New Miami Project Study Targets Neuropathic Pain and Cognitive Decline in Spinal Cord Injury Patients
A new grant-funded study at the University of Miami Miller School of Medicine explores how chronic neuropathic pain affects focus and memory and whether cognitive training can help patients regain control.
For spinal cord injury (SCI) patients, chronic neuropathic pain caused by nervous system damage can have a corrosive impact on quality of life. With so much mental energy focused on pain, cognitive capabilities often suffer, making it more difficult to complete mental tasks or remember important information. In the short run, people have trouble focusing. In the long run, they can experience cognitive decline.
Roberta Vastano, Ph.D., assistant professor of cognitive neuroscience in the Department of Neurological Surgery at the University of Miami Miller School of Medicine and investigator at The Miami Project to Cure Paralysis, has spent years studying the relationships between pain and cognitive function. Her lab recently received a three-year, $400,000 grant from the Craig H. Neilsen Foundation to study how neuropathic pain affects focus and working memory and is developing strategies to help patients overcome it.
The researchers will test whether chronic pain impairs patients’ ability to focus and ignore distractions when processing information from multiple senses. Using electroencephalography (EEG), which measures the brain’s electrical signals, and cognitive tasks that engage two or more senses, the team will examine brain responses to understand how pain interferes with performance during highly demanding cognitive tasks.
“We want to understand how the pain impacts cognitive control, which is the ability to focus on a specific task while ignoring other irrelevant information,” said Dr. Vastano. “This will deepen our understanding of how pain affects cognition and helps us identify patients who could benefit from clinical interventions.”
How Neuropathic Pain Disrupts Cognitive Function After Spinal Cord Injury
People with spinal cord injuries face a variety of cognitive health threats. Many have experienced a traumatic brain injury. Others are slowed by medications. Neuropathic pain is a major issue that can contribute to anxiety, depression and cognitive decline. For many SCI patients, neuropathic pain can seem like an insurmountable distraction, preventing them from focusing on the tasks in front of them.
“When a person has severe, chronic pain, a lot of their cognitive resources are focused on trying to ignore the pain or make it better,” said Dr. Vastano. “Basically, their brains are constantly focused on their bodies, and that doesn’t leave room for much else.”
The EEG measurements, in particular, will provide important insights into brain function to help assess potential cognitive impairments. In addition, each patient will complete a home-based intervention, performing simple cognitive training tasks that require holding and updating information (working memory). While task difficulty will vary, the goal is to strengthen top-down control processes (regulating thoughts and focus to achieve current goals) and test whether this can help reduce pain.
“We create tasks for computers or tablets to help train their cognitive functions to do better, to develop better quality control for those tasks,” said Dr. Vastano. “We also want to see if the pain interferes with the tasks and whether, over time, the exercises can improve their perceptions of the pain.”
Can Cognitive Training Reduce Pain and Improve Mental Function?
By understanding neuropathic pain’s impacts on cognitive capabilities, the researchers hope to reveal new strategies to improve pain management and free up cognitive function. In addition, this pilot project will provide crucial groundwork to begin larger clinical trials that leverage cognitive training to help SCI patients control their pain.
“We are excited about this grant and the research it will fund because we don’t fully understand how neuropathic pain affects cognitive control and working memory,” said Miami Project Scientific Director W. Dalton Dietrich, Ph.D., professor of neurological surgery with the Miller School. “These new insights could give us better tools to help SCI patients control their pain and live better lives.”
More from The Miami Project to Cure Paralysis
With a new grant, the Miami Project aims to personalize transcutaneous spinal cord stimulation treatment for spinal cord injuries.
The Miami Project to Cure Paralysis wins the 2026 Health Care Heroes Award for advancing spinal cord research.
A Miami‑hosted neuromodulation symposium highlights advances in spinal cord injury research, clinical trials and patient‑centered outcomes.
A Miami Project to Cure Paralysis study finds Schwann cell–derived exosomes boost regeneration in severe peripheral nerve injuries.
Tags: Dr. Dalton Dietrich III, Dr. Roberta Vastano, Miami Project to Cure Paralysis, pain and cognitive function, spinal cord injury