Cognitive deficits in fibromyalgia syndrome are associated with pain responses to low intensity pressure stimulation

PLoS One. 2018 Aug 1;13(8):e0201488. doi: 10.1371/journal.pone.0201488. eCollection 2018.


Background: Fibromyalgia syndrome (FMS) is a chronic disorder characterized by widespread musculoskeletal pain and diffuse tenderness, accompanied by complaints including morning stiffness, fatigue, insomnia and affective symptoms. In addition, affected patients frequently experience cognitive impairments such as concentration difficulties, forgetfulness or problems in planning and decision-making. These deficits are commonly ascribed to interference between nociceptive and cognitive processing.

Method: The present study investigated the association of cognitive performance with (a) pain responses to low intensity pressure stimulation (0.45-2.25 kg/cm2), (b) responses to stronger (above-threshold) stimulation (2.70 kg/cm2), and (c) pain threshold and tolerance in 42 women with FMS. Tests of attention, memory, processing speed, and executive functions were applied.

Results: While no significant correlations were seen for pain threshold and pain tolerance, inverse associations arose between pain intensity ratings during pressure stimulation and performance in all evaluated cognitive domains. The magnitude of the correlations increased with decreasing stimulus intensity.

Conclusions: It may be concluded that pain experience during somatosensory stimulation of low intensity is more closely related to attention, memory and executive functions in FMS than the traditional measures of pain threshold and pain tolerance. Considering that pain responses to low intensity stimulation reflect the hyperalgesia and allodynia phenomena characterizing FMS, it may be hypothesized that central nervous pain sensitization is involved in cognitive impairments in the disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cognitive Dysfunction / complications*
  • Cognitive Dysfunction / physiopathology
  • Executive Function
  • Female
  • Fibromyalgia / complications*
  • Fibromyalgia / physiopathology
  • Humans
  • Hyperalgesia / complications*
  • Hyperalgesia / physiopathology
  • Middle Aged
  • Pain Threshold
  • Pressure

Grant support

This research was supported by a grant from the Spanish Ministry of Science and Innovation co-financed by FEDER funds (Project PSI2015-69235P) and a FPU pre-doctoral contract (ref: FPU2014-02808) from a grant from the Spanish Ministry of Education, Culture and Sport. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.