Abstract
Objective: Despite endometriosis impacting at least 10% of women globally, with most self-reporting chronic pelvic pain (CPP) and cognitive difficulties, research reporting on objective cognitive disruptions remains extremely limited, although recent research has identified brain alterations in women with endometriosis that could cause cognitive difficulties. To address this gap, the current research profiled objective cognitive and neuroelectrophysiological distinctions in women with endometriosis, with consideration of CPP status.
Method: We measured cognitive performance via a diverse battery and electroencephalography (P300) in three groups of women: endometriosis with CPP (n = 22), endometriosis without CPP (n = 13), and healthy controls (n = 42). Pain ratings and psychological measures were analyzed as potential moderators of group differences.
Results: Relative to controls, women with endometriosis-associated CPP exhibited significant moderate-to-large difficulties across multiple cognitive domains. In contrast, women with endometriosis without CPP exhibited fairly large significant difficulties only for verbal short-term memory. Pain factors and affective symptomatology emerged as moderators of cognitive performance differences. Regarding electroencephalography, we identified in the parietal planes of women with endometriosis-associated CPP moderately smaller P300 amplitudes, particularly P3b component amplitudes, aligning with previous reports, and pain and affective factors emerged as moderators of group differences.
Conclusions: The behavioral results provide seminal evidence of objective cognitive difficulties in women with endometriosis, particularly those experiencing CPP, who also exhibited reduced P300 amplitudes. The data implicated pain and affective factors as drivers of these differences. These findings warrant consideration in clinical contexts and future research focused on developing targeted interventions for cognitive rehabilitation in endometriosis.