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纤维肌痛症的认知障碍:病例对照研究的荟萃分析。

Cognitive Impairment in Fibromyalgia: A Meta-Analysis of Case-Control Studies.

机构信息

From the School of Nursing (Wu, Fang), College of Nursing, Taipei Medical University; Department of Anesthesiology (Huang), Wan Fang Hospital, Taipei Medical University; Graduate Institute of Clinical Medicine (Huang), College of Medicine, Taipei Medical University; Tungs' Taichung Metroharbor Hospital (Ko), Taichung; and School of Nursing (Tsai), College of Nursing, Taipei Medical University, Taiwan.

出版信息

Psychosom Med. 2018 Jun;80(5):432-438. doi: 10.1097/PSY.0000000000000575.

Abstract

OBJECTIVE

Cognitive dysfunction has been reported in individuals with fibromyalgia. However, findings regarding cognitive function examined using neuropsychological tests have been inconsistent. The aim of the study was to determine domain-specific cognitive impairment in patients with fibromyalgia compared with healthy controls.

METHODS

We conducted a meta-analysis that systematically searched six databases (PubMed, Ovid MEDLINE, Embase, CINAHL, PsycINFO, and Web of Science) for articles published before September 2017.

RESULTS

Twenty-three case-control studies with a total of 2096 participants were included in the meta-analysis. Cognitive function was significantly lower (g = 0.87, 95% confidence interval [CI] = 0.60-1.15) in individuals with fibromyalgia than in healthy controls. Large effect sizes were found in learning/memory and attention/psychomotor speed (g = 0.94, p = .013; g = 1.22, p < .001, respectively); medium effect sizes were reported in executive function and working memory (g = 0.72, p < .001; g = 0.75, p < .001, respectively). Depression and anxiety scores were associated with the effect size of group differences in cognitive function (B = 0.11, p < .001, 95% CI = 0.09-0.13; B = 0.02, p < .001, 95% CI = 0.01-0.02, respectively).

CONCLUSIONS

Cognitive impairment across different cognitive domains was found in individuals with fibromyalgia compared with healthy controls. Mood states (depression and anxiety) may explain the heterogeneity across studies.

摘要

目的

纤维肌痛患者存在认知功能障碍。然而,使用神经心理学测试检查认知功能的结果并不一致。本研究旨在与健康对照组相比,确定纤维肌痛患者的特定领域认知障碍。

方法

我们进行了一项荟萃分析,系统地在六个数据库(PubMed、Ovid MEDLINE、Embase、CINAHL、PsycINFO 和 Web of Science)中搜索了截至 2017 年 9 月之前发表的文章。

结果

共有 23 项病例对照研究,总计 2096 名参与者被纳入荟萃分析。与健康对照组相比,纤维肌痛患者的认知功能明显较低(g = 0.87,95%置信区间[CI] = 0.60-1.15)。在学习/记忆和注意力/心理运动速度方面发现了较大的效应量(g = 0.94,p =.013;g = 1.22,p <.001);在执行功能和工作记忆方面报告了中等效应量(g = 0.72,p <.001;g = 0.75,p <.001)。抑郁和焦虑评分与认知功能组间差异的效应量相关(B = 0.11,p <.001,95%CI = 0.09-0.13;B = 0.02,p <.001,95%CI = 0.01-0.02)。

结论

与健康对照组相比,纤维肌痛患者存在不同认知领域的认知障碍。情绪状态(抑郁和焦虑)可能解释了研究之间的异质性。

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