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Fernandes-Magalhaes R, Carpio A, Ferrera D, Peláez I, De Lahoz ME, Van Ryckeghem D, Van Damme S, Mercado F. Neural mechanisms underlying attentional bias modification in fibromyalgia patients: a double-blind ERP study. Eur Arch Psychiatry Clin Neurosci 2024; 274:1197-1213. [PMID: 37980687 DOI: 10.1007/s00406-023-01709-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/15/2023] [Indexed: 11/21/2023]
Abstract
There is a growing interest in the potential benefits of attentional bias modification (ABM) training in chronic pain patients. However, studies examining the effectiveness of ABM programs in fibromyalgia patients have demonstrated inconclusive effects on both behavioral indices and clinical symptoms. Additionally, underlying neural dynamics of ABM effects could yield new insights but remain yet unexplored. Current study, therefore, aims to investigate the effects of ABM training on known neural electrophysiological indicators of attentional bias to pain (P2, N2a). Thirty-two fibromyalgia patients were enrolled and randomly assigned to an ABM training (N = 16) or control (N = 16) condition (2 weeks duration). Within the ABM training condition participants performed five sessions consisting of a modified version of the dot-probe task in which patients were trained to avoid facial pain expressions, whereas in the control group participants performed five sessions consisting of a standard version of the dot-probe task. Potential ABM training effects were evaluated by comparing a single pre- and post-treatment session, in which event-related potentials (ERPs) were recorded in response to both facial expressions and target stimuli. Furthermore, patients filled out a series of self-report questionnaires assessing anxiety, depression, pain-related worrying, fear of pain, fatigue and pain status. After training, results indicated an overall reduction of the amplitude of the P2 component followed by an enhancement of N2a amplitude for the ABM condition compared to control condition. In addition, scores on anxiety and depression decreased in patients assigned to the training condition. However, we found no effects derived from the training on pain-related and fatigue status. Present study offers new insights related to the possible neural mechanisms underlying the effect of ABM training in fibromyalgia. Clinical trial (TRN: NCT05905159) retrospectively registered (30/05/2023).
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Affiliation(s)
- Roberto Fernandes-Magalhaes
- Department of Psychology, Faculty of Health Sciences, Universidad Rey Juan Carlos, Av. Atenas s/n, 28922, Alcorcón, Madrid, Spain
| | - Alberto Carpio
- Department of Psychology, Faculty of Health Sciences, Universidad Rey Juan Carlos, Av. Atenas s/n, 28922, Alcorcón, Madrid, Spain
| | - David Ferrera
- Department of Psychology, Faculty of Health Sciences, Universidad Rey Juan Carlos, Av. Atenas s/n, 28922, Alcorcón, Madrid, Spain
| | - Irene Peláez
- Department of Psychology, Faculty of Health Sciences, Universidad Rey Juan Carlos, Av. Atenas s/n, 28922, Alcorcón, Madrid, Spain
| | - María Eugenia De Lahoz
- Department of Psychology, Faculty of Health Sciences, Universidad Rey Juan Carlos, Av. Atenas s/n, 28922, Alcorcón, Madrid, Spain
| | - Dimitri Van Ryckeghem
- Department of Clinical Psychological Science, Maastricht University, Maastricht, Netherlands
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Stefaan Van Damme
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Francisco Mercado
- Department of Psychology, Faculty of Health Sciences, Universidad Rey Juan Carlos, Av. Atenas s/n, 28922, Alcorcón, Madrid, Spain.
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Cardoso S, Fernandes C, Barbosa F. Attentional deficits in fibromyalgia: an ERP study with the oddball dual task and emotional stroop task. BMC Psychol 2024; 12:104. [PMID: 38424648 PMCID: PMC10902965 DOI: 10.1186/s40359-024-01601-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/18/2024] [Indexed: 03/02/2024] Open
Abstract
The present study investigated the neural correlates of attentional deficits in fibromyalgia through an Oddball Dual Task and an Emotional Stroop Task, both performed during EEG recordings. Thirty female participants were recruited, being divided into two groups: a group of patients with fibromyalgia (FM, n = 15, Mage = 51.87, SDage = 7.12) and a healthy control group (HC, n = 15, Mage = 46.13, SDage = 8.41). In the Emotional Stroop Task, the behavioural results showed that patients with FM had less hits and longer times reactions than healthy controls. These results were consistent with those obtained with our Event-related Potential (ERP) methodology, which evidenced that patients with FM had higher frontal latencies in the P200 time-window compared to healthy controls. Regarding the Oddball Dual Task, we found that patients with FM had lower P300 amplitudes than healthy participants. Moreover, we found that rare stimuli elicited higher P300 amplitudes than frequent stimuli for healthy controls, but this comparison was non-significant for patients with FM. Taken together, our results suggest that fibromyalgia may be associated to a reduced processing speed, along to reduced neural resources to process stimuli, mainly in distinguishing relevant (rare) and irrelevant (frequent) stimuli according to the goals of the task. Altogether, our results seem to support the hypothesis of generalized attentional deficits in FM.
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Affiliation(s)
- Susana Cardoso
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Avenida Carlos de Oliveira Campos-Castêlo da Maia, 4475-690, Maia, Portugal.
