Subjective Cognitive Dysfunction in Patients With and Without Fibromyalgia: Prevalence, Predictors, Correlates, and Consequences, 2022, Wolfe et al

Abstract

Background: Subjective cognitive dysfunction (SCD) is common in fibromyalgia (FM), where it has been called 'fibrofog.' But its predictors and correlates are not well understood, including the extent to which SCD is present in fibromyalgia and non-fibromyalgia clinical populations. In addition, there are no studies available concerning SCD and fibromyalgia in the general population. We investigated these issues in a longitudinal rheumatic disease research databank and two cross-sectional general population studies.

Methods: 11,150 unselected patients with rheumatoid arthritis completed an assessment of FM and cognitive severity (CS) status using the full 0-3 fibromyalgia 2016 criteria assessment. In addition, CS was dummy coded as present/absent (CS+). Assessments of SCD and fibromyalgia prevalence were available in two German general population studies.

Results: Fibromyalgia was present (FM+) in 2,493 (21.7%) of clinical subjects and absent (FM-) in 9,017 (78.3%) by FM 2016 criteria. Cognitive severity was present in 1,304 (52.3%) of those with fibromyalgia and 1,009 (11.2%) of non-fibromyalgia subjects (FM-). In two general population studies, 42.0% to 52.3% of those with fibromyalgia were CS+ as were 1.4% to 5.5% of FM- subjects. Patients with CS+ had more abnormal scores for every measure of rheumatoid arthritis (RA) severity, fibromyalgia severity, and general health. The presence of CS+ was strongly related to somatic and non-somatic symptoms scores and less strongly to pain variables. The best predictor of CS+ in the clinic and the general population was the symptom severity scale (SSS), a criterion of fibromyalgia.

Conclusions: Persons with SCD have high counts of somatic and psychological symptoms. Subjective cognitive dysfunction is best predicted by a simple symptoms score, and not by pain extent scores. Although SCD is called fibrofog in patients with FM, 43.6% of CS+ cases occurred in FM- subjects. Fibromyalgia and CS are correlated but appear to be different parts of a symptom severity continuum. 'Fibrofog' as a phenomenon linked only to fibromyalgia is a misnomer because it can be identified in many non-fibromyalgia patients as well.

Open access, https://www.cureus.com/articles/793...alence-predictors-correlates-and-consequences

 

It's disappointing that standards are this low in medical research. This person could have done a minimum effort to research this and would have easily found that brain fog, and cognitive dysfunction in general, is a common symptom of chronic illness. This goes well beyond this. And of course how similar it seems to be to "chemo brain", which appears very similar.

But if they restricted that search to academic sources, there would probably be nothing there because it's so dysfunctional that there isn't even a name for it. Systemic failures are so much fun!

 

I'm confused. This paper refers to Subjective Cognitive Dysfunction. Who is declaring it to be subjective? The patient or the researcher?

 

I am not fond of the first author (Frederick Wolfe) of the referenced study above. Here is another paper he contributed to: (re: Somatic Symptom Disorder, Body Distress Syndrome and Fibromyalgia)

https://pubmed.ncbi.nlm.nih.gov/32305723/

For the record, Frederick Wolfe decried giving PwFM that diagnosis, on the basis of harming society, (or something...?).