Cognitive complaints in women with fibromyalgia: Are they due to depression or to objective cognitive dysfunction?

Gelonch, Olga; Garolera, Maite; Valls, Joan; Rosselló, Lluís; Pifarré, Josep

doi:10.1080/13803395.2017.1301391

Cited by 33 publications

(41 citation statements)

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“…Theoretical models and empirical observations suggest negative impact of aversive mood states on cognition ( Eysenck et al, 2007 ; Snyder, 2013 ). Accordingly, various studies demonstrated stronger cognitive impairments in FMS patients exhibiting more severe symptoms of depression and anxiety ( Hassett et al, 2008 ; Munguía-Izquierdo et al, 2008 ; Gelonch et al, 2016 , 2017 ). However, some FMS studies directly comparing the impacts of depression and anxiety with the impact of pain severity revealed the closest connection between pain and performance ( Reyes del Paso et al, 2012 , 2015 ; Duschek et al, 2013 ; Weiss et al, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Cognitive Impairments in Fibromyalgia Syndrome: Associations With Positive and Negative Affect, Alexithymia, Pain Catastrophizing and Self-Esteem

2018

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Fibromyalgia syndrome (FMS) is a chronic condition characterized by widespread pain accompanied by symptoms like depression, anxiety, sleep disturbance and fatigue. In addition, affected patients frequently report cognitive disruption such as forgetfulness, concentration difficulties or mental slowness. Though cognitive deficits in FMS have been confirmed in various studies, not much is known about the mechanisms involved in their origin. This study aimed to investigate the contribution of affect-related variables to cognitive impairments in FMS. For this purpose, 67 female FMS patients and 32 healthy control subjects completed a battery of cognitive tests measuring processing speed, attention, visuospatial and verbal memory, cognitive flexibility and planning abilities. In addition, participants completed self-report questionnaires pertaining to positive and negative affect, alexithymia, pain catastrophizing and self-esteem. Clinical characteristics including pain severity, symptoms of depression and anxiety, insomnia and fatigue were also assessed. FMS patients showed markedly poorer performance than healthy controls in all of the cognitive domains assessed, in addition to greater levels of depression, anxiety, negative affect, alexithymia and pain catastrophizing, and lower self-esteem and positive affect. In exploratory correlation analysis in the FMS sample, lower cognitive performance was associated with higher pain severity, depression, anxiety, negative affect, alexithymia and pain catastrophizing, as well as lower self-esteem and positive affect. However, in regression analyses, pain, self-esteem, alexithymia, and pain catastrophizing explained the largest portion of the variance in performance. While interference effects of clinical pain in cognition have been previously described, the present findings suggest that affective factors also substantially contribute to the genesis of cognitive impairments. They support the notion that affective disturbances form a crucial aspect of FMS pathology, whereas strategies aiming to improve emotional regulation may be a beneficial element of psychological therapy in the management of FMS.

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Section: Introductionmentioning

confidence: 99%

Cognitive Impairments in Fibromyalgia Syndrome: Associations With Positive and Negative Affect, Alexithymia, Pain Catastrophizing and Self-Esteem

2018

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“…In a recent study incorporating objective measures of cognitive performance, depression together with working memory, and everyday physical functioning predicted (32% of the total variance) subjective cognitive complaints (Gelonch et al., ), indicating that perceived subjective dyscognition may not only be partially related to objective cognitive impairments but also to affective symptomatology. Regarding the contributing role of depression to fibrofog in our results, in the known‐groups validity analyses, significant differences in mean MISCI scores were found among samples of patients with FM with or without comorbid depression and a clinical comparative group without FM suffering residual depressive symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…In this regard, higher catastrophizing or pain‐related fear/anxiety can be related to more difficulties in diverting attention away from a painful event, so limiting the available attentional resources (Roth, Geisser, Theisen‐Goodvich, & Dixon, ). In previous studies in patients with chronic pain or FM, despite heterogeneous results, cognitive complaints have been linked to pain intensity, depression (Gelonch, Garolera, Valls, Rosselló, & Pifarré, ; McCracken & Iverson, ), anxiety, sleep problems, and fatigue (Kravitz & Katz, ). As proposed by Williams et al.…”

Section: Introductionmentioning

confidence: 99%

“…Given the well‐known contributive effect of depressive symptoms on fibrofog reported by many authors (e.g. Gelonch et al., ), known‐groups validity of the MISCI and the putative additive effect of depression on fibrofog were tested by comparing MISCI scores in three clinical samples: (1) Patients with FM without depression, (2) with FM and comorbid depression, and (3) patients without FM reporting residual depressive symptoms. Sensitivity to change in the MISCI was also assessed after a MBSR program using early‐stage data from the EUDAIMON study, a randomized controlled trial (RCT) examining the cost‐effectiveness of mindfulness‐based stress reduction in patients with FM (Feliu‐Soler et al., ).…”

Section: Introductionmentioning

confidence: 99%

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Digging into the construct of fibrofog: Psychometric properties of the Spanish version of the Multidimensional Inventory of Subjective Cognitive Impairment in patients with fibromyalgia

