Exploring the neuropsychological profile of patients with fibromyalgia with insights from pain, psychological, and clinical predictors.

Objective: Dyscognition is a frequently overlooked symptom in fibromyalgia (FM) that negatively impacts functioning and contributes to disability. Previous research has substantiated these complaints but lacks a comprehensive assessment battery to establish a neuropsychological profile. Further, the factors contributing to their genesis remain poorly understood. This study aimed to characterize the cognitive profile of FM participants compared to healthy controls using an inclusive battery of neuropsychological measures and to explore the contribution of pain, psychological, and clinical variables in explaining this profile among FM participants.

Method: For this purpose, 33 FM participants and 32 age- and sex-matched healthy controls completed 17 cognitive tests measuring five broad domains. Participants also completed tests measuring pain sensitivity, endogenous pain modulation, and questionnaires on spontaneous pain severity, interference, and psychological and clinical characteristics.

Results: Compared to controls, FM participants reported elevated levels of depression, anxiety, alexithymia, and pain catastrophizing, alongside lower sleep quality and quality of life. They also reported higher spontaneous pain severity and interference, demonstrated heightened sensitivity to evoked pain, and reduced pain modulation. Moreover, our analysis identified a distinct cognitive profile in FM participants, characterized by poorer performance in memory and executive function measures. Elevated spontaneous pain severity and poor sleep quality emerged as key predictors of this cognitive profile.

Conclusions: The present study offers insights into the cognitive profile of FM and substantiates the factors involved in its development. These findings contribute to explaining the high prevalence of dyscognition in FM and suggest multiple treatment targets for addressing these symptoms. (PsycInfo Database Record (c) 2025 APA, all rights reserved).