Association between descending pain modulatory system and cognitive impairment in fibromyalgia: A cross-sectional exploratory study
Background The successful regulation of sensory input to the central nervous system depends on the descending pain modulatory system (DPMS). For the effective regulation of sensory input to the central nervous system and behavioral responses to pain, the DPMS is required. Its connection to fibromyal...
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Published in | Frontiers in behavioral neuroscience Vol. 16; p. 917554 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Lausanne
Frontiers Research Foundation
29.09.2022
Frontiers Media S.A |
Subjects | |
Online Access | Get full text |
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Summary: | Background
The successful regulation of sensory input to the central nervous system depends on the descending pain modulatory system (DPMS). For the effective regulation of sensory input to the central nervous system and behavioral responses to pain, the DPMS is required. Its connection to fibromyalgia (FM)-related cognitive dysfunction has not yet been investigated. Therefore, this study tested whether measures of verbal fluency, sustained attention, and short-term and working memory could distinguish FM patients from healthy controls (HC). Additionally, it investigated, using a standardized paradigm, the link between cognitive ability and the function of the DPMS in responders and non-responders to the conditioned pain modulation test (CPM-test).
Materials and methods
We enrolled 21 HC women and 69 FM patients, all of whom ranged in age from 30 to 65. We employed scores from the Trail Making Test (TMTB-A) (sustained and divided attention), the Controlled Oral Word Association Test (COWAT) (orthographic and semantic fluency), and the Digits subtest of the Wechsler Adult Intelligence Scale (WAIS-III) as dependent variables.
Results
A generalized linear model (GLM) adjusted by educational level revealed significantly lower scores in FM than HC on the Span digits forward, COWAT-orthographic, and TMTB-A. For FM patients, multilevel MANCOVA revealed that the cognitive performance of non-responders compared to responders to CPM-test showed lower adjusted scores in Span digits forward (Partial-η
2
= 0.358,
P
= 0.001), Span digits backward (Partial-η
2
= 0.358,
P
= 0.001), COWAT-orthographic (Partial-η
2
= 0.551,
P
= 0.001), COWAR-semantic (Partial-η
2
= 0.355,
P
= 0.001), and TMTB-A (Partial-η
2
= 0.360,
P
= 0.001). The association between the cognitive tests and the DPMS is moderated by the serum level of brain-derived neurotrophic factor (BDNF). Additionally, these cognitive assessments had a positive correlation with antidepressant use and pain threshold. The cognitive assessments, on the other hand, were conversely associated with a life of quality.
Conclusion
Based on these findings, it can be shown that HC performed substantially better on cognitive exams than FM did. They demonstrated a link between clinical complaints about attention and memory and decreased DPMS effectiveness. Additionally, they demonstrated that the BDNF is a moderating element in a potential relationship between the severity of cognitive impairment and DPMS dysfunction. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Reviewed by: Francisco Gallo, Instituto Tecnológico de Buenos Aires, Argentina; Francisco Mercado, Rey Juan Carlos University, Spain Edited by: Magdalena Miranda, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina This article was submitted to Learning and Memory, a section of the journal Frontiers in Behavioral Neuroscience ORCID: Iraci L. S. Torres, https://orcid.org/0000-0002-3081-115X |
ISSN: | 1662-5153 1662-5153 |
DOI: | 10.3389/fnbeh.2022.917554 |