Article information
Introducción
El deterioro cognitivo en los pacientes con dolor crónico es hoy día un tema de gran interés clínico, debido a que estas personas con frecuencia se quejan de problemas cognitivos.
ObjetivoInvestigar las capacidades de atención, perceptivas y de memoria visuoespacial en los pacientes con dolor crónico en comparación con un grupo control y evaluar si entre estos pacientes hay diferencias, teniendo en cuenta las características de la propia enfermedad y la capacidad de reserva cognitiva.
Material y métodosSe seleccionó a 2 grupos de pacientes, enfermos de fibromialgia y artritis reumatoide con corta duración de la enfermedad, y se los comparó con un grupo control. Todos los sujetos completaron un protocolo de exploración de memoria visual y espacial, velocidad de procesamiento, memoria de trabajo, visuopercepción, atención y orientación. Para todos ellos se obtuvo una medida de reserva cognitiva.
ResultadosLos pacientes con dolor crónico presentan una peor ejecución cognitiva que los controles. Los pacientes con artritis ejecutan la tarea peor que los de fibromialgia cuando requiere mayor velocidad de procesamiento visuomotor y un déficit en la integración en tareas visuoperceptivas. Los enfermos de fibromialgia obtuvieron peores puntuaciones en las tareas de memoria espacial y orientación.
ConclusionesLos pacientes aquejados de fibromialgia y artritis tienen déficit aun cuando la cronicidad de la enfermedad sea breve. Dicho déficit parece no explicarse por efectos colaterales de dichas afecciones, ya que los perfiles cognitivos no son similares y aparecen desde el inicio de la enfermedad.
Palabras clave:
Alteraciones neuropsicológicas
Artritis reumatoide
Fibromialgia
Memoria
Neuropsicología
Reserva cognitiva
Introduction
Cognitive disturbance in patients with fibromyalgia and rheumatoid arthritis is today a topic of a great clinical interest, largely due to the fact that these persons often complain about cognitive problems.
ObjectiveThis study is aimed to assess the visuospatial memory, attention and perceptive capacities in chronic pain patients.
Material and methodsGroups were constituted by fibromyalgia patients and rheumatoid arthritis patients, as well as a control group.
All the subjects completed a battery of visual and spa-tial memory, speed of processing, working memory, attention, orientation and visuoperceptive abilities. A cognitive reserve measurement was obtained.
ResultsResults show that chronic pain patients displayed worse cognitive performance than controls. Moreover, arthritis patients execute poorly when compared to the group of fibromyalgia in tasks that demand visuoperceptive integration and visuomotor processing. Patients suffering fibromyalgia obtained worse punctuations than those with arthritis in spatial memory and spatial orientation tasks.
ConclusionsBoth groups developed important cognitive deficits, which cannot be explained by the collateral effects of such pathologies, because cognitive profiles are not similar and appear from the beginning of the disease.
Key words:
Neurpsycologic alterations
Rheumatoid arthritis
Fibromyalgia
Memory
Neuropsycology
Cognitive reserve
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Parte de este trabajo ha sido financiado por el proyecto SEJ2005-05067/PSIC
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