain.2012.11.012","article-title":"The Central Sensitization Inventory (CSI): Establishing clinically significant values for identifying central sensitivity syndromes in an outpatient chronic pain sample","volume":"14","author":"Neblett","year":"2013","journal-title":"J. Pain"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1177\/0271678X221124656","article-title":"Cerebral vasomotor reactivity across the continuum of subjective cognitive impairment, amnestic mild cognitive impairment and probable Alzheimer\u2019s dementia: A transcranial Doppler and PET\/MRI study","volume":"43","author":"Saka","year":"2023","journal-title":"J. Cereb. Blood Flow Metab."},{"key":"ref_59","first-page":"75","article-title":"Stroop Test TBAG Form: Standardisation for Turkish Culture, Reliability and Validity","volume":"2","author":"Soysal","year":"1999","journal-title":"Turk. J. Clin. Psy"},{"key":"ref_60","first-page":"273","article-title":"Reliability and validity of the standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish population","volume":"13","author":"Ertan","year":"2002","journal-title":"Turk. Psikiyatr. Derg."},{"key":"ref_61","first-page":"69","article-title":"Trail making test: Predictive validity study on Turkish patients with Alzheimer dementia","volume":"16","author":"Cangoz","year":"2013","journal-title":"Turk. Geriatr. Derg."},{"key":"ref_62","first-page":"189","article-title":"A Study to Determine the Norms for the Trail Making Test For the Age Range of 20\u201349 in Turkey","volume":"26","author":"Can","year":"2015","journal-title":"Turk. Psikiyatr. Derg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1213\/ANE.0000000000002864","article-title":"Correlation coefficients: Appropriate use and interpretation","volume":"126","author":"Schober","year":"2018","journal-title":"Anesth. Analg."},{"key":"ref_64","unstructured":"Alpar, R. (2016). Applied Statistics and Validity-Reliability with Examples from Sports, Health and Educational Sciences, Detay Publishing."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.pmn.2024.06.008","article-title":"Relationships between function, pain severity and psychological and cognitive levels in people with chronic neck pain: Cross-sectional study","volume":"25","author":"Tanik","year":"2024","journal-title":"Pain Manag. Nurs."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e4698","DOI":"10.1097\/MD.0000000000004698","article-title":"Factors associated with increased risk for pain catastrophizing in patients with chronic neck pain: A retrospective cross-sectional study","volume":"95","author":"Park","year":"2016","journal-title":"Medicine"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.ejpain.2004.10.005","article-title":"Neuropsychological assessment of chronic non-malignant pain patients treated in a multidisciplinary pain centre","volume":"9","author":"Christrup","year":"2005","journal-title":"Eur. J. Pain"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1023\/A:1009020914358","article-title":"Chronic pain and neuropsychological functioning","volume":"10","author":"Hart","year":"2000","journal-title":"Neuropsychol. Rev."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1080\/23279095.2021.1980795","article-title":"Determination of cognitive status and influencing variables in patients with chronic neck pain: A cross-sectional study","volume":"30","author":"Oz","year":"2023","journal-title":"Appl. Neuropsychol. Adult"},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Patel, M., Hasoon, J., Diez Tafur, R., Lo Bianco, G., and Abd-Elsayed, A. (2025). The impact of chronic pain on cognitive function. Brain Sci., 15.","DOI":"10.3390\/brainsci15060559"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Wiech, K., and Tracey, I. (2013). Pain, decisions, and actions: A motivational perspective. Front. Neurosci., 7.","DOI":"10.3389\/fnins.2013.00046"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.jfma.2024.04.001","article-title":"Relationships between muscle strength, lung function, and cognitive function in Chinese middle-aged and older adults: A study based on the China health and retirement longitudinal study (CHARLS)","volume":"124","author":"Ma","year":"2025","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"106139","DOI":"10.1016\/j.bandc.2024.106139","article-title":"Size or strength? How components of muscle relate to behavioral and neuroelectric measures of executive function independent of aerobic fitness","volume":"175","author":"Baumgartner","year":"2024","journal-title":"Brain Cogn."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Kostka, M., Morys, J., Ma\u0142ecki, A., and Nowacka-Chmielewska, M. (2024). Muscle-brain crosstalk mediated by exercise-induced myokines\u2014Insights from experimental studies. Front. Physiol., 15.","DOI":"10.3389\/fphys.2024.1488375"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Arosio, B., Calvani, R., Ferri, E., Coelho-Junior, H.J., Carandina, A., Campanelli, F., Ghiglieri, V., Marzetti, E., and Picca, A. (2023). Sarcopenia and cognitive decline in older adults: Targeting the muscle\u2013brain axis. Nutrients, 15.","DOI":"10.3390\/nu15081853"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.jns.2014.02.008","article-title":"Decreased physical activity predicts cognitive dysfunction and reduced cerebral blood flow in heart failure","volume":"339","author":"Alosco","year":"2014","journal-title":"J. Neurol. Sci."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/s12576-017-0525-0","article-title":"Relationship between cognitive function and regulation of cerebral blood flow","volume":"67","author":"Ogoh","year":"2017","journal-title":"J. Physiol. Sci."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"De Ridder, D., Vanneste, S., Smith, M., and Adhia, D. (2022). Pain and the triple network model. Front. Neurol., 13.","DOI":"10.3389\/fneur.2022.757241"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.tics.2011.08.003","article-title":"Large-scale brain networks and psychopathology: A unifying triple network model","volume":"15","author":"Menon","year":"2011","journal-title":"Trends Cogn. Sci."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1523\/JNEUROSCI.4123-07.2008","article-title":"Beyond feeling: Chronic pain hurts the brain, disrupting the default-mode network dynamics","volume":"28","author":"Baliki","year":"2008","journal-title":"J. Neurosci."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/5\/956\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T15:33:34Z","timestamp":1779723214000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/5\/956"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,14]]},"references-count":80,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["medicina62050956"],"URL":"https:\/\/doi.org\/10.3390\/medicina62050956","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,14]]}}}