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.
| | - Carina Fernandes
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Faculty of Human and Social Sciences, University Fernando Pessoa, Porto, Portugal
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP) & RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC), Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Dass R, Kalia M, Harris J, Packham T. Understanding the Experience and Impacts of Brain Fog in Chronic Pain: A Scoping Review. Can J Pain 2023; 7:2217865. [PMID: 37441085 PMCID: PMC10334862 DOI: 10.1080/24740527.2023.2217865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 05/10/2023] [Accepted: 05/22/2023] [Indexed: 07/15/2023]
Abstract
Introduction Approximately 15% to 40% of persons with chronic pain as a primary disorder experience brain fog. Prior research has investigated the etiology of "brain fog" in conditions in which pain presents as a key feature (e.g., fibromyalgia). However, it remains understudied in the context of chronic 10 musculoskeletal pain. Following current scoping review guidelines, we obtained stakeholder input from patient and health care professionals (HCPs) to define this phenomenon. Specific aims of this review were to (1) identify factors contributing to brain fog, (2) identify the functional correlates of brain fog and assessments used to measure them, and (3) establish a definition of brain fog that can be employed by researchers and HCPs to advance research and care. Methods A scoping review was conducted using recommendations of the Joanna Briggs Institute methodology of scoping reviews and the Levac et al methodology. Embase, Cinahl, PsycINFO, and Medline was searched to identify relevant sources. Findings were verified with patient and healthcare professionals. Results We identified four 15 key features of brain fog: perceived variability, subjective cognitive dysfunction, participation limitations, and changes in functional activities. We developed a model of brain fog illustrating the overlapping categories of contributors to brain fog in chronic musculoskeletal pain: (1) neuroanatomical and neurophysiological, (2) mental health/emotional, and (3) environmental/lifestyle. Conclusion The results of this scoping review conclude that the inconsistency in research regarding brain fog in 20 chronic musculoskeletal pain is obstructing a clear understanding of the phenomenon and therefore may be impeding persons with chronic pain and brain fog from receiving optimal care.
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Affiliation(s)
- Ronessa Dass
- School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Mohini Kalia
- Faculty of Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Jocelyn Harris
- School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Tara Packham
- School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
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Chen J, Wang X, Xu Z. The Relationship Between Chronic Pain and Cognitive Impairment in the Elderly: A Review of Current Evidence. J Pain Res 2023; 16:2309-2319. [PMID: 37441267 PMCID: PMC10335316 DOI: 10.2147/jpr.s416253] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
Chronic pain and cognitive impairment are prevalent geriatric syndromes in the population of older adults, and they are the main cause of disability in people over sixty-five years of age. As the global population continues to age, chronic pain and cognitive impairment will affect an increasing number of older adults. While numerous studies in recent years have shown that chronic pain is associated with cognitive decline, the exact mechanisms linking the two remain unclear. In this review, we aim to present the available evidence on the connection between chronic pain and cognitive impairment and to discuss the potential mechanisms by which chronic pain affects cognitive function. In addition, we review potential therapeutic interventions targeting psychological factors, microglia activation, and altered gut flora that may improve and prevent cognitive decline in people with chronic pain.
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Affiliation(s)
- Jintao Chen
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, People’s Republic of China
| | - Xinyi Wang
- Department of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Zherong Xu
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, People’s Republic of China
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Villafaina S, Leon-Llamas JL, Murillo-Garcia A, Gusi N. Impact of being physically active on the brain electrocortical activity, brain volumetry and performance in the Stroop color and word test in women with fibromyalgia. Sci Rep 2022; 12:12616. [PMID: 35871256 PMCID: PMC9308776 DOI: 10.1038/s41598-022-16903-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Physical exercise is one of the treatment approaches with the most robust evidence against fibromyalgia (FM) symptoms. This study aimed to investigate the impact of being physically active on the Stroop Color and Word Test (SCWT) performance as well as to investigate and compare the brain electrocortical activity during SCWT. A total of 31 women completed the SCWT while EEG was recorded. People with FM were divided into two groups (physically and non-physically active) according to the WHO guidelines. Furthermore, magnetic resonance imaging was acquired and health-related quality of life, the impact of the disease, and the six-minute walking test were administered. Physically active group showed better performance in the SCWT, exhibiting less error in name different color patches condition (C), more correct responses in named color-word condition (CW) and higher interference score than non-physically active group. Moreover, a significantly higher theta power spectrum in the Fp1 during the condition C in the SCWT and a higher volume in the right rostral middle frontal gyrus have been found in the physically active group. Furthermore, physically active women with FM showed positively correlations between correct responses in names of colors printed in black condition (W) in the SCWT and theta power in the F3, Fz, Fp2 and F4 scalp positions. Regarding non-physically active women with FM, errors in condition CW negatively correlated with the volume of left superior frontal gyrus, left rostral middle frontal gyrus, right rostral middle frontal gyrus, left caudal middle frontal gyrus and right caudal middle frontal gyrus. Furthermore, physically active group showed increased performance in the 6 min walking test and lower disease impact. Fulfil the physical activity recommendation seems to protect brain health since better SCWT performance, greater frontal theta power and higher volume in the right rostral middle frontal gyrus have been found in physically active women with FM.
