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纤维肌痛中的计划与问题解决障碍:更新、抑制和心理灵活性的预测作用。

Planning and Problem-Solving Impairments in Fibromyalgia: The Predictive Role of Updating, Inhibition, and Mental Flexibility.

作者信息

Fernández-Sánchez Marisa, Martín-Plasencia Pilar, Fernandes-Magalhaes Roberto, Barjola Paloma, Del Pino Ana Belén, Martínez-Íñigo David, Peláez Irene, Mercado Francisco

机构信息

Department of Psychology, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Alcorcon, Spain.

Research Group in Cognitive Neuroscience, Pain and Rehabilitation (NECODOR), Rey Juan Carlos University, 28922 Alcorcon, Spain.

出版信息

J Clin Med. 2025 Jul 25;14(15):5263. doi: 10.3390/jcm14155263.


DOI:10.3390/jcm14155263
PMID:40806885
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12347619/
Abstract

: Fibromyalgia syndrome (FMS) is a chronic pain condition in which executive function (EF) alterations have been reported, though strikingly, relationships between simple executive functions (EFs) (updating, inhibition, and mental flexibility) and high-order ones, such as planning and problem-solving, have not been addressed yet in this population. This research aimed to firstly explore how low-level EFs play a role in planning and problem-solving performances. : Thirty FMS patients and thirty healthy participants completed a series of neuropsychological tests evaluating low- and high-order EFs. Clinical and emotional symptoms were assessed with self-report questionnaires, while pain and fatigue levels were measured with numerical scales. Importantly, specific drug restrictions were accounted for. : Patients scored lower in most neurocognitive tests, with statistical significance noted only for visuospatial working memory (WM) and two planning and problem-solving tests. Pain, fatigue, and sleep disturbances showed important effects on most of the cognitive outcomes. Multiple regression analyses reflected that planning and problem-solving were successfully and partially predicted by updating, inhibition, and mental flexibility (though differences emerged between tasks). : Our study confirms the presence of cognitive impairments in FMS, especially in high-order EFs, supporting patients' complaints. Clinical symptoms play a role in FMS dyscognition but do not explain it completely. For the first time, as far as the authors know, simple EF influences on planning and problem-solving tests have been described for FMS patients. These results might help in unraveling the dysexecutive profile in FMS to design more adjusted treatment options.

摘要

纤维肌痛综合征(FMS)是一种慢性疼痛疾病,尽管已有报道称其存在执行功能(EF)改变,但值得注意的是,在这一人群中,简单执行功能(如更新、抑制和心理灵活性)与高阶执行功能(如计划和解决问题)之间的关系尚未得到探讨。本研究旨在首先探究低阶执行功能在计划和解决问题表现中所起的作用。30名纤维肌痛综合征患者和30名健康参与者完成了一系列评估低阶和高阶执行功能的神经心理学测试。临床和情绪症状通过自我报告问卷进行评估,而疼痛和疲劳程度则用数字量表进行测量。重要的是,考虑到了特定的药物限制因素。患者在大多数神经认知测试中的得分较低,仅在视觉空间工作记忆(WM)以及两项计划和解决问题的测试中具有统计学意义。疼痛、疲劳和睡眠障碍对大多数认知结果显示出重要影响。多元回归分析表明,更新、抑制和心理灵活性成功且部分地预测了计划和解决问题的能力(尽管不同任务之间存在差异)。我们的研究证实了纤维肌痛综合征患者存在认知障碍,尤其是在高阶执行功能方面,这支持了患者的主诉。临床症状在纤维肌痛综合征的认知功能障碍中起作用,但并不能完全解释这一现象。据作者所知,首次描述了简单执行功能对纤维肌痛综合征患者计划和解决问题测试的影响。这些结果可能有助于阐明纤维肌痛综合征的执行功能障碍特征,从而设计出更具针对性的治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6a5/12347619/82be987735d8/jcm-14-05263-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6a5/12347619/ee1c527f1cbc/jcm-14-05263-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6a5/12347619/52885dc8198b/jcm-14-05263-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6a5/12347619/d700214164f7/jcm-14-05263-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6a5/12347619/6d8cc60712d2/jcm-14-05263-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6a5/12347619/294f687131f7/jcm-14-05263-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6a5/12347619/82be987735d8/jcm-14-05263-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6a5/12347619/ee1c527f1cbc/jcm-14-05263-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6a5/12347619/52885dc8198b/jcm-14-05263-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6a5/12347619/d700214164f7/jcm-14-05263-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6a5/12347619/6d8cc60712d2/jcm-14-05263-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6a5/12347619/294f687131f7/jcm-14-05263-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6a5/12347619/82be987735d8/jcm-14-05263-g006.jpg

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本文引用的文献

[1]
Negative Affect and Planning Ability in Preschool Children: A Mediation Model of Working Memory, Inhibition, and Cognitive Flexibility.

Scand J Psychol. 2025-4

[2]
The role of cognitive flexibility on higher level executive functions in mild cognitive impairment and healthy older adults.

BMC Psychol. 2024-5-30

[3]
Executive functions and problem-solving-The contribution of inhibition, working memory, and cognitive flexibility to science problem-solving performance in elementary school students.

J Exp Child Psychol. 2024-8

[4]
Stress specifically deteriorates working memory in peripheral neuropathic pain and fibromyalgia.

Brain Commun. 2023-7-5

[5]
Decision Making and Fibromyalgia: A Systematic Review.

Brain Sci. 2022-10-27

[6]
Association between descending pain modulatory system and cognitive impairment in fibromyalgia: A cross-sectional exploratory study.

Front Behav Neurosci. 2022-9-29

[7]
The cumulative effect of fibromyalgia symptoms on cognitive performance: The mediating role of pain.

Appl Neuropsychol Adult. 2024

[8]
Revealing the Role of Social Support on Cognitive Deficits in Fibromyalgia Syndrome.

Behav Neurol. 2022

[9]
Variability of Reaction Time as a Marker of Executive Function Impairments in Fibromyalgia.

Behav Neurol. 2022

[10]
Fibromyalgia Syndrome and Cognitive Decline: The Role of Body Mass Index and Clinical Symptoms.

J Clin Med. 2022-6-14

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