Executive function and decision making in women with Fibromyalgia Syndrome

A study by researchers in Spain has shown that the cognitive difficulties suffered by women with Fibromyalgia Syndrome impact on their neuropsychological performance.

The researchers note that patients with Fibromyalgia Syndrome (Fibro) typically report cognitive problems that are disturbing in everyday life. Despite these substantial subjective complaints by Fibro patients, very few studies have addressed objectively the effect of such problems on neuropsychological performance.

The study aimed to examine possible impairment of executive function and decision-making in a sample of 36 women diagnosed with Fibro and 36 healthy women matched in age, education, and socio-economic status.

For the study, the researchers contrasted performance of both groups on two measures of executive functioning: the Wisconsin Card Sorting Test (WCST), which assesses cognitive flexibility skills, and the Iowa Gambling Tasks (IGT; original and variant versions), which assess emotion-based decision-making.

The researchers also examined the relationship between executive function performance and pain experience, and between executive function and personality traits of novelty-seeking, harm avoidance, reward dependence, and persistence (measured by the Temperament and Character Inventory-Revised).

Results showed that on the WCST, the women with Fibro showed poorer performance than healthy comparison women on the number of categories and non-perseverative errors, but not on perseverative errors.

The Fibro patients also showed an altered learning curve in the original IGT (where reward is immediate and punishment is delayed), suggesting compromised emotion-based decision-making; but not in the variant IGT (where punishment is immediate but reward is delayed), suggesting hypersensitivity to reward. Personality variables were very mildly associated with cognitive performance in FM women

In summary, the women with Fibro had reduced cognitive flexibility compared to the healthy controls, and also had compromised emotion-based decision-making.

References:

1. Verdejo-García A, López-Torrecillas F, Calandre EP, Delgado-Rodríguez A, Bechara A. Executive function and decision-making in women with fibromyalgia. Arch Clin Neuropsychol. 2009 Feb;24(1):113-22. Epub 2009 Mar 11.