Executive functions in fibromyalgia: A systematic review.

Abstract

The study investigated impairment in executive functions (EF) in patients with Fibromyalgia (FM), based on a systematic review. Methods: Following the PRISMA writing guide, the search took place in the PsychInfo, PubMed/MEDLINE, Scopus, Web of Science, LILACS and ProQuest T&D databases, without delimiting the time frame. A total of 2,164 studies were identified. After the selection steps, in which the eligibility criteriaempirical studies; with individuals diagnosed with FM; studies that used EF measurement instruments; comparative studies that included a healthy control group-were applied, 21 articles were included for analysis. Results: There was evidence of impairment in inhibitory control and attention, a result that was maintained even after controlling for anxiety and depression. Deficits in working memory were also suggested while few studies investigated impairments in cognitive flexibility. There was no consistent evidence of compromise in fluency, decision-making, or planning. Conclusions: The study contributes to a mapping of the area, identifying the constructs and instruments most used. The findings can direct future studies and the clinical practice in the treatment of people with FM. The neuropsychological assessment can be a relevant resource to address possible executive difficulties in these patients and the consequences for their treatment and functionality. Public Significance StatementPatients with Fibromyalgia present inhibitory control and attention impairments. Depression, anxiety, and pain can be moderators in the relation between Fibromyalgia and executive functions difficulties. Neuropsychological assessment can be an important tool to understand executive functions difficulties in Fibromyalgia patients, collaborating to directing multi-professional intervention and treatment strategies.

Evaluation of Cognitive Performance in Patients with Fibromyalgia Syndrome: A Case–Control Study

“…Our results agree with those of previous studies showing that patients with FMS had worse scores in attention, processing speed, long-term memory, and mental inhibition, but our findings disagree with differences in working memory [41,42]. Thus, it should be noted that the most notable difference between women with and without FMS at the executive level was seen in difficulties at the inhibitory level, in agreement with the review by Mendonça et al [6], where almost 100 executive functions were analyzed in patients with FMS, and the most significant result identified a deficit regarding inhibitory control. The aforementioned results agree with previous meta-analyses showing that cognitive problems in patients with FMS do not affect all domains and executive functions at the same level [8,9].…”

“…Cognitive alterations are self-reported by up to 60% of patients with FMS and can range from overall short-and long-term memory loss (e.g., problem with recalling names or words) to deficit attention and executive function deficits [6]. In fact, this subjective experience of cognitive dysfunction self-perceived by patients with FMS has been called "fibrofog" [7].…”

Understanding the Experience and Impacts of Brain Fog in Chronic Pain: A Scoping Review

“…Eight papers defined fibro-fog as a specific phenomenon in patients diagnosed with fibromyalgia. 27 , 40 , 42–47 Fibro-fog has been broadly described as cognitive impairments in fibromyalgia 27 , 47 , 48 ; however, the most common features include issues with attention and memory. 45 , 46 For example, Gunendi et al 44 described fibro-fog as a state of impaired central processing of sensory stimuli characterized by difficulty focusing attention, remembering new information, making decisions, and performing tasks.…”