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Pinotsis DA, Fitzgerald S, See C, Sementsova A, Widge AS. Toward biophysical markers of depression vulnerability. Front Psychiatry 2022; 13:938694. [PMID: 36329919 PMCID: PMC9622949 DOI: 10.3389/fpsyt.2022.938694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
A major difficulty with treating psychiatric disorders is their heterogeneity: different neural causes can lead to the same phenotype. To address this, we propose describing the underlying pathophysiology in terms of interpretable, biophysical parameters of a neural model derived from the electroencephalogram. We analyzed data from a small patient cohort of patients with depression and controls. Using DCM, we constructed biophysical models that describe neural dynamics in a cortical network activated during a task that is used to assess depression state. We show that biophysical model parameters are biomarkers, that is, variables that allow subtyping of depression at a biological level. They yield a low dimensional, interpretable feature space that allowed description of differences between individual patients with depressive symptoms. They could capture internal heterogeneity/variance of depression state and achieve significantly better classification than commonly used EEG features. Our work is a proof of concept that a combination of biophysical models and machine learning may outperform earlier approaches based on classical statistics and raw brain data.
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Affiliation(s)
- D. A. Pinotsis
- Centre for Mathematical Neuroscience and Psychology, Department of Psychology, City, University of London, London, United Kingdom
- The Picower Institute for Learning and Memory, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - S. Fitzgerald
- Centre for Mathematical Neuroscience and Psychology, Department of Psychology, City, University of London, London, United Kingdom
| | - C. See
- Department of Computer Science, City, University of London, London, United Kingdom
| | - A. Sementsova
- Department of Computer Science, City, University of London, London, United Kingdom
| | - A. S. Widge
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
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Sound-Induced Flash Illusions Support Cortex Hyperexcitability in Fibromyalgia. Pain Res Manag 2022; 2022:7355102. [PMID: 36199588 PMCID: PMC9527419 DOI: 10.1155/2022/7355102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/19/2022] [Accepted: 09/01/2022] [Indexed: 12/04/2022]
Abstract
Objectives Fibromyalgia (FM) is characterized by spontaneous chronic widespread pain in combination with hyperalgesia to pressure stimuli. Sound-induced flash illusions (SIFIs) reflect cross-modal interactions between senses allowing to assess a visual cortical hoerexcitability (VCH) by evaluating the fission and fusion illusions disruption. The aims of the present study were to explore whether SIFIs are perceived differently in patients with fibromyalgia as compared to healthy controls (HCs) and how migraine affects fission and fusion illusions in fibromyalgia. Methods A single flash (F) accompanied by 0 to 4 beeps (B) was presented to induce the fission illusion while multiple flash (i.e., 2 to 4) accompanied by 0 or 1 beep was presented to induce fusion illusion. The mean number of perceived flashes in fission and fusion illusion trials was compared between the groups (i.e., FM, FM with migraine, and HCs) using repeated-measures analysis of variance. Medication history was recorded along with the administration of Fibromyalgia Impact Questionnaire and Hospital Anxiety and Depression scales. Results Twenty-four patients with FM (mean age 51, 2 ± 10, 6 years; 22 females), seventeen patients with FM and migraine without aura (mean age 47.8 ± 11.4 years; 16 females; 13 chronic, 4 episodic migraine), and forty-one age- and sex-matched HCs (mean age 47.3 ± 6.9 years; 34 females) participated in the study. Fission and fusion illusory effects were detected in all the participants. However, in FM patients, the fission illusion was reduced and almost abolished as compared to HCs (1F1B, p = 0.02; 1F2B, p < 0.0001; 1F3B, p < 0.0001; 1F4B, p = 0.0001), while there were no differences between groups in fusion trials. Migraine did not affect the fission and the fusion illusions. Conclusion Results from this study confirm that patients with FM have a VCH suggesting that the pathological changes in cortical excitability might have important roles in the pathophysiology of FM. SIFI represents a noninvasive behavioral tool for the exploration of cross-sensory functional interplay.
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Yam M, Glatt S, Nosatzki S, Mirelman A, Hausdorff JM, Goldstein L, Giladi N, Fahoum F, Maidan I. Limited Ability to Adjust N2 Amplitude During Dual Task Walking in People With Drug-Resistant Juvenile Myoclonic Epilepsy. Front Neurol 2022; 13:793212. [PMID: 35237227 PMCID: PMC8884027 DOI: 10.3389/fneur.2022.793212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/04/2022] [Indexed: 11/23/2022] Open
Abstract
Juvenile myoclonic epilepsy (JME) is one of the most common epileptic syndromes; it is estimated to affect 1 in 1,000 people worldwide. Most people with JME respond well to medication, but up to 30% of them are drug-resistant. To date, there are no biomarkers for drug resistance in JME, and the poor response to medications is identified in retrospect. People with JME have frontal dysfunction manifested as impaired attention and difficulties in inhibiting habitual responses and these dysfunctions are more pronounced in drug-resistant individuals. Frontal networks play an important role in walking and therefore, gait can be used to overload the neural system and expose subtle changes between people with drug-responsive and drug-resistant JME. Electroencephalogram (EEG) is a promising tool to explore neural changes during real-time functions that combine a cognitive task while walking (dual tasking, DT). This exploratory study aimed to examine the alteration in electrical brain activity during DT in people with drug-responsive and drug-resistant JME. A total of 32 subjects (14 males and 18 females) participated: 11 drug-responsive (ages: 31.50 ± 1.50) and 8 drug-resistant (27.27 ± 2.30) people with JME, and 13 healthy controls (29.46 ± 0.69). The participants underwent EEG examination during the performance of the visual Go/NoGo (vGNG) task while sitting and while walking on a treadmill. We measured latencies and amplitudes of N2 and P3 event-related potentials, and the cognitive performance was assessed by accuracy rate and response time of Go/NoGo events. The results demonstrated that healthy controls had earlier N2 and P3 latencies than both JME groups (N2: p = 0.034 and P3: p = 0.011), however, a limited ability to adjust the N2 amplitude during walking was noticeable in the drug-resistant compared to drug-responsive. The two JME groups had lower success rates (drug-responsive p < 0.001, drug-resistant p = 0.004) than healthy controls, but the drug-resistant showed longer reaction times compared to both healthy controls (p = 0.033) and drug-responsive (p = 0.013). This study provides the first evidence that people with drug-resistant JME have changes in brain activity during highly demanding tasks that combine cognitive and motor functions compared to people with drug-responsive JME. Further research is needed to determine whether these alterations can be used as biomarkers to drug response in JME.
