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Fibro Fog and Dyscognition

Otherwise known as "fibro fog," dyscognition is the new medical term researchers are using to describe symptoms related to difficulty concentrating, disorganized thinking, memory problems, and inability to stay focused or alert. According to neuro-psychologist Jennifer Glass, Ph.D., at the University of Michigan, "These cognitive symptoms are often more troubling to the patient than other symptoms."1

Fibro Fog and DyscognitionReviewing the research findings for dyscognition in people with FM and CFS/ME, Glass states, "In the past, some controversy existed over whether the perceived cognitive problems could be demonstrated with objective testing. However, enough evidence has now been found to safely say that objective cognitive deficits can be shown in both CFS and FM patients." Indeed, it is no longer a question of whether you grapple with processes that drain the brain, but rather, the question now being asked is: "What causes dyscognition?"

Glass sites several interesting findings that may form a strong foundation for helping researchers identify the cause of dyscognition in FM patients:

Glass points out that standard neuropsychological tests were designed to detect overall impairments rather than a pattern of cognitive processes that are specific to FM. "For example, FM patients appear to be quite sensitive to the effects of distraction, but most neuropsychologic testing takes place in a distraction-free environment quite different from the hectic world." There is also the possibility that the pain itself may be a distracting factor.

If pain is suspected to play a distracting role that produces the dyscognition in FM, what about sleep? Glass points to early studies in CFS patients that failed to correlate levels of fatigue with degrees of self-reported dyscognition, while recent reports show that mental fatigue does correlate with cognitive dysfunction. This highlights the importance of looking at mental "brain" fatigue as opposed to the general symptom of fatigue, in which the latter could pertain to the muscles or post-exertional malaise. Although the majority of FM patients exhibit symptoms of generalized fatigue, mental fatigue, and disturbed sleep, these components of the disease have not yet been assessed for their potential role in generating dyscognition.

1. Glass JM, Curr Rheum Reps 8:425-9, 2006.
2. Bangert A, et al. Arthritis Rheum 48:S90, abstract # 117, 2003.

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