Division of General Neurology, Department of Neurology, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, 112, Taiwan.
School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Sci Rep. 2021 Jan 14;11(1):1311. doi: 10.1038/s41598-020-79349-0.
Fibromyalgia (FM) is a stress-related chronic pain disorder with common cognitive complaints. This study characterized cognitive dysfunction in patients with FM and explored whether these changes are linked to altered cortisol levels. Consecutive 44 patients with FM and 48 healthy controls were enrolled for the assessments of subjective and objective cognitive functions and diurnal levels of salivary cortisol (sampled at awakening, 30 min after awakening, 3 pm, and bedtime). All measurements were compared between the groups and evaluated for clinical correlation. The FM group had more subjective cognitive complaints and performed poorer in objective cognitive testing in memory (delayed recall in Chinese Version Verbal Learning Test and Taylor Complex Figure Test), language (Boston Naming Test), and executive domains (Wisconsin Card Sorting Test) after adjustments for education. The diurnal cortisol levels of patients with FM tended to be lower, especially at 30 min after awakening and bedtime. Moreover, moderate positive correlations existed between the Chinese Version Verbal Learning Test, Boston Naming Test and the morning cortisol levels within the FM group. We suggested the altered cognitive function in FM may be linked to stress maladaptation. Future studies are warranted to elucidate whether stress management improves cognitive performance in patients with FM.
纤维肌痛（FM）是一种与压力相关的慢性疼痛障碍，常伴有认知功能障碍。本研究旨在探讨 FM 患者认知功能障碍的特点，以及这些变化是否与皮质醇水平的改变有关。连续纳入 44 例 FM 患者和 48 例健康对照者进行主观和客观认知功能以及唾液皮质醇昼夜节律（分别在觉醒时、觉醒后 30 分钟、下午 3 点和睡前采集）的评估。比较两组间所有测量值，并评估其与临床的相关性。FM 组患者的主观认知障碍更多，在记忆（汉语词汇学习测验延迟回忆、Taylor 复杂图形测验）、语言（波士顿命名测验）和执行功能（威斯康星卡片分类测验）等客观认知测试中的表现更差，校正教育程度后差异仍有统计学意义。FM 患者的皮质醇昼夜节律趋于降低，尤其是在觉醒后 30 分钟和睡前。此外，FM 组患者的汉语词汇学习测验、波士顿命名测验与清晨皮质醇水平呈中度正相关。我们推测 FM 患者认知功能的改变可能与应激适应不良有关。未来的研究需要阐明应激管理是否能改善 FM 患者的认知功能。
