Association between descending pain modulatory system and cognitive impairment in fibromyalgia: A cross-sectional exploratory study
BackgroundThe 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 fibromyalg...
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Behavioral Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnbeh.2022.917554/full |
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| author | Paul Vicuña Serrano Paul Vicuña Serrano Maxciel Zortea Maxciel Zortea Rael Lopes Alves Rael Lopes Alves Gerardo Beltran Gerardo Beltran Gerardo Beltran Cibely Bavaresco Deliberali Amanda Maule Iraci L. S. Torres Iraci L. S. Torres Felipe Fregni Wolnei Caumo Wolnei Caumo Wolnei Caumo Wolnei Caumo |
| author_facet | Paul Vicuña Serrano Paul Vicuña Serrano Maxciel Zortea Maxciel Zortea Rael Lopes Alves Rael Lopes Alves Gerardo Beltran Gerardo Beltran Gerardo Beltran Cibely Bavaresco Deliberali Amanda Maule Iraci L. S. Torres Iraci L. S. Torres Felipe Fregni Wolnei Caumo Wolnei Caumo Wolnei Caumo Wolnei Caumo |
| author_sort | Paul Vicuña Serrano |
| collection | DOAJ |
| description | BackgroundThe 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 methodsWe 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.ResultsA 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-η2 = 0.358, P = 0.001), Span digits backward (Partial-η2 = 0.358, P = 0.001), COWAT-orthographic (Partial-η2 = 0.551, P = 0.001), COWAR-semantic (Partial-η2 = 0.355, P = 0.001), and TMTB-A (Partial-η2 = 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.ConclusionBased 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. |
| first_indexed | 2024-04-11T10:42:16Z |
| format | Article |
| id | doaj.art-759fc9d79dd748c4b374a5d2dc27e926 |
| institution | Directory Open Access Journal |
| issn | 1662-5153 |
| language | English |
| last_indexed | 2024-04-11T10:42:16Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Behavioral Neuroscience |
| spelling | doaj.art-759fc9d79dd748c4b374a5d2dc27e9262022-12-22T04:29:09ZengFrontiers Media S.A.Frontiers in Behavioral Neuroscience1662-51532022-09-011610.3389/fnbeh.2022.917554917554Association between descending pain modulatory system and cognitive impairment in fibromyalgia: A cross-sectional exploratory studyPaul Vicuña Serrano0Paul Vicuña Serrano1Maxciel Zortea2Maxciel Zortea3Rael Lopes Alves4Rael Lopes Alves5Gerardo Beltran6Gerardo Beltran7Gerardo Beltran8Cibely Bavaresco Deliberali9Amanda Maule10Iraci L. S. Torres11Iraci L. S. Torres12Felipe Fregni13Wolnei Caumo14Wolnei Caumo15Wolnei Caumo16Wolnei Caumo17Post-graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, BrazilLaboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, BrazilLaboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, BrazilDepartment of Psychology, UNISINOS, São Leopoldo/Porto Alegre, BrazilPost-graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, BrazilLaboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, BrazilPost-graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, BrazilLaboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, BrazilInstitute of Neurosciences, Universidad Catolica de Cuenca (UCACUE), Cuenca, EcuadorLaboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, BrazilLaboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, BrazilPost-graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, BrazilLaboratório de Farmacologia da Dor e Neuromodulação: Investigacoes Pre-clinicas, Centro de Pesquisa Experimental (CPE), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, BrazilLaboratory of Neuromodulation and Center for Clinical Research Learning, Department of Physics and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, United StatesLaboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, BrazilLaboratório de Farmacologia da Dor e Neuromodulação: Investigacoes Pre-clinicas, Centro de Pesquisa Experimental (CPE), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, BrazilPain and Palliative Care Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, BrazilDepartment of Surgery, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, BrazilBackgroundThe 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 methodsWe 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.ResultsA 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-η2 = 0.358, P = 0.001), Span digits backward (Partial-η2 = 0.358, P = 0.001), COWAT-orthographic (Partial-η2 = 0.551, P = 0.001), COWAR-semantic (Partial-η2 = 0.355, P = 0.001), and TMTB-A (Partial-η2 = 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.ConclusionBased 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.https://www.frontiersin.org/articles/10.3389/fnbeh.2022.917554/fullfibromyalgiafibrofogcognitive impairmentworking memorydescendant pain modulation system |
| spellingShingle | Paul Vicuña Serrano Paul Vicuña Serrano Maxciel Zortea Maxciel Zortea Rael Lopes Alves Rael Lopes Alves Gerardo Beltran Gerardo Beltran Gerardo Beltran Cibely Bavaresco Deliberali Amanda Maule Iraci L. S. Torres Iraci L. S. Torres Felipe Fregni Wolnei Caumo Wolnei Caumo Wolnei Caumo Wolnei Caumo Association between descending pain modulatory system and cognitive impairment in fibromyalgia: A cross-sectional exploratory study Frontiers in Behavioral Neuroscience fibromyalgia fibrofog cognitive impairment working memory descendant pain modulation system |
| title | Association between descending pain modulatory system and cognitive impairment in fibromyalgia: A cross-sectional exploratory study |
| title_full | Association between descending pain modulatory system and cognitive impairment in fibromyalgia: A cross-sectional exploratory study |
| title_fullStr | Association between descending pain modulatory system and cognitive impairment in fibromyalgia: A cross-sectional exploratory study |
| title_full_unstemmed | Association between descending pain modulatory system and cognitive impairment in fibromyalgia: A cross-sectional exploratory study |
| title_short | Association between descending pain modulatory system and cognitive impairment in fibromyalgia: A cross-sectional exploratory study |
| title_sort | association between descending pain modulatory system and cognitive impairment in fibromyalgia a cross sectional exploratory study |
| topic | fibromyalgia fibrofog cognitive impairment working memory descendant pain modulation system |
| url | https://www.frontiersin.org/articles/10.3389/fnbeh.2022.917554/full |
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