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Affiliation(s)
- Mor Yam
- Laboratory of Early Markers of Neurodegeneration, Centre for the Study of Movement, Cognition, and Mobility, Tel Aviv Sourasky Medical Centre, Neurological Institute, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Sigal Glatt
- Laboratory of Early Markers of Neurodegeneration, Centre for the Study of Movement, Cognition, and Mobility, Tel Aviv Sourasky Medical Centre, Neurological Institute, Tel Aviv, Israel
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shai Nosatzki
- Laboratory of Early Markers of Neurodegeneration, Centre for the Study of Movement, Cognition, and Mobility, Tel Aviv Sourasky Medical Centre, Neurological Institute, Tel Aviv, Israel
| | - Anat Mirelman
- Laboratory of Early Markers of Neurodegeneration, Centre for the Study of Movement, Cognition, and Mobility, Tel Aviv Sourasky Medical Centre, Neurological Institute, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jeffrey M. Hausdorff
- Laboratory of Early Markers of Neurodegeneration, Centre for the Study of Movement, Cognition, and Mobility, Tel Aviv Sourasky Medical Centre, Neurological Institute, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Lilach Goldstein
- Epilepsy Unit, Tel Aviv Sourasky Medical Centre, Neurological Institute, Tel Aviv, Israel
| | - Nir Giladi
- Laboratory of Early Markers of Neurodegeneration, Centre for the Study of Movement, Cognition, and Mobility, Tel Aviv Sourasky Medical Centre, Neurological Institute, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Firas Fahoum
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Epilepsy Unit, Tel Aviv Sourasky Medical Centre, Neurological Institute, Tel Aviv, Israel
| | - Inbal Maidan
- Laboratory of Early Markers of Neurodegeneration, Centre for the Study of Movement, Cognition, and Mobility, Tel Aviv Sourasky Medical Centre, Neurological Institute, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Epilepsy Unit, Tel Aviv Sourasky Medical Centre, Neurological Institute, Tel Aviv, Israel
- *Correspondence: Inbal Maidan
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Fernandes-Magalhaes R, Ferrera D, Peláez I, Martín-Buro MC, Carpio A, De Lahoz ME, Barjola P, Mercado F. Neural correlates of the attentional bias towards pain-related faces in fibromyalgia patients: An ERP study using a dot-probe task. Neuropsychologia 2022; 166:108141. [PMID: 34995568 DOI: 10.1016/j.neuropsychologia.2021.108141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 12/29/2021] [Accepted: 12/31/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND One of the major cognitive deficits in fibromyalgia has been linked to the hypervigilance phenomenon. It is mainly reflected as a negative bias for allocating attentional resources towards both threatening and pain-related information. Although the interest in its study has recently grown, the neural temporal dynamics of the attentional bias in fibromyalgia still remains an open question. METHOD Fifty participants (25 fibromyalgia patients and 25 healthy control subjects) performed a dot-probe task. Two types of facial expressions (pain-related and neutral) were employed as signal stimuli. Then, as a target stimulus, a single dot replaced the location of one of these two faces. Event-related potentials (ERP) in response to facial expressions and target stimulation (i.e., dot) were recorded. Reaction time (RT) and accuracy measures in the experimental task were collected as behavioural outcomes. RESULTS Temporal dynamics of brain electrical activity were analysed on two ERP components (P2 and N2a) sensitive to the facial expressions meaning. Pain-related faces elicited higher frontal P2 amplitudes than neutral faces for the whole sample. Interestingly, an interaction effect between group and facial expressions was also found showing that pain-related faces elicited enhanced P2 amplitudes (at fronto-central regions, in this case) compared to neutral faces only when the group of patients was considered. Furthermore, higher P2 amplitudes were observed in response to pain-related faces in patients with fibromyalgia compared to healthy control participants. Additionally, a shorter latency of P2 (at centro-parietal regions) was also detected for pain-related facial expressions compared to neutral faces. Regarding the amplitude of N2a, it was lower for patients as compared to the control group. Non-relevant effects of the target stimulation on the ERPs were found. However, patients with fibromyalgia exhibited slower RT to locate the single dot for incongruent trials as compared to congruent and neutral trials. CONCLUSIONS Data suggest the presence of an attentional bias in fibromyalgia that it would be followed by a deficit in the allocation of attentional resources to further process pain-related information. Altogether the current results suggest that attentional biases in fibromyalgia might be explained by automatic attentional mechanisms, which seem to be accompanied by an alteration of more strategic or controlled attentional components.
