Galvez-Sánchez Carmen M, Duschek Stefan, Reyes Del Paso Gustavo A
Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Murcia, Murcia, Spain.
Department of Psychology, Institute of Psychology, UMIT TIROL - University for Health Sciences Medical Informatics and Technology, Hall in Tirol, Austria.
Psychol Res Behav Manag. 2024 Mar 28;17:1399-1415. doi: 10.2147/PRBM.S446798. eCollection 2024.
Fibromyalgia syndrome (FMS) and rheumatoid arthritis (RA) are chronic pain disorders, with clearly distinct pathogenetic mechanisms, frequently accompanied by symptoms like depression, fatigue, insomnia and cognitive problems. This study compared performance in various cognitive domains between patients with FMS and RA. The role of clinical symptoms severity in determine the differences in cognitive performance was also investigated.
A cross-sectional study was conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. In total, 64 FMS patients, 34 RA patients and 32 healthy controls participated, all women. Using factor analysis, questionnaire scores were combined to yield a symptom severity factor, which was used as a control variable in the group comparisons.
Without controlling for symptom severity, both patient groups performed worse than controls in all the cognitive domains assessed (visuospatial memory; verbal memory; strategic planning and self-regulation; processing speed, attention and cognitive flexibility; and planning and organizational abilities); overall deficits were greater in FMS than in RA patients. FMS patients reported more severe clinical symptoms (current pain intensity, total pain, state anxiety, depression, fatigue and insomnia) than RA patients. After controlling for symptom severity, a large proportion of the cognitive test parameters no longer differed between FMS and RA patients.
The study confirmed significant impairments in attention, memory, and higher cognitive functions in both FMS and RA. The greater deficits seen in FMS patients may at least partly be explained by more severe pain and secondary symptoms. Cognitive screening may facilitate the development of personalized treatment plans to optimize the quality of life of FMS and RA patients.
纤维肌痛综合征（FMS）和类风湿关节炎（RA）是慢性疼痛疾病，其发病机制明显不同，常伴有抑郁、疲劳、失眠和认知问题等症状。本研究比较了FMS患者和RA患者在各个认知领域的表现。还研究了临床症状严重程度在决定认知表现差异中的作用。
根据加强流行病学观察性研究报告（STROBE）声明进行了一项横断面研究。共有64名FMS患者、34名RA患者和32名健康对照者参与，均为女性。通过因子分析，将问卷得分合并得出症状严重程度因子，该因子在组间比较中用作控制变量。
在不控制症状严重程度的情况下，两个患者组在所有评估的认知领域（视觉空间记忆、言语记忆、战略规划与自我调节、处理速度、注意力和认知灵活性以及规划和组织能力）的表现均比对照组差；FMS患者的总体缺陷比RA患者更大。FMS患者报告的临床症状（当前疼痛强度、总疼痛、状态焦虑、抑郁、疲劳和失眠）比RA患者更严重。在控制症状严重程度后，FMS患者和RA患者之间的大部分认知测试参数不再有差异。
该研究证实FMS和RA患者在注意力、记忆力和更高认知功能方面存在显著损害。FMS患者中观察到的更大缺陷可能至少部分是由更严重的疼痛和继发症状所解释。认知筛查可能有助于制定个性化治疗方案，以优化FMS和RA患者的生活质量。
