Are Fibromyalgia Patients Cognitively Impaired? Objective and Subjective Neuropsychological Evidence

Tesio, Valentina; Torta, Diana; Colonna, Fabrizio; Leombruni, Paolo; Ghiggia, Ada; Fusaro, Enrico; Geminiani, Giuliano; Torta, Riccardo; Castelli, Lorys

doi:10.1002/acr.22403

Cited by 74 publications

(102 citation statements)

References 42 publications

(40 reference statements)

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“…Significant decrements in processing speed have been documented in FMS patients using a variety of tests [186,192,202,203], even though normal results have also been obtained with certain tasks [204,205], and occasionally, FMS patients perform even better than controls [202]. However, it is often not possible to clearly distinguish between reduced mental processing speed, decreased psychomotor speed, or a combination of both [206].…”

Section: Cognitive Complaints/fibrofogmentioning

confidence: 90%

“…As a matter of fact, there are indications that cognitive deficits in FMS patients become most obvious in the presence of a distractor or source of stimulus competition, not only in tests of attention but also in tests of working memory [193,194]. Working memory is another cognitive domain where FMS patients very consistently perform more poorly compared to healthy controls [186,187,192,195,196]. While addressed in fewer studies, certain measures of semantic memory also show impairments in FMS, including decreased verbal fluency, naming speed, and vocabulary [187,195,197].…”

Section: Cognitive Complaints/fibrofogmentioning

confidence: 99%

“…FMS patients assess their cognitive performance as significantly worse not only compared to healthy controls but also compared to patients with other rheumatic diseases or chronic pain disorders [179,[182][183][184][185][186]. Some uncertainty remains over whether these subjective complaints reflect truly impaired function or biased perception on the part of the patient.…”

Section: Cognitive Complaints/fibrofogmentioning

confidence: 99%

“…There are data suggesting that patients greatly overestimate the magnitude of their concentration and memory deficits [182,183]. While global memory complaints were assessed in these studies, questions focusing on self-reported memory and attentional function in a specific daily life context generally reveal correlations between subjective cognitive complaints and certain tests of neuropsychological function [184][185][186].…”

Section: Cognitive Complaints/fibrofogmentioning

confidence: 99%

“…Unfortunately, this concept has been rather broadly or incompletely defined in many studies. When attention is broken down into processes of alerting, orienting, and executive functioning, FMS patients show deficits in alerting and temporal orienting, but not visual orienting, and in various aspects of executive control [125,186,187,[189][190][191][192]. Cognitive inhibition, i.e., the ability to keep focused despite distractions, can be conceptualized as a component of executive function and is quite consistently found to be impaired in FMS patients.…”

Section: Cognitive Complaints/fibrofogmentioning

confidence: 99%

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Fibromyalgia: A Critical and Comprehensive Review

Borchers

Gershwin

2015

Clinic Rev Allerg Immunol

225

217

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Fibromyalgia is a disorder that is part of a spectrum of syndromes that lack precise classification. It is often considered as part of the global overview of functional somatic syndromes that are otherwise medically unexplained or part of a somatization disorder. Patients with fibromyalgia share symptoms with other functional somatic problems, including issues of myalgias, arthralgias, fatigue and sleep disturbances. Indeed, there is often diagnostic and classification overlap for the case definitions of a variety of somatization disorders. Fibromyalgia, however, is a critically important syndrome for physicians and scientists to be aware of. Patients should be taken very seriously and provided optimal care. Although inflammatory, infectious, and autoimmune disorders have all been ascribed to be etiological events in the development of fibromyalgia, there is very little data to support such a thesis. Many of these disorders are associated with depression and anxiety and may even be part of what has been sometimes called affected spectrum disorders. There is no evidence that physical trauma, i.e., automobile accidents, is associated with the development or exacerbation of fibromyalgia. Treatment should be placed on education, patient support, physical therapy, nutrition, and exercise, including the use of drugs that are approved for the treatment of fibromyalgia. Treatment should not include opiates and patients should not become poly pharmacies in which the treatment itself can lead to significant morbidities. Patients with fibromyalgia are living and not dying of this disorder and positive outlooks and family support are key elements in the management of patients.