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Affiliation(s)
- Roberto Fernandes-Magalhaes
- Department of Psychology, School of Health Sciences, Rey Juan Carlos University, Madrid, Spain; Clinical Foundation of the Rey Juan Carlos University, Madrid, Spain
| | - David Ferrera
- Department of Psychology, School of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Irene Peláez
- Department of Psychology, School of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | | | - Alberto Carpio
- Department of Psychology, School of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - María Eugenia De Lahoz
- Department of Psychology, School of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Paloma Barjola
- Department of Psychology, School of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Francisco Mercado
- Department of Psychology, School of Health Sciences, Rey Juan Carlos University, Madrid, Spain.
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Oliva V, Gregory R, Brooks JC, Pickering AE. Central pain modulatory mechanisms of attentional analgesia are preserved in fibromyalgia. Pain 2022; 163:125-136. [PMID: 33941755 PMCID: PMC8675057 DOI: 10.1097/j.pain.0000000000002319] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/06/2021] [Accepted: 03/11/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT Fibromyalgia is a prevalent pain condition that is associated with cognitive impairments including in attention, memory, and executive processing. It has been proposed that fibromyalgia may be caused by altered central pain processing characterised by a loss of endogenous pain modulation. We tested whether attentional analgesia, where cognitive engagement diminishes pain percept, was attenuated in patients with fibromyalgia (n = 20) compared with matched healthy controls (n = 20). An individually calibrated, attentional analgesia paradigm with a 2 × 2 factorial design was used with brain and brainstem-focussed functional magnetic resonance imaging. Patients with fibromyalgia had both lower heat pain thresholds and speeds in a visual attention task. When this was taken into account for both attentional task and thermal stimulation, both groups exhibited an equivalent degree of attentional analgesia. Functional magnetic resonance imaging analysis showed similar patterns of activation in the main effects of pain and attention in the brain and brainstem (with the sole exceptions of increased activation in the control group in the frontopolar cortex and the ipsilateral locus coeruleus). The attentional analgesic effect correlated with activity in the periaqueductal gray and rostral ventromedial medulla. These findings indicate that patients with fibromyalgia can engage the descending pain modulatory system if the attentional task and noxious stimulus intensity are appropriately titrated.
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Affiliation(s)
- Valeria Oliva
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Robert Gregory
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, United Kingdom
- Anaesthesia, Pain & Critical Care Sciences, Bristol Medical School, University Hospitals Bristol, Bristol, United Kingdom
| | - Jonathan C.W. Brooks
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- University of East Anglia Brain Imaging Centre, School of Psychology, Norwich, United Kingdom
| | - Anthony E. Pickering
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, United Kingdom
- Anaesthesia, Pain & Critical Care Sciences, Bristol Medical School, University Hospitals Bristol, Bristol, United Kingdom
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Ibraheem W, Mckenzie S, Wilcox-Omubo V, Abdelaty M, Saji SE, Siby R, Alalyani W, Mostafa JA. Pathophysiology and Clinical Implications of Cognitive Dysfunction in Fibromyalgia. Cureus 2021; 13:e19123. [PMID: 34858761 PMCID: PMC8614169 DOI: 10.7759/cureus.19123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 10/29/2021] [Indexed: 11/24/2022] Open
Abstract
Cognitive dysfunction is a complaint of many patients diagnosed with fibromyalgia. Although the main symptoms of the disease are fatigue, widespread musculoskeletal pain, poor sleep quality, and tenderness points, the cognitive symptoms can be more distressing than the pain itself, and negatively affect their lives; however, many healthcare professionals underestimate these cognitive complaints and it is still one of the least researched topics. Proper management of these symptoms at an early stage may have a great impact to improve the mental health, physical function, and overall health of these patients. Hence, this traditional review aimed to look at the previous body of literature in PubMed in the past five years to address the pathophysiology of the cognitive dysfunction in fibromyalgia patients, to find the risk factors of cognitive dysfunction in these patients, to discover the recent modalities for treatment, and to figure out the clinical implications and recent recommendations by researchers on screening, diagnosis, and management of fibromyalgia and its cognitive dysfunction symptoms. This review has shown the various mechanisms of cognitive dysfunction. Some mechanisms are related to disease symptomologies, such as excessive pain perception, and others are related to hormonal and metabolite changes in the brain. Tobacco smoking and high body mass index showed an inverse impact on cognitive dysfunction and quality of life in fibromyalgia. Other risk factors and clinical implications were discussed in detail.
