Schmidt-Wilcke T, Wood P, Lürding R
Neurologische Klinik der Universität Regensburg, Regensburg.
Schmerz. 2010 Feb;24(1):46-53. doi: 10.1007/s00482-009-0872-8.
The primary symptom of fibromyalgia (FM) is chronic, widespread pain accompanied by diffuse tenderness to light palpation. However, many patients report a multitude of additional complaints and symptoms. Besides fatigue, exhaustibility and stiffness, a decrease in concentration and memory are further complaints that add significantly to the degree of suffering. This complaint, often termed "fibrofog", is increasingly recognised as an independent symptom that has made its way into the medical literature under the term "dyscognition". Nonetheless there are only a few studies that have specifically investigated neuropsychological deficits in FM patients in order to further specify clinical complaints. The studies performed so far have provided increasing evidence that FM patients have attention and working memory deficits, which are most prominent when patients have to cope with an additional source of distraction. With this review we intend to give an overview of the neuropsychological studies in FM performed so far and to assess possible implications for the underlying pathophysiology. In addition, we discuss potential clinical approaches to these symptoms. A systematic literature review up to June 2009 was carried out using the keywords (pairs) "fibromyalgia" and "cognition", "fibromyalgia" and "dyscognition", "fibromyalgia" and "cognitive deficits".
纤维肌痛（FM）的主要症状是慢性广泛性疼痛，并伴有轻触时的弥漫性压痛。然而，许多患者报告了大量其他不适和症状。除了疲劳、易疲惫和僵硬外，注意力不集中和记忆力下降也是进一步的不适症状，这些症状显著增加了患者的痛苦程度。这种症状通常被称为“纤维性脑雾”，越来越被视为一种独立症状，并以“认知障碍”之名进入了医学文献。尽管如此，仅有少数研究专门调查了纤维肌痛患者的神经心理学缺陷，以便进一步明确临床症状。迄今为止所开展的研究越来越多地表明，纤维肌痛患者存在注意力和工作记忆缺陷，当患者不得不应对额外的干扰源时，这些缺陷最为明显。通过本综述，我们旨在概述迄今为止在纤维肌痛领域开展的神经心理学研究，并评估其对潜在病理生理学的可能影响。此外，我们还将讨论针对这些症状的潜在临床方法。我们使用关键词（组）“纤维肌痛”和“认知”、“纤维肌痛”和“认知障碍”、“纤维肌痛”和“认知缺陷”进行了截至2009年6月的系统文献综述。
