title: Associations Between Cognitive Performance and Pain in Chronic Fatigue Syndrome: Comorbidity with Fibromyalgia Does Matter.
abstract: BACKGROUND
  In addition to the frequently reported pain complaints, performance-based cognitive capabilities in patients with chronic fatigue syndrome (CFS) with and without comorbid fibromyalgia (FM) are significantly worse than those of healthy controls. In various chronic pain populations, cognitive impairments are known to be related to pain severity. However, to the best of our knowledge, the association between cognitive performance and experimental pain measurements has never been examined in CFS patients.
  
  
  OBJECTIVE
  This study aimed to examine the association between cognitive performance and self-reported as well as experimental pain measurements in CFS patients with and without FM.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  The present study took place at the Vrije Universiteit Brussel and the University of Antwerp.
  
  
  METHODS
  Forty-eight (18 CFS-only and 30 CFS+FM) patients and 30 healthy controls were studied. Participants first completed 3 performance-based cognitive tests designed to assess selective and sustained attention, cognitive inhibition, and working memory capacity. Seven days later, experimental pain measurements (pressure pain thresholds [PPT], temporal summation [TS], and conditioned pain modulation [CPM]) took place and participants were asked to fill out 3 questionnaires to assess self-reported pain, fatigue, and depressive symptoms.
  
  
  RESULTS
  In the CFS+FM group, the capacity of pain inhibition was significantly associated with cognitive inhibition. Self-reported pain was significantly associated with simple reaction time in CFS-only patients. The CFS+FM but not the CFS-only group showed a significantly lower PPT and enhanced TS compared with controls.
  
  
  CONCLUSIONS
  The cross-sectional nature of this study does not allow for inferences of causation.
  
  
  CONCLUSIONS
  The results underline disease heterogeneity in CFS by indicating that a measure of endogenous pain inhibition might be a significant predictor of cognitive functioning in CFS patients with FM, while self-reported pain appears more appropriate to predict cognitive functioning in CFS patients without FM.
authors.affiliation: Pain in Motion Research Group (www.paininmotion.be).
authors.forename: Kelly
authors.initials: K
authors.lastname: Ickmans
authors.affiliation: 1Pain in Motion Research Group (www.paininmotion.be); Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium.
authors.forename: Mira
authors.initials: M
authors.lastname: Meeus
authors.affiliation: Pain in Motion Research Group (www.paininmotion.be); Department of Human Physiology and Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium; Department of Neurology, Faculty of Medicine, University of Antwerp, Antwerp, Belgium.
authors.forename: Margot
authors.initials: M
authors.lastname: De Kooning
authors.affiliation: Private practice for internal medicine, Ghent, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Lambrecht
authors.affiliation: Department of Human Physiology and Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; VIPER Research Unit, Royal Military Academy, Brussels, Belgium.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Pattyn
authors.affiliation: Pain in Motion Research Group (www.paininmotion.be); Department of Human Physiology and Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium;
authors.forename: Jo
authors.initials: J
authors.lastname: Nijs
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003071:Cognition; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000523:psychology; D015673:Fatigue Syndrome, Chronic / Q000150:complications* / Q000523:psychology*; D005260:Female; D005356:Fibromyalgia / Q000150:complications* / Q000523:psychology*; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D008875:Middle Aged; D009483:Neuropsychological Tests; D010146:Pain / Q000150:complications* / Q000523:psychology*; D010147:Pain Measurement; D017288:Pain Threshold; D011597:Psychomotor Performance; D011930:Reaction Time / Q000502:physiology