Wilson Jenna M, Meints Samantha M, Edwards Robert R, Yamin Jolin B, Moore David J
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA.
School of Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, United Kingdom.
Pain Rep. 2024 Jan 12;9(1):e1. doi: 10.1097/PR9.0000000000001122. eCollection 2024 Jan.
Patients with fibromyalgia show impaired cognitive performance compared with healthy, pain-free controls. Sleep disturbance, anxiety, and depression are highly prevalent among patients with fibromyalgia, and each is associated with impaired cognitive performance. Yet, limited work has explored whether psychosocial factors contribute to group differences in cognitive performance.
This secondary data analysis investigated differences in cognitive performance between patients with fibromyalgia and healthy controls, and whether psychosocial factors accounted for these differences.
Adults with fibromyalgia (N = 24) and healthy, pain-free controls (N = 26) completed 2 cognitive tasks and the Patient-Reported Outcomes Measurement Information System sleep disturbance, anxiety, and depression short forms. Independent samples tests were used to test for differences in cognitive performance between patients with fibromyalgia and healthy controls. Pearson correlations were conducted to examine associations between psychosocial factors and cognitive performance. Psychosocial factors significantly related to cognitive performance were explored as potential mediators of group differences in cognitive performance.
Patients with fibromyalgia demonstrated poorer accuracy for divided attention compared with healthy controls, and sleep disturbance mediated this group difference. On the attentional switching task, healthy controls showed a greater switch-cost for accuracy compared with patients with fibromyalgia, but there was no group difference in reaction time. Anxiety and depression were not related to cognitive performance.
We found that patients with fibromyalgia reported greater sleep disturbance and, in turn, had poorer accuracy on the divided attention task. Sleep disturbance is modifiable with behavioral interventions, such as cognitive behavioral therapy, and may be a target for improving sleep quality and cognitive performance among patients with fibromyalgia.
与健康且无疼痛的对照组相比，纤维肌痛患者的认知表现受损。睡眠障碍、焦虑和抑郁在纤维肌痛患者中极为普遍，且每一项都与认知表现受损相关。然而，仅有有限的研究探讨了社会心理因素是否导致了认知表现的组间差异。
这项二次数据分析调查了纤维肌痛患者与健康对照组在认知表现上的差异，以及社会心理因素是否能解释这些差异。
患有纤维肌痛的成年人（N = 24）和健康且无疼痛的对照组（N = 26）完成了两项认知任务以及患者报告结局测量信息系统睡眠障碍、焦虑和抑郁简表。采用独立样本t检验来检测纤维肌痛患者与健康对照组在认知表现上的差异。进行Pearson相关性分析以检验社会心理因素与认知表现之间的关联。将与认知表现显著相关的社会心理因素作为认知表现组间差异的潜在中介因素进行探究。
与健康对照组相比，纤维肌痛患者在分散注意力方面的准确性较差，睡眠障碍介导了这一组间差异。在注意力转换任务中，与纤维肌痛患者相比，健康对照组在准确性方面的转换成本更高，但在反应时间上没有组间差异。焦虑和抑郁与认知表现无关。
我们发现纤维肌痛患者报告有更严重的睡眠障碍，进而在分散注意力任务中的准确性更差。睡眠障碍可通过认知行为疗法等行为干预进行改善，并且可能是改善纤维肌痛患者睡眠质量和认知表现的一个靶点。