Feliu‐Soler

Pérez‐Aranda

Andrés‐Rodríguez

et al. 2018

J Appl Biobehavioral Res

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Perceived dyscognition or fibrofog has been ranked as one major contributor of distress in fibromyalgia (FM). The Multidimensional Inventory of Subjective Cognitive Impairment (MISCI) was devised as a brief and comprehensive self-report measure of cognitive function in FM. The main objective of the present study was to assess the psychometric properties of the Spanish version of the MISCI.One hundred and twenty patients with FM were included, and dimensionality, reliability, and validity of the MISCI

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“…In North America alone, chronic pain costs over $650 billion in health care and lost productivity [ 3 ]. Fibromyalgia is a complex clinical disorder characterized by chronic widespread pain that is also associated with sleep disturbance, fatigue, irritable bowel syndrome, depressed mood, and, possibly cognitive dysfunction [ 4 , 5 ]. Patients suffering with fibromyalgia very frequently report functional disability and impaired quality of life [ 6 ]; furthermore, fibromyalgia is a common disorder estimated to affect 1.6% of men and 4.9% of women [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Combination Analgesic Development for Enhanced Clinical Efficacy (CADENCE Trial): Study Protocol for a Double-Blind, Randomized, Placebo-Controlled Crossover Trial of an Alpha-Lipoic Acid – Pregabalin Combination for the Treatment of Fibromyalgia Pain

Gilron¹,

Tu²,

Holden³

et al. 2017

JMIR Res Protoc

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BackgroundFibromyalgia is a clinical disorder commonly presenting with chronic widespread pain as well as sleep disturbance, fatigue, depression, and cognitive dysfunction. There is an urgent need for treatment strategies that provide better pain relief and fewer adverse effects (AEs). Efforts to develop rational combinations of specific fibromyalgia treatments have demonstrated potential for measurable improvements in pain relief, quality of life, and health care utilization. More than half of fibromyalgia patients receive 2 or more analgesics but current combination use is based on limited evidence. As an early proof-of-concept project from the Canadian Institutes of Health Research–Strategy on Patient-Oriented Research Chronic Pain Network, this trial protocol is expected to advance the field by rigorously evaluating a new treatment combination for fibromyalgia.ObjectiveWe will test the hypothesis that analgesic combinations containing at least one nonsedating agent would be as safe but more effective than either monotherapy because of additive pain relief without increasing overall AEs. Pregabalin (PGB), a sedating anticonvulsant, is proven effective for fibromyalgia, and the antioxidant, alpha-lipoic acid (ALA), one of the only nonsedating systemic agents proven effective for neuropathic pain, is currently being evaluated in fibromyalgia. Thus, we will conduct a clinical trial to compare a PGB+ALA combination to each monotherapy for fibromyalgia.MethodsUsing a double-blind, double-dummy, crossover design, 54 adults with fibromyalgia will be randomly allocated to 1 of 6 sequences of treatment with PGB, ALA, and PGB+ALA combination. During each of 3 different treatment periods, participants will take 2 sets of capsules containing (1) ALA (or placebo) and (2) PGB (or placebo) for 31 days, followed by an 11-day taper/washout period. The primary outcome will be mean daily pain intensity (0 to 10 scale) at maximal tolerated doses (MTDs) during each period. Secondary outcomes, assessed at MTD, will include global improvement, adverse events, mood, and quality of life.ResultsThis trial attained ethics approval March 6, 2017 (Queen’s University Health Sciences and Affiliated Teaching Hospitals Research Ethics Board protocol number ANAE-313-17), and recruitment is set to start in August 2017.ConclusionsThis trial will provide rigorous evidence comparing the efficacy of a PGB-ALA combination to PGB alone and ALA alone in the treatment of fibromyalgia.Trial RegistrationInternational Standard Randomized Controlled Trial Number ISRCTN14939460; https://www.isrctn.com/ ISRCTN1493946 (Archived by WebCite at http://www.webcitation.org/6sFqAjxkt)

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Cognitive complaints in women with fibromyalgia: Are they due to depression or to objective cognitive dysfunction?

Abstract: Cognitive complaints are very frequent in patients with fibromyalgia, and these are related to functional and cognitive impairment as well as to depressive symptoms.

Cited by 33 publications

References 46 publications

Cognitive Impairments in Fibromyalgia Syndrome: Associations With Positive and Negative Affect, Alexithymia, Pain Catastrophizing and Self-Esteem

Cognitive Impairments in Fibromyalgia Syndrome: Associations With Positive and Negative Affect, Alexithymia, Pain Catastrophizing and Self-Esteem

Digging into the construct of fibrofog: Psychometric properties of the Spanish version of the Multidimensional Inventory of Subjective Cognitive Impairment in patients with fibromyalgia

Combination Analgesic Development for Enhanced Clinical Efficacy (CADENCE Trial): Study Protocol for a Double-Blind, Randomized, Placebo-Controlled Crossover Trial of an Alpha-Lipoic Acid – Pregabalin Combination for the Treatment of Fibromyalgia Pain

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