• Kevin Pacheco-Barrios, Paulo E P Teixeira, Daniela Martinez-Magallanes, Moacir Silva Neto, Elly Angelica Pichardo, Lucas Camargo, Daniel Lima, Alejandra Cardenas-Rojas, and Felipe Fregni.
• Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Charlestown, MA, United States.
• Pain Med. 2024 Apr 23.

BackgroundThe different clinical presentations of fibromyalgia (FMS) may play independent roles in the unclear etiology of cognitive impairments and depressive symptoms seen in this population. Understanding how these clinical presentations are associated with FMS's clinical and neurophysiological aspects is important when developing effective treatments.AimTo explore the relationship between memory complaints and depressive symptoms, and the different clinical and neurophysiological characteristics of FMS.MethodsCross-sectional data analysis from a randomized clinical trial. Baseline demographics, physical fitness, sleep, anxiety, depression, cortical excitability, and pain (clinical and mechanistic) data from 63 FMS subjects were used. Multiple linear and logistic association models were constructed.ResultsFinal regression models including different sets of predictions were statistically significant (p < 0.001), explaining approximately 50% of the variability in cognitive complaints and depression status. Older subjects had higher levels of anxiety, poor sleep quality, lower motor threshold, and higher relative theta power in the central area, are more likely to have clinical depression. Higher anxiety, pain and theta power were associated with an increase memory complaint.ConclusionDepression symptoms seem to be associated with TMS-indexed motor threshold and psychosocial variables, while memory complaints are associated with pain intensity and higher theta oscillations. These mechanisms may be catalyzed and/or triggered by some behavioral and clinical features such as older age, sleep disruption, and anxiety. The correlation with clinical variables suggests the increasing of theta oscillations is a compensatory response in patients with FMS, which can be explored in future studies to improve the treatment for FMS.© The Author(s) 2024. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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