Universitat de Lleida, Lleida, Spain.
Brain, Cognition and Behavior: Clinical Research, Consorci Sanitari de Terrassa, Terrassa, Spain.
PLoS One. 2018 Jul 5;13(7):e0200057. doi: 10.1371/journal.pone.0200057. eCollection 2018.
Fibromyalgia (FM) patients frequently complain of cognitive problems, but it remains unclear whether these cognitive complaints can be attributed to a dysfunction of the central nervous system or if they can be explained by other factors associated with the disease, such as depression, anxiety and sleep dysfunction.
One hundred and ten patients with FM were compared with thirty-three patients diagnosed with a depressive disorder (DD) and fifty healthy controls (HC). Several measures of attention and executive functions were used to make these comparisons and the patients were also asked to complete questionnaires on depression, anxiety and sleep quality. Univariate analyses of covariance (ANCOVA) were performed to identify and control confounders and multiple linear models were used to examine the effects of fibromyalgia and depression on cognitive measures.
FM and HC differed significantly with respect to depression, anxiety and sleep dysfunction, whereas FM and DD did not differ in terms of symptoms of depression and anxiety. However, FM was associated with a worse quality of sleep than DD. Comparisons of cognitive performance between groups showed that short-term and working memory and inattention measures were only associated with symptoms of depression, whereas selective attention was associated with both depression and fibromyalgia, and processing speed, cognitive flexibility and inhibitory control showed a significant interaction between depression and fibromyalgia. Moreover, cognitive flexibility and inhibition abilities were specifically associated with FM.
FM patients show a cluster of cognitive impairment in the attentional and executive domains, although some of the symptoms observed could be explained by the severity of the symptoms of depression, while others seem to depend on the effects of fibromyalgia. Implications of the findings for the understanding and management of cognitive impairment of FM patients are discussed.
纤维肌痛（FM）患者经常抱怨认知问题，但仍不清楚这些认知问题是归因于中枢神经系统功能障碍，还是可以用与疾病相关的其他因素（如抑郁、焦虑和睡眠功能障碍）来解释。
将 110 名 FM 患者与 33 名被诊断为抑郁症（DD）的患者和 50 名健康对照者（HC）进行比较。使用几种注意力和执行功能测试进行比较，并要求患者填写抑郁、焦虑和睡眠质量问卷。采用单变量协方差分析（ANCOVA）来识别和控制混杂因素，采用多元线性模型来检验纤维肌痛和抑郁对认知测量的影响。
FM 和 HC 在抑郁、焦虑和睡眠功能障碍方面存在显著差异，而 FM 和 DD 在抑郁和焦虑症状方面无差异。然而，FM 与 DD 相比，睡眠质量更差。组间认知表现的比较表明，短期和工作记忆以及注意力不集中的测量指标仅与抑郁症状相关，而选择性注意力与抑郁和纤维肌痛都相关，处理速度、认知灵活性和抑制控制则显示出抑郁和纤维肌痛之间存在显著的交互作用。此外，认知灵活性和抑制能力与 FM 特异性相关。
FM 患者在注意力和执行域表现出一系列认知障碍，尽管观察到的一些症状可以用抑郁症状的严重程度来解释，而其他症状似乎取决于纤维肌痛的影响。讨论了这些发现对理解和管理 FM 患者认知障碍的意义。
