Background & Aims
Interoception, the ability to detect and interpret body signals is essential to orchestrate homeostasis, emotional and cognitive responses and behavior selection. In chronic pain patients, impaired ability to detect, represent, and regulate internal bodily states may have deleterious consequences in managing pain and other related symptoms. For example, in Fibromyalgia, a condition that has pain, fatigue, sleep problems, cognitive disorders has core symptoms, interoceptive deficits have been reported. It has been argued that this is related to emotional state, impacting regulation of body states. While the relationship between interoception, emotional processing and symptoms in this condition has been studied, less attention has been devoted to investigating the relationship between interoception and cognitive deficits found in this condition. The current study aims to investigate the relationship between interoceptive dimensions and the cognitive functioning of Fibromyalgia patients.
Methods
Patients with fibromyalgia were recruited and assessed by rheumatologists for confirmation of inclusion and exclusion criteria. Patients underwent a comprehensive assessment of sociodemographic, clinical, and psychological characteristics using a battery of questionnaires. Subsequently, they completed a cognitive assessment consisting of two neuropsychological tasks: Digit-span and Stroop Test. Afterward, three Interoceptive dimensions were assessed: Interoception Accuracy was measured by the heartbeat counting task (IA), Interoception Awareness was assessed by rating confidence on the heartbeat counting (IAw), and Interoception Sensibility (IS) was measured by the Multidimensional Assessment of Interoceptive Awareness questionnaire. Correlations and linear regressions were applied to assess relationships between cognitive performance and different Interoception dimensions.
Results
Twenty-nine female patients diagnosed with Fibromyalgia completed the protocol. We found correlations between IA, measured by the heartbeat counting task with the performance of the two cognitive tasks, specifically, with Digit-span direct (r=0.491, p=0.007) and total Digit-span (r=0.524, p=0.004), Stroop word (r=0.449, p=0.02), colour (r=0.522, p=0.007), and inhibition tasks (r=0.688, p<0.001). On the other hand, negative correlations found between the self-reported IS dimensions of Attention regulation (r=-.505, p=.006), Self-regulation (r=-.434, p=.021), and Trusting (r=-.412, p=.029) with the digit-span inverse task. There were no correlations between IAw and cognitive tasks. Years of diagnosis and symptoms duration were correlated with IS Attention regulation (rs=0.429, p=0.047), Self-regulation (rs=0.602, p=0.003), and Trusting (rs=0.461, p=0.031) and IAw average confidence (rs=0.444, p=0.020). No other clinical or psychological characteristic correlated to the cognitive tasks.
Conclusions
This study explored the relations between interoception and cognitive functioning in Fibromyalgia patients. Patients with a higher ability to detect and report cardiac signals had higher cognitive functioning, notably higher inhibitory control. Moreover, patients who self-reported better interoceptive attention, regulation, and trust in their body signals performed lower performance on an external attention task. The study highlights the need to separate the ability to detect and use body signals from the ability to regulate them. While the first may be essential for self-regulation, managing cognitive tasks, the second may impose challenges to the resources needed to perform these cognitive tasks. Given the significant impact cognitive deficits in chronic pain patients, further studies on the relationship between interoceptive abilities and cognition is essential to detail these relations and develop strategies to help patients use inner insights to overcome these deficits.
References
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Presenting Author
Mariana Agostinho
Poster Authors
Mariana Agostinho
Master
University of Haifa & Universidade Católica Portuguesa
Lead Author
Manuel Luís Capelas
Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, Lisbon, Portugal
Lead Author
Fernando Pimentel dos Santos
Nova Medical School, CHRC Campus, Lisbon, Portugal. e Hospital Egas Moniz – ULS Lisboa Ocidental.
Lead Author
Rita Canaipa
Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, Lisbon, Portugal
Lead Author
Topics
- Specific Pain Conditions/Pain in Specific Populations: Fibromyalgia