Ickmans Kelly, Meeus Mira, De Kooning Margot, Lambrecht Luc, Pattyn Nathalie, Nijs Jo
Pain in Motion Research Group (www.paininmotion.be).
1Pain in Motion Research Group (www.paininmotion.be); Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium.
Pain Physician. 2015 Sep-Oct;18(5):E841-52.
BACKGROUND: In addition to the frequently reported pain complaints, performance-based cognitive capabilities in patients with chronic fatigue syndrome (CFS) with and without comorbid fibromyalgia (FM) are significantly worse than those of healthy controls. In various chronic pain populations, cognitive impairments are known to be related to pain severity. However, to the best of our knowledge, the association between cognitive performance and experimental pain measurements has never been examined in CFS patients. OBJECTIVES: This study aimed to examine the association between cognitive performance and self-reported as well as experimental pain measurements in CFS patients with and without FM. STUDY DESIGN: Observational study. SETTING: The present study took place at the Vrije Universiteit Brussel and the University of Antwerp. METHODS: Forty-eight (18 CFS-only and 30 CFS+FM) patients and 30 healthy controls were studied. Participants first completed 3 performance-based cognitive tests designed to assess selective and sustained attention, cognitive inhibition, and working memory capacity. Seven days later, experimental pain measurements (pressure pain thresholds [PPT], temporal summation [TS], and conditioned pain modulation [CPM]) took place and participants were asked to fill out 3 questionnaires to assess self-reported pain, fatigue, and depressive symptoms. RESULTS: In the CFS+FM group, the capacity of pain inhibition was significantly associated with cognitive inhibition. Self-reported pain was significantly associated with simple reaction time in CFS-only patients. The CFS+FM but not the CFS-only group showed a significantly lower PPT and enhanced TS compared with controls. LIMITATIONS: The cross-sectional nature of this study does not allow for inferences of causation. CONCLUSIONS: The results underline disease heterogeneity in CFS by indicating that a measure of endogenous pain inhibition might be a significant predictor of cognitive functioning in CFS patients with FM, while self-reported pain appears more appropriate to predict cognitive functioning in CFS patients without FM.
背景：除了经常报告的疼痛主诉外，患有和未患有合并纤维肌痛（FM）的慢性疲劳综合征（CFS）患者基于表现的认知能力明显低于健康对照组。在各种慢性疼痛人群中，认知障碍已知与疼痛严重程度相关。然而，据我们所知，从未在CFS患者中研究过认知表现与实验性疼痛测量之间的关联。 目的：本研究旨在探讨患有和未患有FM的CFS患者的认知表现与自我报告的以及实验性疼痛测量之间的关联。 研究设计：观察性研究。 地点：本研究在布鲁塞尔自由大学和安特卫普大学进行。 方法：对48名患者（18名单纯CFS患者和30名CFS+FM患者）和30名健康对照者进行了研究。参与者首先完成了3项基于表现的认知测试，旨在评估选择性和持续性注意力、认知抑制和工作记忆能力。7天后，进行实验性疼痛测量（压力疼痛阈值[PPT]、时间总和[TS]和条件性疼痛调制[CPM]），并要求参与者填写3份问卷以评估自我报告的疼痛、疲劳和抑郁症状。 结果：在CFS+FM组中，疼痛抑制能力与认知抑制显著相关。在单纯CFS患者中，自我报告的疼痛与简单反应时间显著相关。与对照组相比，CFS+FM组而非单纯CFS组的PPT显著降低，TS增强。 局限性：本研究的横断面性质不允许进行因果推断。 结论：结果强调了CFS中的疾病异质性，表明内源性疼痛抑制指标可能是患有FM的CFS患者认知功能的重要预测指标，而自我报告的疼痛似乎更适合预测未患有FM的CFS患者的认知功能。
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