If you have fibromyalgia, you most likely have also experienced some memory loss and difficulty concentrating – what we often refer to as fibro-fog. You may have even felt at times like you were literally losing your mind – like parts of your brain just quit working. These cognitive functioning problems are so common with FM that they have been included in the proposed new fibromyalgia diagnostic criteria.
We know that cognitive functioning problems exist with FM; what we don't know is why. What causes them? A new study presented at the 6th World Congress of the World Institute of Pain suggests that pain may be the primary factor contributing to our cognitive impairment.
Study Design and Results
The researchers evaluated 35 fibromyalgia patients and 29 healthy controls. All of the participants were tested using a neuropsychologic test that quantifies numerical ability, attentional control, and speed of cognitive processing. In order to determine what factors might have an effect on cognitive function, subjects were also given questionnaires that measured pain, depression, anxiety, fatigue, sleep and medication intake.
The FM group performed fewer calculations than the control group in each of the five task sessions and they showed less improvement in performance over time. This was pretty much what the researchers had expected. What surprised them, however, was that it was the level of their pain that predicted their cognitive performance. In other words, the higher the pain level, the lower the cognitive functioning ability. The other factors measured – depression, anxiety, fatigue and sleep – had no relationship to cognitive functioning.
That was the first surprise, but the researchers had an even bigger surprise in store. They had hypothesized that the patients taking opioid medications would not do as well because the opioids would disrupt their cognitive functioning. But surprise – the patients taking opioid medication performed better than those who who were not!
In an interview with Medscape Medical News, Stefan Duschek, Ph.D., from the University of Munich, in Germany, who presented the study, said, "Pain is an attention-demanding condition; one may suppose that central nociceptive activity detracts from cognition by requiring enhanced neural processing resources."
In a nutshell, the brain can only handle so much at one time. When it is busy trying to deal with pain, it can't perform other functions as well.
This is such an interesting study. For years many doctors have tried to dismiss our cognitive difficulties, attributing them to depression or medication. But it turns out that what we've known all along is true – it's the pain that's causing most of our cognitive problems.
I suspect that if there was more focus on treating our pain early and thoroughly, many of our other symptoms would improve as well.
6th World Congress of the World Institute of Pain: Abstract 112. Presented February 4, 2012.
Johnson, K. (2012, February 6). Pain negatively affects cognition in fibromyalgia. Medscape Medical News.
Published On: February 22, 2012