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Affiliation(s)
- Weaam Ibraheem
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Simon Mckenzie
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Victory Wilcox-Omubo
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohamed Abdelaty
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sandra E Saji
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Rosemary Siby
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Wafaa Alalyani
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Jihan A Mostafa
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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12
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Zhang X, Gao R, Zhang C, Chen H, Wang R, Zhao Q, Zhu T, Chen C. Evidence for Cognitive Decline in Chronic Pain: A Systematic Review and Meta-Analysis. Front Neurosci 2021; 15:737874. [PMID: 34630023 PMCID: PMC8492915 DOI: 10.3389/fnins.2021.737874] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/20/2021] [Indexed: 02/05/2023] Open
Abstract
Background: People with chronic pain (CP) sometimes report impaired cognitive function, including a deficit of attention, memory, executive planning, and information processing. However, the association between CP and cognitive decline was still not clear. Our study aimed to assess the association of CP as a risk factor with cognitive decline among adults. Methods: We included data from clinical studies. Publications were identified using a systematic search strategy from PubMed, Embase, and Cochrane Library databases from inception to October 10, 2020. We used the mean cognitive outcome data and the standard deviations from each group. The standardized mean difference (SMD) or odds ratio (OR), and 95% confidence intervals (CI) were performed for each cognitive decline outcome. I 2-values were assessed to quantify the heterogeneities. Results: We included 37 studies with a total of 52,373 patients with CP and 80,434 healthy control participants. Because these studies used different evaluative methods, we analyzed these studies. The results showed CP was associated with cognitive decline when the short-form 36 health survey questionnaire (SF-36) mental component summary (SMD = -1.50, 95% CI = -2.19 to -0.81), the Montreal cognitive assessment (SMD = -1.11, 95% CI = -1.60 to -0.61), performance validity testing (SMD = 3.05, 95% CI = 1.74 to 4.37), or operation span (SMD = -1.83, 95% CI = -2.98 to -0.68) were used. However, we got opposite results when the studies using International Classification of Diseases and Related Health Problems classification (OR = 1.58, 95% CI = 0.97 to 2.56), the Mini-Mental State Examination (SMD = -0.42, 95% CI = -0.94 to 0.10; OR = 1.14, 95% CI = 0.91 to 1.42), and Repeatable Battery for the Assessment of Neuropsychological Status memory component (SMD = -0.06, 95% CI = -0.37 to 0.25). Conclusion: There may be an association between CP and the incidence of cognitive decline when some cognitive, evaluative methods were used, such as short-form 36 health survey questionnaire, Montreal cognitive assessment, performance validity testing, and operation span.
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Affiliation(s)
- Xueying Zhang
- Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Rui Gao
- Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Changteng Zhang
- Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Hai Chen
- Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ruiqun Wang
- Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qi Zhao
- Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Zhu
- Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Chan Chen
- Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
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13
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Mercado F, Ferrera D, Fernandes-Magalhaes R, Peláez I, Barjola P. Altered sub-processes of working memory in fibromyalgia patients: An ERP study using N-back task. PAIN MEDICINE 2021; 23:475-487. [PMID: 34145889 DOI: 10.1093/pm/pnab190] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Cognitive dysfunction in fibromyalgia has become a key symptom considered by patients as more disabling than pain itself. Experimental evidence from neuropsychological and neuroimaging studies indicates that such cognitive impairments are especially robust when patients need to set in motion working memory processes, suggesting the existence of an altered functioning underlying the cerebral cortices of the frontoparietal memory network. However, the temporal dynamics of working memory sub-processes have not yet been explored in fibromyalgia. SUBJECTS Thirty-six right-handed women participated in the experiment: comprising eighteen patients with fibromyalgia and eighteen healthy controls. METHODS Event-related potentials (ERPs) and behavioural responses were recorded while participants were engaged in a 2-back working memory task. Principal Component Analyses (PCA) were used to define and quantify the ERP components associated with working memory processes. RESULTS Fibromyalgia patients exhibited worse performance than the control group, as revealed by their number of errors in the working memory task. Moreover, both scalp parieto-occipital P2 and parieto-occipital P3 amplitudes were lower for patients than for healthy control participants. Regression analyses revealed that lower P3 amplitudes were observed in those patients with fibromyalgia reporting higher pain ratings. CONCLUSIONS Current results suggest that both encoding of information (as reflected by P2) and subsequently, context updating and the replacement (as seen in lower P3 amplitudes), as a part of working memory sub-processes, are impaired in fibromyalgia. Studying the temporal dynamics of working memory using ERP methodology is a helpful approach to detect specific cognitive impaired mechanisms in this chronic pain syndrome. These new data could be used to develop more specific treatments adapted for each patient.
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Affiliation(s)
- Francisco Mercado
- Psychobiology Unit, School of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - David Ferrera
- Psychobiology Unit, School of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Roberto Fernandes-Magalhaes
- Psychobiology Unit, School of Health Sciences, Rey Juan Carlos University, Madrid, Spain.,Clinical Foundation of the Rey Juan Carlos University, Madrid, Spain
| | - Irene Peláez
- Psychobiology Unit, School of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Paloma Barjola
- Psychobiology Unit, School of Health Sciences, Rey Juan Carlos University, Madrid, Spain
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14
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Mouraux A, Bannister K, Becker S, Finn DP, Pickering G, Pogatzki-Zahn E, Graven-Nielsen T. Challenges and opportunities in translational pain research - An opinion paper of the working group on translational pain research of the European pain federation (EFIC). Eur J Pain 2021; 25:731-756. [PMID: 33625769 PMCID: PMC9290702 DOI: 10.1002/ejp.1730] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
For decades, basic research on the underlying mechanisms of nociception has held promise to translate into efficacious treatments for patients with pain. Despite great improvement in the understanding of pain physiology and pathophysiology, translation to novel, effective treatments for acute and chronic pain has however been limited, and they remain an unmet medical need. In this opinion paper bringing together pain researchers from very different disciplines, the opportunities and challenges of translational pain research are discussed. The many factors that may prevent the successful translation of bench observations into useful and effective clinical applications are reviewed, including interspecies differences, limited validity of currently available preclinical disease models of pain, and limitations of currently used methods to assess nociception and pain in non-human and human models of pain. Many paths are explored to address these issues, including the backward translation of observations made in patients and human volunteers into new disease models that are more clinically relevant, improved generalization by taking into account age and sex differences, and the integration of psychobiology into translational pain research. Finally, it is argued that preclinical and clinical stages of developing new treatments for pain can be improved by better preclinical models of pathological pain conditions alongside revised methods to assess treatment-induced effects on nociception in human and non-human animals. Significance: For decades, basic research of the underlying mechanisms of nociception has held promise to translate into efficacious treatments for patients with pain. Despite great improvement in the understanding of pain physiology and pathophysiology, translation to novel, effective treatments for acute and chronic pain has however been limited, and they remain an unmet medical need.
