Cognitive profiling in fibromyalgia patients using the MoCA

Fibromyalgia (FM) is characterized by persistent widespread pain, fatigue, sleep problems, and cognitive impairment. Although central sensitization and imbalanced monoamines contribute to FM, the connections between symptom severity, mood, cognition, and duloxetine's effects require more study.

This cross-sectional case-control study included 145 women (aged 25-60 years) from a tertiary neurology center: 55 healthy controls and 90 FM patients. Of the FM patients, 48 were untreated, while 42 received treatment. Clinical severity was measured by the Fibromyalgia Impact Questionnaire (FIQ), depressive symptoms by the Beck Depression Inventory (BDI), and global/domain cognition by the Montreal Cognitive Assessment (MoCA).

Untreated FM had the highest median FIQ (69.1), followed by treated FM (49.2) and controls (26.1; p < 0.001). The BDI scores followed a similar trend (23.5 vs. 18.0 vs. 10.0; p < 0.001). Untreated FM had lower MoCA total scores (23.0) compared to treated FM (24.0) and controls (27.0). Notable impairments in attention, executive function, and memory were observed in the untreated group. FIQ showed negative correlations with the MoCA total (r = -0.743) and attention (r = -0.637), while BDI correlated negatively with the MoCA total (r = -0.473).

The severity of FM is reflected in the levels of depression and cognitive impairment. These data allow for routine affective and cognitive assessments and a tailored, multidisciplinary FM management approach.