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Section: Cognitive Complaints/fibrofogmentioning

confidence: 90%

Section: Cognitive Complaints/fibrofogmentioning

confidence: 99%

Section: Cognitive Complaints/fibrofogmentioning

confidence: 99%

Section: Cognitive Complaints/fibrofogmentioning

confidence: 99%

Section: Cognitive Complaints/fibrofogmentioning

confidence: 99%

See 3 more Smart Citations

Fibromyalgia: A Critical and Comprehensive Review

Borchers

Gershwin

2015

Clinic Rev Allerg Immunol

225

217

View full text Add to dashboard Cite

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Mind the Mood: Momentary Depression and Anxiety Moderate the Correspondence Between Subjective and Objective Cognitive Functioning in Fibromyalgia

Kairys

Valentine

Whibley

et al. 2023

Arthritis Care & Research

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ObjectiveSubjective cognitive dysfunction (SCD) affects 55–75% of individuals with fibromyalgia (FM), but those reporting cognitive difficulties often lack corresponding objective deficits. Symptoms of depression and anxiety are prevalent in FM and may account for part of this discrepancy. This study was undertaken to investigate whether momentary (within‐day, across 7 days) changes in mood moderate the relationship between within‐the‐moment SCD and mental processing speed performance.MethodsA total of 50 individuals with FM (mean age 44.8 years, mean education 15.7 years, 88% female, 86% White) completed momentary assessments of subjective cognitive functioning, depressive and anxious symptoms, and a test of processing speed. Assessments were completed 5 times per day for 8 consecutive days on a study‐specific smartphone application.ResultsMomentary ratings of SCD were positively associated with mean reaction time (P < 0.001) and variability of processing speed (P = 0.02). Depressive symptoms moderated the relationship between SCD and processing speed, with lower correspondence when depressive symptoms were higher (P = 0.03). A similar moderating effect was demonstrated for both depression (P = 0.02) and anxiety (P = 0.03) on the association between SCD and variability in processing speed performance.ConclusionIndividuals with FM may have more accurate self‐perception of momentary changes in mental processing speed during periods of less pronounced mood symptoms based on their corresponding objective processing speed performance. However, during moments of heightened depression and anxiety, we found increasingly less correspondence between SCD and objective performance, suggesting that psychological symptoms may play an important role in self‐perception of cognitive dysfunction in FM as it relates to mental processing speed.

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The Role of Environmental Distractions in the Experience of Fibrofog in Real‐World Settings

Kratz

Whibley

Kim

et al. 2020

ACR Open Rheumatology

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Objective. Perceived cognitive dysfunction in people with fibromyalgia (FM), "fibrofog," is commonly reported and has been demonstrated in neurocognitive testing. Distractibility and inattention have been implicated as potential contributors to fibrofog, but the role of environmental distractions has not been explored. In this study, ambulatory assessment methods were used to examine whether FM is related to more environmental distractions and to examine the impact of distractions on subjective and objective cognitive functioning.Methods. Fifty people with FM and 50 age-, sex-, and education-matched controls without FM completed 8 consecutive days of ambulatory assessments. Five times per day, participants reported perceived cognitive functioning and environmental distractions and completed validated tests of processing speed and working memory.Results. The FM group reported distractions in a higher proportion of the ambulatory cognitive testing sessions (40.5%) compared with the group without FM (29.8%; P < 0.001) and more often reported multiple simultaneous distractions. For both groups, sound was the most common distraction. The group with FM reported more distractions caused by light, and the group without FM reported more social distractions. Group differences in subjective and objective cognitive functioning were not augmented during distraction relative to during periods of no distraction. There were no group differences in within-person changes in cognitive functioning as a function of distraction.Conclusion. The group with FM reported more distractions than the group without FM; both groups reported poorer processing speed when distracted, and the effects of distraction on test performance did not differ significantly by group. Findings suggest that sensitivity to environmental distractions may play a role in the experience of cognitive dysfunction in FM.

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Are Fibromyalgia Patients Cognitively Impaired? Objective and Subjective Neuropsychological Evidence

Cited by 74 publications

References 42 publications

Fibromyalgia: A Critical and Comprehensive Review

Fibromyalgia: A Critical and Comprehensive Review

Mind the Mood: Momentary Depression and Anxiety Moderate the Correspondence Between Subjective and Objective Cognitive Functioning in Fibromyalgia

The Role of Environmental Distractions in the Experience of Fibrofog in Real‐World Settings

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