A relação entre sensibilidade, modulação e variabilidade da dor, e desempenho cognitivo na Fibromialgia

Abstract

Pain studies face the difficulties inherent in pain being a complex, subjective and difficult experience to measure. The Focused Analgesia Selection Test (FAST) was developed to improve pain assessment by studying the variability in pain reports.However, the reasons for the differences in performance in this paradigm and the underlying cognitive mechanisms remain unclear. The present research aims to study the relationship between pain variability, sensitivity and modulation and the importance of executive functions in these mechanisms. Twenty-nine participants with fibromyalgia and fifteen healthy participants were studied through an executive function assessment task, the StroopTest, and a pain assessment protocol that included variability, measured by FAST,sensitivity, measured by thresholds of different modalities (electrical, thermal and pressure) and thermal tolerance, as well as modulation measured through the Conditioned Pain and Temporal Summing Paradigm. Clinical characteristics were also evaluated through the Brief Pain Inventory, Fibromyalgia Impact Questionnaire, FACIT, Hospital Depression and Anxiety Scale and Health Status Questionnaire. The results showed that participants with fibromyalgia, despite having greater sensitivity to pain, showed less variability in pain reports, that is, they were more accurate in pain assessment than those in the control group. There were no differences between groups related to sensitivity and modulation measures. At the cognitive level, the executive function task used did not detect systematic differences between pain groups or mechanisms. Variability in pain reports seems to be a specific skill that may be related to prolonged exposure to pain rather than sensitivity and modulation. Further studies are needed to investigate the role of executive functions in this competence.

Date of Award	18 Nov 2020
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Rita Canaipa (Supervisor)