Del Pino Ana Belén, Peláez Irene, García-Romero Alejandro, Fernández-Sánchez Maria Luisa, Barjola Paloma, Soto-León Vanesa, Oliviero Antonio, Mercado Francisco
Department of Psychology, Faculty of Health Sciences, Universidad Rey Juan Carlos, Av. Atenas s/n, Madrid 28922, Spain; Research Group on Cognitive Neuroscience, Pain and Rehabilitation (NECODOR), Faculty of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain.
Department of Psychology, Faculty of Health Sciences, Universidad Rey Juan Carlos, Av. Atenas s/n, Madrid 28922, Spain.
Neuroimage. 2025 Aug 1;316:121307. doi: 10.1016/j.neuroimage.2025.121307. Epub 2025 Jun 4.
Patients with fibromyalgia are characterised by having, along with persistent chronic pain, cognitive impairments, mainly in working memory capacity. It has been suggested that abnormalities in fronto-parietal neural circuits might account for this dysfunction. However, limited body of neuroimaging research and mixed or inconsistent results have led to inconclusive evidence. Our investigation aimed to explore the neural links between working memory dysfunction and brain grey matter volume in fibromyalgia using voxel-based morphometry (VBM), considering the influence of pain and affective symptoms. Thirty female patients with fibromyalgia and twenty-seven healthy female individuals participated in the present investigation. Working memory functioning was assessed using the Wechsler Adult Intelligence Scale III (WAIS-III) and the Wechsler Memory Scale III (WMS-III). VBM data (global and regional grey matter volume) were also analysed. As expected, fibromyalgia patients scored lower on Arithmetic, Letter-Number Sequencing and Working Memory Index than healthy individuals. Nonetheless, we found no differences in grey matter volume between groups. Moderation analyses highlighted the importance of considering affective symptoms of fibromyalgia, such as depression, to characterize associations between local grey matter volumes in the insula and prefrontal cortices (orbitofrontal and ventrolateral prefrontal cortex) with working memory functioning. These results suggest that moderate to severe symptoms of depression appear to be critical for understanding the emergence of associations between grey matter volume and working memory, offering valuable new insights into this complex relationship. Further research based on multimodal imaging approaches is needed to refine current findings and explore neural circuits underlying cognitive impairment in fibromyalgia.
纤维肌痛患者的特征是，除了持续的慢性疼痛外，还存在认知障碍，主要是工作记忆能力方面的障碍。有人提出，额顶神经回路的异常可能是这种功能障碍的原因。然而，神经影像学研究的数量有限，结果也参差不齐或相互矛盾，导致证据不确凿。我们的研究旨在使用基于体素的形态学测量（VBM）方法，探讨纤维肌痛患者工作记忆功能障碍与脑灰质体积之间的神经联系，同时考虑疼痛和情感症状的影响。30名女性纤维肌痛患者和27名健康女性个体参与了本研究。使用韦氏成人智力量表第三版（WAIS-III）和韦氏记忆量表第三版（WMS-III）评估工作记忆功能。还分析了VBM数据（整体和局部灰质体积）。正如预期的那样，纤维肌痛患者在算术、字母数字排序和工作记忆指数方面的得分低于健康个体。尽管如此，我们发现两组之间的灰质体积没有差异。调节分析强调了考虑纤维肌痛的情感症状（如抑郁）对于表征岛叶和前额叶皮质（眶额和腹外侧前额叶皮质）局部灰质体积与工作记忆功能之间关联的重要性。这些结果表明，中度至重度抑郁症状似乎对于理解灰质体积与工作记忆之间关联的出现至关重要，为这一复杂关系提供了有价值的新见解。需要基于多模态成像方法的进一步研究来完善当前的发现，并探索纤维肌痛中认知障碍背后的神经回路。
