(119) The Role of Environmental Distractions in the Experience of Fibrofog in Real-World Settings

Abstract

Cognitive problems in fibromyalgia (FM), or “fibrofog,” are highly prevalent but not well-characterized. Research shows that deficits in cognitive performance in FM only emerge in the context of a stimulating testing environment, suggesting a potentially important role for distraction in the experience of both subjective (perceived) and objective (performed) fibrofog. Unexplored to date is the role of real-world distractions in fibrofog in everyday life. To address limitations in our understanding of fibrofog in daily life, we conducted a study of ambulatory subjective and objective cognitive function in a sample of adults with FM and age-, sex-, and education-matched healthy controls (HC) to test the hypotheses that: 1) people with FM report environmental distractions at a higher rate than HCs; and 2) relative to HCs, people with FM show steeper declines in subjective and objective cognitive functioning in the context of real-world distraction. Fifty adults with FM and 52 controls (N=102) completed ecological momentary assessments of perceived cognitive dysfunction on a numerical rating scale of 0-100 and cognitive tests of processing speed (Symbol Search) and working memory (Dot Matrix) via a smartphone app, 5X/day for 8 consecutive days. After each cognitive testing session, participants were asked whether they were distracted by anything in the environment during testing. Consistent with expectations, the FM group reported distractions during ambulatory tests at a higher rate (41.1% of tests) compared to the HCs (30.0% of tests; χ2=45.20, p