Ranum Rylea M, Toussaint Loren L, Whipple Mary O, Vincent Ann
Department of Psychology; Luther College, Decorah, IA, USA.
Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Mayo Clin Proc Innov Qual Outcomes. 2022 Feb 21;6(2):143-147. doi: 10.1016/j.mayocpiqo.2021.12.007. eCollection 2022 Apr.
Fibromyalgia (FM) is a common and disabling disorder characterized by chronic widespread pain, fatigue, and dyscognition. Previous studies have shown strong positive correlations between pain, fatigue, and dyscognition. However, bidirectional relationships, particularly with dyscognition modeled as a predictor, have rarely been established. The purpose of this study was to examine the bidirectional, predictive nature of the relationships between these FM symptoms. Pain, fatigue, and dyscognition were measured via the Brief Pain Inventory, Multidimensional Fatigue Inventory, and Multiple Ability Self-Report Questionnaire at baseline and a 2-year follow-up in a large sample of 450 well-characterized female patients with FM. Relationships between FM symptoms were evaluated using a cross-lagged, longitudinal model. Dyscognition, pain, and fatigue were positively correlated at both baseline and follow-up (s .13 -.53, s<.01). Dyscognition at baseline was predictive of dyscognition (=.76, β=.75, <.001), pain, (=.01, β=.09, =.033) and fatigue (=.05, β=.08, =.050) at follow-up. Pain at baseline was predictive of pain (=.59, β=.59, <.001), dyscognition (=.88, β=.07, =.022), and fatigue (=.85, β=.11, =.004) at follow-up. Fatigue at baseline was only associated with fatigue (=.61, β=.60, <.001) at follow-up. Dyscognition is predictive of future pain and fatigue in patients with FM. Continued work should examine dyscognition as a clinical predictor of future severity of core symptoms such as pain and fatigue.
纤维肌痛（FM）是一种常见的致残性疾病，其特征为慢性广泛性疼痛、疲劳和认知障碍。先前的研究表明，疼痛、疲劳和认知障碍之间存在很强的正相关性。然而，双向关系，尤其是以认知障碍作为预测因素的双向关系，却很少被确立。本研究的目的是检验这些纤维肌痛症状之间关系的双向预测性质。在450名特征明确的女性纤维肌痛患者的大样本中，通过简明疼痛量表、多维疲劳量表和多项能力自陈问卷在基线和2年随访时测量疼痛、疲劳和认知障碍。使用交叉滞后纵向模型评估纤维肌痛症状之间的关系。在基线和随访时，认知障碍、疼痛和疲劳均呈正相关（s = 0.13 - 0.53，p < 0.01）。基线时的认知障碍可预测随访时的认知障碍（r = 0.76，β = 0.75，p < 0.001）、疼痛（r = 0.01，β = 0.09，p = 0.033）和疲劳（r = 0.05，β = 0.08，p = 0.050）。基线时的疼痛可预测随访时的疼痛（r = 0.59，β = 0.59，p < 0.001）、认知障碍（r = 0.88，β = 0.07，p = 0.022）和疲劳（r = 0.85，β = 0.11，p = 0.004）。基线时的疲劳仅与随访时的疲劳相关（r = 0.61，β = 0.60，p < 0.001）。认知障碍可预测纤维肌痛患者未来的疼痛和疲劳。后续研究应将认知障碍作为未来疼痛和疲劳等核心症状严重程度的临床预测指标进行检验。
