Cognitive Dysfunction in Fibromyalgia: Slow Access to the Mental Lexicon


Summary: Lexical access speed, the time needed for the brain to access the catalogue of words in long-term memory, is assumed to provide a foundation for a broad array of cognitive operations. It was hypothesized that deficits in lexical speed are likely to play a central role in deficiencies in cognitive performance of patients with fibromyalgia, who as a group show deficits in lexical speed.

This was tested in a sample of 209 patients with fibromyalgia and in 72 control patients with memory deficits. Participants completed the Stroop word-naming measure of lexical access speed and 12 neurocognitive measures.

Deficit in lexical access speed occurred at approximately twice the frequency (48.3% vs 25.0%) in fibromyalgia. The average delay in speed of lexical access was 171 msec. in fibromyalgia and 163 msec. in controls. Those with deficits in lexical access speed displayed deficiencies on 10 of 12 cognitive measures in the fibromyalgia group, and on 8 of 12 cognitive measures in the control group.

The premise that lexical access speed is disproportionately present in fibromyalgia and serves as a foundation for a wide array of cognitive operations is supported.

Source: Psychological Reports, December 24, 2014. By Frank Leavitt and Robert S. Katz. Department of Behavioral Sciences, Rush Medical College, Chicago, IL.

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8 thoughts on “Cognitive Dysfunction in Fibromyalgia: Slow Access to the Mental Lexicon”

  1. gabby123 says:

    What is the best to try to explain this to someone who doesn’t know anything about Fibromyalgia? Whenever I try to explain anything about Fibro it comes out sounding like mombo jumbo.

    Thank you for any help.

    1. Wilmahorne says:

      Hi Katheline
      Look up the spoon theory, mentioned in some fibro blog’s.

      I know it is difficult to explain to others and you will find that most of the time they still don’t understand after you explained, but with the spoon theory you can at least explain how you feel.

    2. KimMichelle says:

      During a particularly bad fibro fog episode, i find that my speech can be blurred or the words drop out somewhere between my brain and mouth. Is this a normal symptom of cognitive dysfunction?

    3. IanH says:

      It depends on what they want to know:
      What it does to people.
      What causes it.

      The first Q? is most common.

      Exaggerated pain and constant aching over most of the body.
      Excessive stiffness in muscles affecting mobility.
      Excessive fatigue after exertion.
      Inability to think as normal or foggy thinking and poor memory (30 year old with a 90 year old brain)
      Interference with sleep, constant waking-no deep (or resting)sleep.
      Hypersensitivity, such as to heat, noise and bright light.
      Poor gut balance with alternating diarrhia and constipation.

      The condition worsens many aging states such as arthritis, cardiovascular function and cognitive (mental)function.

      What causes it?
      No one knows but most evidence points to an immune system disease affecting many bodily systems, a bit like Lupus but affecting the neuro-vascular (nerves and blood vessel) systems. This causes poor blood flow to the brain, nerves and muscles which in turn causes the symptoms.

    4. IanH says:

      Think of the cognitive dysfunction as a slowness of nerve impulses (messages). They are truly retarded. Unfortunately when the nerve impulses are slowed, retrieval of information is not only slowed but interfered with and what comes out can be nonesensical.

      Cognition refers to: attention, memory (immediate and long term), judgement & evaluation. so any of these can be affected in FM.

      Attention is the most problematic because it can cause accidents such as dropping a cup, tripping in the road, misusing a power tool etc. Generally I advise ALL people with FM to truly do only one thing at a time and don’t converse while doing something else, for example walking along with cup of coffee while taking to the person walking with you. Sounds trite but is a very typical situation. Another, more serious is talking to a passenger (or worse on a phone) while driving. A risk for anyone but much worse for a person with FM.

      Add to this the frustration and the information (attention, memory, judgement) becomes even more affected.

      Secondly cognition also involves emotion. Our emotions mostly come from our thoughts. For example many people with FM suffer from almost uncontrollable rage or depression. Once an upsetting event occurs (and it could be minor) the emotional signalling is not properly dampened {this is because the dampening or inhibitory signals are too slow to dampen the upsetting signals} and the upsetting signals are “amplified”.

    5. fl5932 says:

      A simpler explanation of cognitive dysfunction in fibromyalgia by the same authors is on-line at

      Its entitled Fibro fog When fibromyalgia affects your thinking.

      See Fibro Fog: Arthritis Self-Management.

  2. vonny02 says:

    Does cognitive disfunfuntion only affect retrieval of words, ie for conversation.
    I have had a very foggy day today, i had trouble with preparing a meal
    In which order to prepare and what to prepare with..

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