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Affiliation(s)
- André Mouraux
- Institute of Neuroscience (IONS), UCLouvain, Brussels, Belgium
| | - Kirsty Bannister
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Susanne Becker
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - David P Finn
- Pharmacology and Therapeutics, Centre for Pain Research, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Gisèle Pickering
- Department of Clinical Pharmacology, Inserm CIC 1405, University Hospital, CHU Clermont-Ferrand, France.,Fundamental and Clinical Pharmacology of Pain, University Clermont Auvergne, Clermont-Ferrand, France
| | - Esther Pogatzki-Zahn
- Department of Anesthesiology, Critical Care Medicine and Pain Therapy, University Hospital Muenster, Muenster, Germany
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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15
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Steiner GZ, Barry RJ, Wassink K, De Blasio FM, Fogarty JS, Cave AE, Love S, Armour M. Neuronal Correlates of Cognitive Control Are Altered in Women With Endometriosis and Chronic Pelvic Pain. Front Syst Neurosci 2020; 14:593581. [PMID: 33390910 PMCID: PMC7772245 DOI: 10.3389/fnsys.2020.593581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 11/11/2020] [Indexed: 12/13/2022] Open
Abstract
Endometriosis is a debilitating women's health condition and is the most common cause of chronic pelvic pain. Impaired cognitive control is common in chronic pain conditions, however, it has not yet been investigated in endometriosis. The aim of this study was to explore the neuronal correlates of cognitive control in women with endometriosis. Using a cross-sectional study design with data collected at a single time-point, event-related potentials were elicited during a cued continuous performance test from 20 women with endometriosis (mean age = 28.5 ± 5.2 years) and 20 age- and gender-matched controls (mean age = 28.5 ± 5.2 years). Event-related potential components were extracted and P3 component amplitudes were derived with temporal principal components analysis. Behavioral and ERP outcomes were compared between groups and subjective pain severity was correlated with ERP component amplitudes. No significant behavioral differences were seen in task performance between the groups (all p > 0.094). Target P3b (all p < 0.034) and SW (all p < 0.040), and non-target early P3a (eP3a; all p < 0.023) and late P3a (lP3a; all p < 0.035) amplitudes were smaller for the endometriosis compared to the healthy control group. Lower non-target eP3a (p < 0.001), lP3a (p = 0.013), and SW (p = 0.019) amplitudes were correlated with higher pain severity scores. Findings suggest that endometriosis-associated chronic pelvic pain is linked to alterations in stimulus-response processing and inhibitory control networks, but not impaired behavioral performance, due to compensatory neuroplastic changes in overlapping cognitive control and pain networks.
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Affiliation(s)
- Genevieve Z Steiner
- NICM Health Research Institute and Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia.,Brain & Behaviour Research Institute and School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Robert J Barry
- Brain & Behaviour Research Institute and School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Katherine Wassink
- Brain & Behaviour Research Institute and School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Frances M De Blasio
- Brain & Behaviour Research Institute and School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Jack S Fogarty
- Brain & Behaviour Research Institute and School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Adele E Cave
- NICM Health Research Institute and Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
| | - Sapphire Love
- Brain & Behaviour Research Institute and School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Mike Armour
- NICM Health Research Institute and Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
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16
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Wang WE, Ho RLM, Gatto B, van der Veen SM, Underation MK, Thomas JS, Antony AB, Coombes SA. Cortical dynamics of movement-evoked pain in chronic low back pain. J Physiol 2020; 599:289-305. [PMID: 33067807 DOI: 10.1113/jp280735] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/13/2020] [Indexed: 01/22/2023] Open
Abstract
KEY POINTS Cortical activity underlying movement-evoked pain is not well understood, despite being a key symptom of chronic musculoskeletal pain. We combined high-density electroencephalography with a full-body reaching protocol in a virtual reality environment to assess cortical activity during movement-evoked pain in chronic low back pain. Movement-evoked pain in individuals with chronic low back pain was associated with longer reaction times, delayed peak velocity and greater movement variability. Movement-evoked pain was associated with attenuated disinhibition in prefrontal motor areas, as evidenced by an attenuated reduction in beta power in the premotor cortex and supplementary motor area. ABSTRACT Although experimental pain alters neural activity in the cortex, evidence of changes in neural activity in individuals with chronic low back pain (cLBP) remains scarce and results are inconsistent. One of the challenges in studying cLBP is that the clinical pain fluctuates over time and often changes during movement. The goal of the present study was to address this challenge by recording high-density electroencephalography (HD-EEG) data during a full-body reaching task to understand neural activity during movement-evoked pain. HD-EEG data were analysed using independent component analyses, source localization and measure projection analyses to compare neural oscillations between individuals with cLBP who experienced movement-evoked pain and pain-free controls. We report two novel findings. First, movement-evoked pain in individuals with cLBP was associated with longer reaction times, delayed peak velocity and greater movement variability. Second, movement-evoked pain was associated with an attenuated reduction in beta power in the premotor cortex and supplementary motor area. Our observations move the field forward by revealing attenuated disinhibition in prefrontal motor areas during movement-evoked pain in cLBP.
