Hostname: page-component-76fb5796d-5g6vh Total loading time: 0 Render date: 2024-04-28T03:17:35.271Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychological Function, Anxiety, Depression and Pain Impact in Fibromyalgia Patients

Published online by Cambridge University Press:  14 November 2014

Ana Mª Cuevas-Toro ,
Francisca López-Torrecillas ,
Mª Carmen Díaz-Batanero  and
Mª Nieves Pérez-Marfil
Ana Mª Cuevas-Toro*
Affiliation:
Universidad de Huelva (Spain)
Francisca López-Torrecillas
Affiliation:
Universidad de Granada (Spain)
Mª Carmen Díaz-Batanero
Affiliation:
Universidad de Huelva (Spain)
Mª Nieves Pérez-Marfil
Affiliation:
Universidad de Granada (Spain)
*
*Correspondence concerning this article should be addressed to Ana Mª Cuevas Toro. Universidad de Huelva. Facultad de Ciencias de la Educación. Departamento de Psicología Evolutiva y de la Educación. Campus de El Carmen. Avda. Tres de Marzo, s/n. 21071. Huelva (Spain). E-mail: ana.cuevas@dpee.uhu.es
Get access Rights & Permissions [Opens in a new window]

Abstract

Cognitive deficits have a significant impact on the daily performance of fibromyalgia patients. This paper analyzes executive functioning and decision-making performance, and the relationships between these functions and pain, anxiety, depression and medication in fibromyalgia patients. A group of fibromyalgia patients (FG) (n = 85) was compared with a healthy control group (CG) (n = 85) in their performance in the Wisconsin Card Sorting Test (WCST) and the Iowa Gambling Task (IGT). In the WCST, results showed a percentage of non-perseverative errors significantly higher in the CG than in the FG (p = .026), the other variables (percentage of perseverative errors, number of categories and failures to maintain set) showed no significant differences. In relation to decision-making (IGT), once the rules had been learnt, the FG made fewer advantageous choices than the CG, but these differences were not statistically significant (p = .325). In the FG, pain severity (p = .010) and impact on daily activities (p = .016) interfered with decision-making, unlike anxiety, depression or medication, which did no relate to it. In executive function, pain and impact on daily activities were associated with the percentage of perseverative errors (p = .051) and the number of categories (p = .031), whereas pain severity was related to failures to maintain set (p = .039), indicative of increased distractibility and poor attentional ability. In conclusion, FG showed normal performance in executive functioning and decision-making. Moreover, pain was associated with neuropsychological functioning whereas anxiety, depression and medication were not.

Keywords

fibromyalgianeuropsychological functioningpain
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 17 , 2014 , E78
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4 th Rev. Ed.). Washington, DC: APA.Google Scholar
Apkarian, A. V., Sosa, Y., Krauss, B. R., Thomas, P. S., Fredrickson, B. E., Levy, R. E., … & Chialvo, D. R. (2004). Chronic pain patients are impaired on an emotional decision-making task. Pain, 108, 129–136. http://dx.doi.org/10.1016/j.pain.2003.12.015 Google Scholar
Bechara, A., Damasio, A. R., Damasio, H., & Anderson, S. W. (1994). Insensitivity to future consequences following damage to human prefrontal cortex. Cognition, 50, 7–15. http://dx.doi.org/10.1016/0010-0277(94)90018-3 Google Scholar
Bechara, A., Damasio, H., & Damasio, A. R. (2000). Emotion, decision making and the orbitofrontal cortex. Cerebral Cortex, 10, 295–307. http://dx.doi.org/10.1093/cercor/10.3.295 Google Scholar
Bechara, A., Dolan, S., & Hindes, A., (2002). Decisions-making and addiction (part II): Myotpia for the future or hipersensitivity to reward? Neuropsychologia, 40, 1690–1705. http://dx.doi.org/10.1016/S0028-3932(02)00016-7 Google Scholar
