2026 ECNP Congress

PS02-2174

Carpal tunnel syndrome, psychological and cognitive impact in addition to sensory motor Vegetative Symptoms

Fiona Zeka — A. Muça, S. Gjeci, A. Cecia, E. Petrela Zaimi, R. Alimehmeti · Klinika EGO - Mjek Psikiater & Psikologe - Konsulta Psikiatrike & Psikologjike, Psychology, Tirane, Albania

2026 ECNP Congress

Introduction

Carpal Tunnel Syndrome (CTS) is a common peripheral neuropathy that occurs when the median nerve is compressed at the level of the wrist. It is typically classified into six stages, with higher stages indicating increased severity of symptoms, including pain, numbness, tingling, and weakness in the hand and wrist. The final stage is characterized by significant sensory loss and motor deficits of the hand (National Institute of Arthritis and Musculoskeletal and Skin Diseases). Although CTS has been widely studied in clinical and surgical contexts, its neuropsychological impact remains insufficiently explored. Previous research indicates that persistent pain is associated with cognitive impairment (Hart RP et al., 2003). One proposed explanation is that chronic pain consumes a substantial proportion of available cognitive resources, thereby limiting performance in tasks requiring attention and executive functioning (Phelps CR et al., 2021). Additionally, studies in older adults suggest that chronic pain particularly affects mental flexibility, a key component of executive functioning (Karp JF et al., 2006). Moreover, chronic pain and decreased function in daily life is linked to emotional health and psychological well-being.

Methods

This prospective cohort study was conducted at “Mother Theresa” University Hospital in Tirana, within the Department of Neuroscience, Neurosurgery Service. The study included 123 patients aged between 18 and 75 years who were diagnosed with CTS. All participants underwent neuropsychological assessment both before and three months after surgical intervention. The Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) was used to evaluate pain severity and functional impairment of the hand (Levine DW et al., 1993). Cognitive functioning was assessed using the Trail Making Test (TMT), which measures processing speed, attention, and executive functioning. Emotional status, including symptoms of anxiety and depression, was evaluated using the Hospital Anxiety and Depression Scale (HADS). Statistical analysis was performed using SPSS version 26.0 to compare preoperative and postoperative outcomes.

Results

Statistical analysis revealed significant improvements in cognitive performance following surgical treatment of CTS. Patients demonstrated better performance on both parts of the Trail Making Test (TMT-A and TMT-B), indicating enhanced attention, processing speed, and executive functioning after surgery. Furthermore, results showed a significant improvement in emotional status, with reductions in both anxiety and depression scores as measured by HADS. Comparisons between preoperative and postoperative assessments indicated that patients experienced better overall psychological well-being three months after surgery.

Conclusions

People who have CTS experience anxiety and depression, which improves 3 months aftersurgery. Moreover, those people also have better cognitive performance after surgery. Futurestudies need to differentiate whether cognitive performance is ameliorated by improvement ofdepression and anxiety or because of structural brain changes found in the literature review.Furthermore, a high number of women in menopause developed CTS; this is an indicatorwhich supports the hypothesis of hormonal changes causing CTS, and this needs furtherresearch to gain statistical power.

References

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