University of Michigan, Ann Arbor.
University of Aberdeen, Aberdeen, UK, and University of Michigan, Ann Arbor.
Arthritis Care Res (Hoboken). 2020 Dec;72(12):1669-1677. doi: 10.1002/acr.24089. Epub 2020 Nov 9.
Perceived cognitive dysfunction in fibromyalgia (FM), "fibrofog," is common. Prior laboratory-based studies have limited our understanding of cognitive function in FM in daily life. The objective of this study was to explore levels of subjective and objective cognitive functioning and the association between subjective and objective aspects of cognition in people with and without FM in the lived environment.
Participants (n = 50 adults with FM; n = 50 adults without FM, matched for age, sex, and education) completed baseline measures of subjective and objective cognitive functioning (NIH Toolbox). They also completed ecological momentary assessments of cognitive clarity and speed and tests of processing speed and working memory, via a smart phone app, 5×/day for 8 days.
On baseline objective measures, the FM group demonstrated poorer cognitive functioning across 3 NIH Toolbox tests. There were no strong correlations between subjective and objective cognitive functioning in both the FM and control groups. In the lived environment, the FM group demonstrated poorer subjective cognition and objective working memory; groups did not differ on processing speed. Momentary ratings of subjective cognitive dysfunction were significantly related to changes in objective processing speed but not working memory, with no group differences.
Findings indicate worse laboratory-based and ambulatory subjective and objective cognitive function for those individuals with FM compared to those without FM. Similar associations between measures of subjective and objective cognitive functioning for the groups suggest that people with FM are not overstating cognitive difficulties. Future research examining contributors to ambulatory fibrofog is warranted.
纤维肌痛(FM)患者常感到认知功能障碍,即“纤维雾”。先前基于实验室的研究限制了我们对日常生活中 FM 患者认知功能的理解。本研究旨在探索有和无 FM 人群在生活环境中主观和客观认知功能的水平,以及认知的主观和客观方面之间的关联。
参与者(n=50 名 FM 成年患者;n=50 名年龄、性别和教育程度相匹配的无 FM 成年对照者)完成了主观和客观认知功能的基线测量(NIH 工具包)。他们还通过智能手机应用程序,每天 5 次,连续 8 天,完成了认知清晰度和速度的生态瞬时评估以及处理速度和工作记忆测试。
在基线客观测量中,FM 组在 3 项 NIH 工具包测试中表现出较差的认知功能。在 FM 和对照组中,主观和客观认知功能之间没有很强的相关性。在生活环境中,FM 组表现出较差的主观认知和客观工作记忆;两组在处理速度上没有差异。主观认知障碍的瞬时评分与客观处理速度的变化显著相关,但与工作记忆无关,两组之间无差异。
研究结果表明,与无 FM 者相比,FM 个体的实验室和动态主观及客观认知功能更差。两组之间主观和客观认知功能测量之间的相似关联表明,FM 患者并没有夸大认知困难。未来研究应探讨动态纤维雾的促成因素。