Calandre, E. P., García-Carrillo, J., García-Leiva, J. M., Rico-Villademoros, F., Molina-Barea, R., & Rodríguez-López, C. M. (2011). Subgrouping patients with fibromyalgia according to the results of the fibromyalgia impact questionnaire: A replication study. Rheumatology International, 31, 1555–1559. http://dx.doi.org/10.1007/s00296-010-1521-3 Google Scholar
Correa, A., Miró, E., Martínez, M. P., Sánchez, A. I., & Lupiáñez, J. (2011). Temporal preparation and inhibitory deficit in fibromyalgia syndrome. Brain and Cognition; 75, 211–216. http://dx.doi.org/10.1016/j.bandc.2010.11.005 Google Scholar
De la Cruz, M. V. (1997). Test de Clasificación de Tarjetas de Wisconsin [Wisconsin Cards Sorting Test]. Madrid, Spain: TEA Ediciones.Google Scholar
Dick, B., Eccleston, C., & Crombez, G. (2002). Attentional functioning in fibromyalgia, rheumatoid arthritis, and musculoskeletal pain patients. Arthritis Care and Research, 47, 639–644. http://dx.doi.org/10.1002/art.10800 Google Scholar
Eccleston, C., & Crombez, G. (1999). Pain demands attention: A cognitive-affective model of the interruptive function of pain. Psychological Bulletin, 125, 356–366. http://dx.doi.org/10.1037//0033-2909.125.3.356 Google Scholar
Gelonch, O., Garolera, M., Rosselló, L., & Pifarré, J. (2013). Disfunción cognitiva en la fibromialgia [Cognitive dysfunction in fibromyalgia]. Revista de Neurología, 56, 573–588.Google Scholar
González, A., Fernández, P., & Torres, I. (2010). Aceptación del dolor crónico en pacientes con fibromialgia: Adaptación del Chronic Pain Acceptance Questionnaire (CPAQ) a una muestra española. [Acceptance of chronic pain in fibromyalgia patients: Adaptation of Chronic Pain Acceptance Questionnaire (CPAQ) in a Spanish population]. Psicothema, 22, 997–1003.Google Scholar
Glass, J. M. (2008). Fibromyalgia and cognition. The Journal of Clinical Psychiatry, 69, 20–24.Google Scholar
Glass, J. M. (2009). Review of cognitive dysfunction in fibromyalgia: A convergence on working memory and attentional control impairments. Rheumatic Diseases Clinics of North America, 35, 299–311. http://dx.doi.org/10.1016/j.rdc.2009.06.002 Google Scholar
Glass, J. M. (2010). Cognitive dysfunction in fibromyalgia syndrome. Journal of Musculoskeletal Pain, 18, 367–372. http://dx.doi.org/10.3109/10582452.2010.502626 CrossRefGoogle Scholar
Glass, J. M., Williams, D. A., Fernández-Sánchez, M. L., Kairys, A, Barjola, P., Heitzeg, M. M., … & Schmidt-Wilcke, T. (2011). Executive function in chronic pain patients and healthy controls: Different cortical activation during response inhibition in fibromyalgia. The Journal of Pain, 12, 1219–1229. http://dx.doi.org/10.1016/j.jpain.2011.06.007 Google Scholar
Grace, G. M., Roach, A. R., & Segerstrom, M. A. (1999). Concentration and memory deficits in patients with fibromyalgia syndrome. Journal of Clinical and Experimental Neuropsychology, 21, 477–487. http://dx.doi.org/10.5555/jcen.21.4.477.876 CrossRefGoogle ScholarPubMed
Grisart, J. M., & van der Linden, M. (2001). Conscious and automatic uses of memory in chronic pain patients. Pain, 94, 305–313. http://dx.doi.org/10.1016/S0304-3959(01)00366-9 Google Scholar
Grisart, J., van der Linden, M., & Masquelier, E. (2002). Controlled processes and automaticity in memory functioning in fibromyalgia patients: Relation with emotional distress and hypervigilance. Journal of Clinical and Experimental Neuropsychology, 24, 994–1009.Google Scholar
Haeton, R. K., Chelune, G. C., Talley, J. L., Kay, G. G., & Curtiss, G. (1993). The Wisconsin Card Sorting Test Manual (revised and expanded). Odessa, Fl: Psychological Assessment Resources.Google Scholar
