Tobacco Use in Fibromyalgia Is Associated With Cognitive Dysfunction

Abstract

Objective To evaluate the association between smoking and cognitive function in patients with fibromyalgia. Patients and Methods We surveyed 668 patients with fibromyalgia from May 1, 2012 through November 30, 2013 at a major tertiary referral center. Patients were categorized by smoking status. Primary outcome of interest was cognitive function (MASQ questionnaire), and secondary outcomes included fibromyalgia symptom severity (FIQ-R questionnaire), quality of life (SF-36 questionnaire), fatigue (MFI-20 questionnaire), sleep (MOS-sleep scale), anxiety (GAD-7 questionnaire), and depression (PHQ-9 questionnaire). Independent Students' t -tests and χ 2 tests were performed for continuous and categorical variables, respectively. Univariate regression analysis identified variables predictive of outcomes, adjusting for age, gender, body mass index, marital status, and educational level. Results Ninety-four (14.07%) patients self-identified as smokers. There was an association of lower education level, unmarried status, and younger age in smokers compared with nonsmokers. In the adjusted univariate regression analysis, fibromyalgia smokers reported greater perceived total cognitive dysfunction ( P =.009) and greater subscale scores of perceived difficulty in language ( P =.03), verbal memory ( P =.003), visual-spatial memory ( P =.02), and attention ( P =.04) compared with nonsmokers with fibromyalgia. For secondary outcomes, smokers with fibromyalgia reported greater severity of fibromyalgia-related symptoms ( P =.006), worse quality-of-life index in the mental component scale ( P =.02), greater sleep problems ( P =.01), and increased anxiety ( P =.001) compared with nonsmokers who had fibromyalgia. Conclusion In patients with fibromyalgia, smoking is a risk factor for cognitive dysfunction. Moreover, smokers with fibromyalgia were more likely to report increased severity of fibromyalgia symptoms, worse quality of life, more sleep problems, and increased anxiety compared with nonsmokers with fibromyalgia.

Prevalence of fibromyalgia in medical students and its association with lifestyle factors – a cross-sectional study

“…Data on correlation analysis between Fibromyalgia severity scale (FSS) and 9 domains of FANTASTIC lifestyle checklist (FLC) stratified according to gender, year of study and division of study alcohol use in FM patients. Ge et al [28] found that to bacco smokers reported higher severity of FM and relat ed symptoms, while another study found that moderate alcohol consumption improved quality of life and symp tom severity of FM patients [29].…”

Sex-Related Differences in Symptoms and Psychosocial Outcomes in Patients With Fibromyalgia: A Prospective Questionnaire Study

“…This was a prospective questionnaire study consisting of 668 total patients with FM who were referred to the Fibromyalgia and Chronic Fatigue Clinic at a tertiary referral center and completed the Fibromyalgia Treatment Program from May 1, 2012, through November 30, 2013. 17 All patients had a confirmed diagnosis of FM in accordance with the 1990 or 2010 American College of Rheumatology criteria. 2 , 26 The initial cohort consisted of consecutive patients who completed baseline questionnaires before attending treatment sessions at the program.…”

“…However, limited studies have examined sex-based differences in the FM patient population, and findings to date are controversial and inconclusive. 17 , 18 Some studies report worse symptoms and clinical outcomes in men with FM, 19 , 20 some report worse outcomes in women with FM, 20 , 21 and some report no differences. 22 , 23 , 24 These discrepancies may be related to sociodemographic and geographical heterogeneity, 9 , 19 , 25 methodological flaws in observational studies not controlling for potential confounding factors, 24 and lack of use of validated instruments to evaluate outcome measures.…”

Effect of Patient Characteristics on Clinical Outcomes More Than 12 Months Following Dorsal Root Ganglion Stimulation Implantation: A Retrospective Review

“…Interestingly, there were no associations between history of smoking or history of psychiatric disorder with responder status after DRG implantation. Studies reveal that tobacco use may intensify pain response via a pathway of increased circulating pro‐inflammatory cytokines (29,30). Similarly, studies also reveal that psychiatric comorbidities, especially untreated psychiatric disorders that are not optimized preimplantation, predict poor response to neuromodulation (31,32).…”