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Affiliation(s)
- Wei-En Wang
- Department of Applied Physiology and Kinesiology, Laboratory for Rehabilitation Neuroscience, University of Florida, Gainesville, FL, USA
| | - Rachel L M Ho
- Department of Applied Physiology and Kinesiology, Laboratory for Rehabilitation Neuroscience, University of Florida, Gainesville, FL, USA
| | - Bryan Gatto
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Susanne M van der Veen
- Department of Physical Therapy, College of Health Professions, Virginia Commonwealth University, VA, USA
| | - Matthew K Underation
- Department of Physical Therapy, College of Health Professions, Virginia Commonwealth University, VA, USA
| | - James S Thomas
- Department of Physical Therapy, College of Health Professions, Virginia Commonwealth University, VA, USA
| | | | - Stephen A Coombes
- Department of Applied Physiology and Kinesiology, Laboratory for Rehabilitation Neuroscience, University of Florida, Gainesville, FL, USA
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17
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Effects of COMT Genotypes on Working Memory Performance in Fibromyalgia Patients. J Clin Med 2020; 9:jcm9082479. [PMID: 32752289 PMCID: PMC7464119 DOI: 10.3390/jcm9082479] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 12/23/2022] Open
Abstract
Growing research has reported the presence of a clear impairment of working memory functioning in fibromyalgia. Although different genetic factors involving dopamine availability (i.e, the COMT gene) have been associated with the more severe presentation of key symptoms in fibromyalgia, scientific evidence regarding the influence of COMT genotypes on cognitive impairment in these patients is still lacking. To this end, 167 participants took part in the present investigation. Working memory performance was assessed by the application of the SST (Spatial Span Test) and LNST (Letter and Number Sequence Test) belonging to the Weschler Memory Scale III. Significant working memory impairment was shown by the fibromyalgia patients. Remarkably, our results suggest that performance according to different working memory measures might be influenced by different genotypes of the COMT gene. Specifically, fibromyalgia patients carrying the Val/Val genotype exhibited significantly worse outcomes for the span of SST backward, SST backward score, SST total score and the Working Memory Index (WMI) than the Val/Val healthy carriers. Furthermore, the Val/Val patients performed worse on the SST backward and SST score than heterozygotes. Our findings are the first to show a link between the COMT gene and working memory dysfunction in fibromyalgia, supporting the idea that higher COMT enzyme activity would contribute to more severe working memory impairment in fibromyalgia.
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18
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Wang K, Cai G, Huang S, Li Y, Li R, Wu W. Performance of healthy persons under pain in different cognitive load tasks: An event-related potential study on experimental pain individuals. Brain Behav 2020; 10:e01713. [PMID: 32558280 PMCID: PMC7428486 DOI: 10.1002/brb3.1713] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE This study aims to determine how brain activities underlying task with different cognitive load would be modulated by the painful state using electroencephalography. METHODS The pain state was established by spraying capsaicin on subjects' left inner forearm. A total of 20 experimental pain subjects and 20 matched nonpain controls underwent cognitive tasks with electroencephalogram recording. We collected and analyzed behavioral and event-related potential (ERP) data. RESULTS High cognitive tasks exhibited significantly longer response times and lower accuracies than low-load tasks. The experimental pain group displayed a significantly lower accuracy than the control group. In addition, the experimental pain group showed no significance between high and low cognitive tasks in early ERP components (amplitude of N1, P2, N2, and early part of late positive potential), whereas the control group exhibited significance between different load tasks. Furthermore, we observed a delay peak energy for delta and theta oscillation in Fz 500-800 ms after the onset for pain persons and high cognitive load tasks. CONCLUSIONS Inadequate early attention modulation, along with delayed peak energy for brain oscillation (delta and theta), could be accountable for a worse performance in cognitive tasks in the experimental pain group. Thus, cognitive load is a highly considerable factor. Overall, this study offers more insights into how healthy population works with cognitive tasks under pain neurologically.
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Affiliation(s)
- Kangling Wang
- Department of Rehabilitation MedicineZhujiang HospitalSouthern Medical UniversityGuangzhouChina
| | - Guiyuan Cai
- Department of Rehabilitation MedicineZhujiang HospitalSouthern Medical UniversityGuangzhouChina
| | - Shimin Huang
- Department of Rehabilitation MedicineZhujiang HospitalSouthern Medical UniversityGuangzhouChina
| | - Yuqi Li
- Department of Rehabilitation MedicineZhujiang HospitalSouthern Medical UniversityGuangzhouChina
| | - Rongdong Li
- Department of Rehabilitation MedicineZhujiang HospitalSouthern Medical UniversityGuangzhouChina
| | - Wen Wu
- Department of Rehabilitation MedicineZhujiang HospitalSouthern Medical UniversityGuangzhouChina
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