Huber, A., Suman, A. L., Biasi, G., & Carli, G. (2008). Predictors of psychological distress and well-being in women with chronic musculoskeletal pain: Two sides of the same coin? Journal of Psychosomatic Research, 64, 169–175. http://dx.doi.org/10.1016/j.jpsychores.2007.09.005 Google Scholar
Iezzi, T., Duckworth, M. P., Vuong, L. N., Archibald, Y. M., & Klinck, A. (2004). Predictors of neurocognitive performance in chronic pain patients. International Journal of Behavioral Medicine, 11, 56–161. http://dx.doi.org/10.1207/s15327558ijbm1101_7 Google Scholar
Kaplan, G. B., Sengör, N. S., Gürvit, H., Genç, I., & Güzelis, C. (2006). A composite neural network model for perseveration and distractibility in the Wisconsin card sorting test. Neural Networks, 19, 375–387. http://dx.doi.org/10.1016/j.neunet.2005.08.015 Google Scholar
Kim, S. H., Kim, S. H., Kim, S. K., Nam, E. J., Han, S. W., & Lee, S. J. (2012). Spatial versus verbal memory impairments in patients with fibromyalgia. International Journal of Rheumatology, 32, 1135–1142. http://dx.doi.org/10.1007/s00296-010-1762-1 Google Scholar
Lázaro, C., Bosch, F., Torrubia, R., & Baños, J. E. (1994). The development of a Spanish Questionnaire for assessing pain: Preliminary data concerning reliability and validity. European Journal of Psychological Assessment, 10, 191–200.Google Scholar
Leavitt, F., & Katz, R. S. (2009) Normalizing memory recall in fibromyalgia with rehearsal: A distraction-counteracting effect. Arthritis and Rheumatism, 61, 740–744. http://dx.doi.org/10.1002/art.24559 Google Scholar
Luerding, R., Weigand, T., Bogdahn, U. & Schmidt-Wilcke, T. (2008). Working memory performance is correlated with local brain morphology in the medial frontal and anterior cingulate cortex in fibromyalgia patients: structural correlates of pain cognition interaction. Brain, 131, 3222–3231. http://dx.doi.org/10.1093/brain/awn229 Google Scholar
Mercado, F., González, J. L., Barjola, P., Fernández-Sánchez, M., López-López, A., Alonso, M. & Gómez-Esquer, F. (2013). Brain correlates of cognitive inhibition in fibromyalgia: Emotional intrusion of symptom-related words, International Journal of Psychophysiology 88, 182–192. http://dx.doi.org/10.1016/j.ijpsycho.2013.03.017 Google Scholar
Miró, E., Lupiáñez, J., Martínez, M. P., Sánchez, A. I., Díaz-Piedra, C., Guzmán, M. A., M. A., & Buela-Casal, G. (2011). Cognitive-behavioral therapy for insomnia improves attentional function in fibromyalgia syndrome: A pilot, randomized controlled trial. Journal of Health Psychology, 16, 770–782. http://dx.doi.org/10.1177/1359105310390544 Google Scholar
Miró, E., Lupiáñez, J., Hita, E., Martínez, M. P., Sánchez, A. I., & Buela-Casal, G. (2011). Attentional deficits in fibromyalgia and its relationships with pain, emotional distress and sleep dysfunction complaints. Psychology and Health, 26, 765–780. http://dx.doi.org/10.1080/08870446.2010.493611 CrossRefGoogle ScholarPubMed
Mongini, F., Keller, R., Deregibus, A., Barbalonga, E., & Mongini, T. (2005). Frontal lobe dysfunction in patients with chronic migraine: A clinical neuropsychological study. Psychiatry Research, 133, 101–106. http://dx.doi.org/10.1016/j.psychres.2003.12.028 Google Scholar
Munguía-Izquierdo, D., Legaz-Arrese, A., Moliner-Urdiales, D., & Reverter-Masía, J. (2008). Neuropsicología de los pacientes con síndromes de fibromialgia: Relación con dolor y ansiedad. [Neuropsychological performance in patients with fibromyalgia syndrome: Relation to pain and anxiety]. Psicothema, 20, 427–431.Google Scholar
Pastor, M. A., López, S., Rodríguez, J., Terol, M. C., & Sánchez, S. (1995). Evaluación Multidimensional del dolor crónico en enfermos reumáticos [Multidimensional Assesstment of chronic pain in rheumatic patients]. Revista de Psicología de la Salud, 7, 79–106.Google Scholar
