Correlating cognition and cortical excitability with pain in fibromyalgia: a case control study

Advances in Rheumatology

Senthil S. Kumaran¹  Uma Kumar²  Suvercha Arya³  Srishti Nanda³  Renu Bhatia³  Vikas Kumar Tiwari³  Ratna Sharma⁴ 

[1] Department of Nuclear Magnetic Resonance and MRI Facility, All India Institute of Medical Sciences, New Delhi, India;Department of Rheumatology, All India Institute of Medical Sciences, New Delhi, India;Pain Research and TMS Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India;Stress and Cognition Electroimaging Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India;

关键词: Fibromyalgia;    Chronic Pain;    Cognition;    Stroop Test;    Reaction Time;    Sleep;    Sleepiness;    Cortical Excitability;    Evoked Potential;    Pain Measurement;    Cross-Sectional Studies;    Case-Control Studies;   

DOI  :  10.1186/s42358-021-00163-x

来源: Springer

【 摘 要 】

BackgroundFibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal symptoms, primarily attributed to sensitization of somatosensory system carrying pain. Few reports have investigated the impact of fibromyalgia symptoms on cognition, corticomotor excitability, sleepiness, and the sleep quality — all of which can deteriorate the quality of life in fibromyalgia. However, the existing reports are underpowered and have conflicting directions of findings, limiting their generalizability. Therefore, the present study was designed to compare measures of cognition, corticomotor excitability, sleepiness, and sleep quality using standardized instruments in the recruited patients of fibromyalgia with pain-free controls.MethodsDiagnosed cases of fibromyalgia were recruited from the Rheumatology department for the cross-sectional, case-control study. Cognition (Mini-Mental State Examination, Stroop color-word task), corticomotor excitability (Resting motor threshold, Motor evoked potential amplitude), daytime sleepiness (Epworth sleepiness scale), and sleep quality (Pittsburgh sleep quality index) were studied according to the standard procedure.ResultsThirty-four patients of fibromyalgia and 30 pain-free controls were recruited for the study. Patients of fibromyalgia showed decreased cognitive scores (p = 0.05), lowered accuracy in Stroop color-word task (for color: 0.02, for word: 0.01), and prolonged reaction time (< 0.01, < 0.01). Excessive daytime sleepiness in patients were found (< 0.01) and worsened sleep quality (< 0.01) were found. Parameters of corticomotor excitability were comparable between patients of fibromyalgia and pain-free controls.ConclusionsPatients of fibromyalgia made more errors, had significantly increased reaction time for cognitive tasks, marked daytime sleepiness, and impaired quality of sleep. Future treatment strategies may include cognitive deficits and sleep disturbances as an integral part of fibromyalgia management.

【 授权许可】

CC BY