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Characterizing "fibrofog": Subjective appraisal, objective performance, and task-related brain activity during a
Brian Walitt1, Marta Čeko2, Manish Khatiwada3
1National Center for Complementary and Integrative Health (NCCIH), NIH, Bethesda, MD, United States; MedStar Washington Hospital Center, Division of Rheumatology, Washington, DC, United States.
Neuroimage. Clinical
|March 9, 2016
Summary
Fibromyalgia patients experience "fibrofog" (subjective cognitive issues) but perform similarly on tasks. Brain activity during cognitive tasks did not differ, suggesting "fibrofog" is subjective, not objective.
Area of Science:
- Neuroscience
- Cognitive Science
- Rheumatology
Background:
- Fibromyalgia is frequently associated with subjective cognitive dysfunction, termed "fibrofog."
- The relationship between perceived cognitive deficits, actual performance, and underlying neural mechanisms in fibromyalgia remains unclear.
Purpose of the Study:
- To investigate the association between self-reported cognitive difficulties, objective working memory performance, and brain activity (BOLD response) during a cognitive task in fibromyalgia patients and healthy controls.
- To explore the neural correlates of subjective cognitive impairment in fibromyalgia.
Main Methods:
- Functional magnetic resonance imaging (fMRI) was used to measure brain activity during a working memory task (N-back).
- Participants included 16 fibromyalgia patients and 13 healthy controls who completed cognitive tasks and self-report questionnaires (MASQ).
- Analysis focused on working memory accuracy, BOLD response during the task, and correlations between subjective appraisal, performance, and brain activity.
Main Results:
- Fibromyalgia patients and controls showed no significant differences in working memory task performance.
- In healthy controls, subjective cognitive appraisal correlated with task accuracy; this association was absent in fibromyalgia patients.
- Fibromyalgia symptom severity positively correlated with perceived cognitive difficulty. BOLD response correlated with accuracy in controls but not in fibromyalgia patients.
- Increased subjective cognitive impairment correlated with decreased BOLD response in distinct brain regions for both groups.
Conclusions:
- "Fibrofog" in fibromyalgia is primarily characterized by subjective cognitive impairment rather than objective performance deficits.
- The neurological underpinnings of the subjective experience of cognitive impairment in fibromyalgia may be distinct from those directly involved in cognitive task execution.
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