title: Executive function in fibromyalgia: Comparing subjective and objective measures.
abstract: BACKGROUND
  There is evidence to suggest the existence of an executive dysfunction in people diagnosed with fibromyalgia, although there are certain inconsistencies between studies. Here, we aim to compare executive performance between patients with fibromyalgia and a control group by using subjective and objective cognitive tests, analyzing the influence of patient mood on the results obtained, and studying associations between the two measures.
  
  
  METHODS
  82 patients diagnosed with fibromyalgia and 42 healthy controls, matched by age and years of education, were assessed using the Behavioral Rating Inventory of Executive Function - Adult Version (BRIEF-A) as a subjective measure of executive functioning. A selection of objective cognitive tests were also used to measure a series of executive functions and to identify symptoms of depression and anxiety.
  
  
  RESULTS
  Patients with fibromyalgia perceived greater difficulties than the control group on all of the BRIEF-A scales. However, after adjustments were made for depression and anxiety the only differences that remained were those associated with the working memory scale and the Metacognition and Global Executive Composite index. In the case of the objective cognitive tests, a significantly worse overall performance was evidenced for the fibromyalgia patients. However, this also disappeared when adjustments were made for depression and anxiety. After this adjustment, fibromyalgia patients only performed significantly worse for the interference effect in the Stroop Test. Although there were no significant associations between most of the objective cognitive tests and the BRIEF-A scales, depression and anxiety exhibited strong associations with almost all of the BRIEF-A scales and with several of the objective cognitive tests.
  
  
  CONCLUSIONS
  Patients with fibromyalgia showed executive dysfunction in subjective and objective measures, although most of this impairment was associated with mood disturbances. Exceptions to this general rule were observed in the impairment of working memory evidenced on the BRIEF-A scale and the inhibition impairment exhibited by the interference effect from the Stroop Test. The two types of measurement provide different yet complementary information.
authors.affiliation: Clinical Research Group for Brain, Cognition and Behavior, Consorci Sanitari de Terrassa, Terrassa, Spain; University of Lleida, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Gelonch
authors.affiliation: Clinical Research Group for Brain, Cognition and Behavior, Consorci Sanitari de Terrassa, Terrassa, Spain; Neuropsychology Unit, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Spain.
authors.forename: Maite
authors.initials: M
authors.lastname: Garolera
authors.affiliation: Institute of Biomedical Research of Lleida, IRB-Lleida, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Valls
authors.affiliation: Rheumatology Section, Fibromyalgia and Chronic Fatigue Syndrome Unit, Hospital Universitari de Santa Maria, Lleida, Spain.
authors.forename: Lluís
authors.initials: L
authors.lastname: Rosselló
authors.affiliation: University of Lleida, Spain; Institute of Biomedical Research of Lleida, IRB-Lleida, Spain. Electronic address: pifarre1@comll.cat.
authors.forename: Josep
authors.initials: J
authors.lastname: Pifarré
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D001007:Anxiety / Q000523:psychology; D016022:Case-Control Studies; D003071:Cognition; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D056344:Executive Function; D005260:Female; D005356:Fibromyalgia / Q000523:psychology*; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D013060:Speech; D057190:Stroop Test; D014145:Trail Making Test; D014825:Vocabulary; D055815:Young Adult