Fibro-Fog: Are Fibromyalgia Patients Cognitively Impaired?


Editor’s comment: Fibromyalgia patients have long been aware of significant cognitive problems such as memory loss and difficulty concentrating – even adopting the term “fibro-fog” to describe the frustrating symptoms. However, it wasn’t until the American College of Rheumatology’s 2010 proposed diagnostic criteria for fibromyalgia included cognitive problems as part of the diagnostic criteria, that the medical profession began to take notice.

Cognitive problems are still often overlooked as the authors of this study noted, “Although the presence of cognitive impairment has recently been added to the diagnostic criteria of the American College of Rheumatology, cognitive dysfunction remains one of the least assessed and treated fibromyalgia domains in general clinical practice, also because of the expertise and time required for neuropsychological tests.” The purpose of this study was to identify simpler screening tools that physicians could use to determine cognitive impairment in fibromyalgia patients based on patient self-reporting rather than having to put the patient through complicated, expensive and time-consuming neuropsychological tests.

Are Fibromyalgia patients cognitively impaired? Objective and subjective neuropsychological evidence

By Valentina Tesio, et al.


Objectives: Patients with Fibromyalgia Syndrome (FM) often complain about a cluster of cognitive disorders that strongly interferes with their work and daily life, but the relationship between impaired cognitive functions and self-reported dysfunctions remains unclear. We aimed to investigate the presence of cognitive impairments in FM patients and to analyze the relationship between the impairments and their evaluation by the patients by means of a comparison with a group of healthy controls.

Methods: 30 FM patients and 30 healthy controls performed a neuropsychological and clinical evaluation of short-term, long-term and working memory, executive functions, and self-evaluation of cognitive impairment, depressive and anxiety symptoms. To thoroughly investigate the executive functions we adopted the model of Miyake and colleagues, which identifies four domains: shifting, inhibition, updating and access.

Results and Conclusions: Our results confirmed the presence of impairments of attention, long-term memory, working memory and shifting and updating executive functions in FM patients, compared to healthy controls.

These impairments are reflected in subjective complaints independently of depressive symptoms. The use of a self-report questionnaire in clinical practice would provide a first and easy screen for the presence of cognitive impairment in FM patients and, in most cases, obviate the need for a time-consuming full neuropsychological test battery.

© 2014 American College of Rheumatology.

Source: Arthritis Care & Research, July 21, 2014. By Valentina Tesio, Diana M.E. Torta, Fabrizio Colonna, Paolo Leombruni, Ada Ghiggia, Enrico Fusaro, Giuliano C. Geminiani, Riccardo Torta and Lorys Castelli. Clinical and Oncological Psychology, “Città della Salute e della Scienza” Hospital of Turin, Italy; Department of Neuroscience, University of Turin, Italy.

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