Ibraheem Weaam, Mckenzie Simon, Wilcox-Omubo Victory, Abdelaty Mohamed, Saji Sandra E, Siby Rosemary, Alalyani Wafaa, Mostafa Jihan A
Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2021 Oct 29;13(10):e19123. doi: 10.7759/cureus.19123. eCollection 2021 Oct.
Cognitive dysfunction is a complaint of many patients diagnosed with fibromyalgia. Although the main symptoms of the disease are fatigue, widespread musculoskeletal pain, poor sleep quality, and tenderness points, the cognitive symptoms can be more distressing than the pain itself, and negatively affect their lives; however, many healthcare professionals underestimate these cognitive complaints and it is still one of the least researched topics. Proper management of these symptoms at an early stage may have a great impact to improve the mental health, physical function, and overall health of these patients. Hence, this traditional review aimed to look at the previous body of literature in PubMed in the past five years to address the pathophysiology of the cognitive dysfunction in fibromyalgia patients, to find the risk factors of cognitive dysfunction in these patients, to discover the recent modalities for treatment, and to figure out the clinical implications and recent recommendations by researchers on screening, diagnosis, and management of fibromyalgia and its cognitive dysfunction symptoms. This review has shown the various mechanisms of cognitive dysfunction. Some mechanisms are related to disease symptomologies, such as excessive pain perception, and others are related to hormonal and metabolite changes in the brain. Tobacco smoking and high body mass index showed an inverse impact on cognitive dysfunction and quality of life in fibromyalgia. Other risk factors and clinical implications were discussed in detail.
认知功能障碍是许多被诊断为纤维肌痛的患者所面临的问题。尽管该疾病的主要症状是疲劳、广泛的肌肉骨骼疼痛、睡眠质量差和压痛点，但认知症状可能比疼痛本身更令人苦恼，并对他们的生活产生负面影响；然而，许多医疗保健专业人员低估了这些认知问题，而且它仍然是研究最少的主题之一。在早期对这些症状进行适当管理可能对改善这些患者的心理健康、身体功能和整体健康有很大影响。因此，这篇传统综述旨在回顾过去五年PubMed上的文献，以探讨纤维肌痛患者认知功能障碍的病理生理学，找出这些患者认知功能障碍的风险因素，发现最近的治疗方法，并弄清楚研究人员对纤维肌痛及其认知功能障碍症状的筛查、诊断和管理的临床意义及最新建议。这篇综述展示了认知功能障碍的各种机制。一些机制与疾病症状有关，如过度的疼痛感知，而其他机制则与大脑中的激素和代谢物变化有关。吸烟和高体重指数对纤维肌痛患者的认知功能障碍和生活质量有反向影响。其他风险因素和临床意义也进行了详细讨论。
