Most people with fibromyalgia (FM) report “fibrofog”, or cognitive dysfunction. To better characterize fibrofog in daily life, we conducted an ambulatory study of subjective and objective cognitive function in real-world settings in persons with FM and sex-, age-, and education-matched healthy controls (HC) to test whether: 1) people with FM demonstrate poorer cognitive function on ambulatory measures; 2) people with FM demonstrate a different diurnal pattern of cognitive function; and 3) subjective cognitive function corresponds more highly with objective cognitive measures in HC compared to FM. Participants (N=102; nFM=50; nHC=52) completed ecological momentary assessments of perceived cognitive function (perceived clarity and speed) 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 at 5 quasi-random times/day for 8 days. The FM group scored significantly lower than HC on measures of self-reported cognitive functioning, as well as on objective measures of processing speed and working memory. Results from multilevel models showed that both groups demonstrated similar diurnal patterns for objective measures of working memory, which was stable across the day, and objective processing speed, which was slowest at wake- and bed-times and fastest midday. For both groups, perceived cognitive dysfunction was highest upon waking and improved across the day; however, the HC group showed a significantly steeper rate of improvement. Perceived cognitive dysfunction corresponded only with processing speed, not working memory, and there were no group differences in these associations. Findings for ambulatory subjective and objective cognitive function in FM are generally consistent with findings from lab-based studies; the FM group demonstrated relatively worse cognitive functioning, but diurnal patterns and associations between objective/subjective functioning were similar to HC.
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