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Archives of Clinical Neuropsychology Advance Access originally published online on March 11, 2009
Archives of Clinical Neuropsychology 2009 24(1):113-122; doi:10.1093/arclin/acp014
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© The Author 2009. Published by Oxford University Press on behalf of the National Academy of Neuropsychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Executive Function and Decision-Making in Women with Fibromyalgia

Antonio Verdejo-Garcíaa,b,c,*, Francisca López-Torrecillasb,c, Elena Pita Calandreb,d, Antonia Delgado-Rodríguezb,e and Antoine Becharaf

a Pharmacology Research Unit, Institut Municipal dInvestigació Mèdica, Barcelona, Spain
b Institute of Neurosciences F. Olóriz, Universidad de Granada, Granada, Spain
c Department Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Granada, Granada, Spain
d Department Farmacología, Universidad de Granada, Granada, Spain
e Department Medicina Legal, Toxicología y Psiquiatría, Universidad de Granada, Granada, Spain
f Brain and Creativity Institute, University of Southern California, Los Angeles, CA, USA

* Corresponding author at: Pharmacology Research Unit, Institut Municipal dInvestigació Mèdica (IMIM), Barcelona Biomedical Research Park, Dr. Aiguader 88, 08003 Barcelona, Spain. Tel.: +34 958242948; fax: +34 958243749. E-mail address: averdejo{at}imim.es (A. Verdejo-Garcia).


  Abstract

Patients with fibromyalgia (FM) typically report cognitive problems, and they state that these deficits are disturbing in everyday life. Despite these substantial subjective complaints by FM patients, very few studies have addressed objectively the effect of such aversive states on neuropsychological performance. In this study we aimed to examine possible impairment of executive function and decision-making in a sample of 36 women diagnosed with FM and 36 healthy women matched in age, education, and socio-economic status. We contrasted performance of both groups on two measures of executive functioning: the Wisconsin Card Sorting Test (WCST), which assesses cognitive flexibility skills, and the Iowa Gambling Tasks (IGT; original and variant versions), which assess emotion-based decision-making. We also examined the relationship between executive function performance and pain experience, and between executive function and personality traits of novelty-seeking, harm avoidance, reward dependence, and persistence (measured by the Temperament and Character Inventory-Revised). Results showed that on the WCST, FM women showed poorer performance than healthy comparison women on the number of categories and non-perseverative errors, but not on perseverative errors. FM patients also showed altered learning curve in the original IGT (where reward is immediate and punishment is delayed), suggesting compromised emotion-based decision-making; but not in the variant IGT (where punishment is immediate but reward is delayed), suggesting hypersensitivity to reward. Personality variables were very mildly associated with cognitive performance in FM women.

Keywords Fibromyalgia; Executive functions; Decision-making; Pain; Cognition; Emotion; Personality

Accepted: September 26, 2008


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