Pastor, M. A., Lledó, A., López-Roig, S., Pons, N., & Martín-Aragón, M. (2010). Predictores de la utilización de recursos sanitarios en la fibromialgia [Predictors of healthcare resource use in Fibromyalgia]. Psicothema, 22, 549–555.Google Scholar
Park, D. C., Glass, J. M., Minear, M., & Crofford, L. J. (2001). Cognitive function in fibromyalgia patients. Arthritis and Rheumatology, 44, 2125–2133. http://dx.doi.org/10.1002/1529-0131(200109)44:9<2125::AID-ART365>3.0.CO;2–1 Google Scholar
Prados, G., & Miró, E. (2012). Fibromialgia y sueño: Una revisión [Fibromyalgia and sleep: A review]. Revista de Neurología, 54, 227–240.CrossRefGoogle Scholar
Quintana, J. M., Padierna, A., Esteban, C., Arostegui, I., Bilbao, A., & Ruiz, I. (2003). Evaluation of the psychometric characteristics of the Spanish version of the Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 107, 216–221. http://dx.doi.org/10.1034/j.1600-0447.2003.00062.x Google Scholar
Reyes del Paso, G. A., Pulgar, Á., Duschek, S., & Garrido, S. (2012). Cognitive impairment in fibromyalgia syndrome: The impact of cardiovascular regulation, pain, emotional disorders and medication. European Journal of Pain, 16, 421–429. http://dx.doi.org/10.1002/j.1532-2149.2011.00032.x Google Scholar
Sánchez, A. I., Martínez, M. P., Miró, E., & Medina, A. (2011). Predictors of the pain perception and self-efficacy for pain control in patients with fibromyalgia. The Spanish Journal of Psychology, 14, 366–373. http://dx.doi.org/10.5209/rev_SJOP.2011.v14.n1.33 Google Scholar
Schmeichel, B. J. (2007). Attention control, memory updating, and emotion regulation temporarily reduce the capacity of executive control. Journal of Experimental Psychology General, 136, 241–255. http://dx.doi.org/10.1037/0096-3445.136.2.241 Google Scholar
Seo, J., Kim, S-H., Kim, Y-T., Song, H-j., Lee, J-j., Kim, S-H., … & Chang, Y. (2012). Working memory impairment in fibromyalgia patients associated with altered frontoparietal. Memory Network. Plos one, 7, e37808. http://dx.doi.org/10.1371/journal.pone.0037808 CrossRefGoogle ScholarPubMed
Sephton, S. E., Studts, J. L., Hoover, K., Weissbecker, I., Lynch, G., Ho, I., … & Salmon, P. (2003). Biological and psychological factors associated with memory function in fibromyalgia syndrome. Health Psychology, 22, 592–597. http://dx.doi.org/10.1037/0278-6133.22.6.592 Google Scholar
Solberg, L., Roach, A. R., & Segerstrom, S. C. (2009). Executive functions, self-regulation, and chronic pain: A review. Annuals and Behavioral Medical, 37, 173–183. http://dx.doi.org/10.1007/s12160-009-9096-5 Google Scholar
Suhr, J. A. (2003). Neuropsychological impairment in fibromyalgia: Relation to depression, fatigue, and pain. Journal of Psychosomatic Research, 55, 321–329.Google Scholar
Verdejo-García, A., López-Torrecillas, F., Pita, E., Delgado-Rodríguez, A., & Bechara, A. (2009). Executive function and decision-making in women with fibromyalgia. Archives of Clinical Neuropsychology, 24, 113–122. http://dx.doi.org/10.1093/arclin/acp014 CrossRefGoogle ScholarPubMed
Verbunt, J. A., Pernot, D., & Smeets, R. (2008). Disability and quality of life in patients with fibromyalgia. Health and Quality of Life Outcomes, 6, 8. http://dx.doi.org/10.1186/1477-7525-6-8 Google Scholar
Walitt, B., Roebuck-Spencer, T., Bleiberg, J., Foster, G., & Weinstein, A. (2008). Automated neuropsychiatric measurements of information processing in Fibromyalgia. Rheumatology International, 28, 561–566. http://dx.doi.org/10.1007/s00296-007-0487-2 Google Scholar
Walteros, C., Sánchez-Navarro, J. P., Muñoz, M. A., Martínez-Selva, J. M., Chialvo, D., & Montoya, P. (2011). Altered associative learning and emotional decision making in fibromyalgia. Journal of Psychosomatic Research, 70, 294–301. http://dx.doi.org/10.1016/j.jpsychores.2010.07.013 Google Scholar