By: Dr Alex Robber
The most common (and well-known) signs of fibromyalgia include muscle pain and fatigue. However, the disorder also includes a range of symptoms which affect memory, attention and concentration, collectively known as dyscognition.
Dyscognition may be “more impaired than chronic pain,” writes the authors of the study, but is mostly understated or undertreated. They concluded that the higher FIQ-R scores “may probably be due to both the dyscognition effect and the higher anxiety and/or depression levels in patients with unrecognized adult ADHD.”
Patients with FMS have impaired pain responsive neurotransmitter function such as dopamine, serotonin, and no adrenaline. Similarly, ADHD is also associated with impaired memory and abnormal neurotransmitters, a chronic neurodevelopment condition.
Attention-deficit hyperactivity disorder (ADHD)
Attention-deficit hyperactivity disorder (ADHD) tends to be more common in women with fibromyalgia than those without this condition and those patients tend to have more impulsive behavioral occurrences. A research was published in the journal Neuropsychiatric Disorder and Treatment with those findings, “Attention-deficit hyperactivity disorder and impulsivity in female patients with fibromyalgia.”
Fibro fog is normal in patients with fibromyalgia, causing symptoms such as mental confusion, difficulty concentrating and remaining alert, loss of memory and pain in speech. Such cognitive deficits are close to those of ADHD, marked by persistent loss of concentration and/or impulse-hyperactivity. Notably, there is a marked prevalence of fibromyalgia in ADHD patients.
What the Fibro-ADHD Study Found
Over 100 people with fibromyalgia have been tested for adult ADHD in this sample by taking a screening questionnaire produced by the World Health Organization (WHO). Such questions include elements on this 18-question screening tool:
- How often do you make careless mistakes when you must work on a boring or difficult project?
- How often do you misplace or have difficulty finding things at home or at work?
- When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
- Participants also had their cognition evaluated.
What the researchers found is that a whopping 45 percent of fibromyalgia individuals tested for adult ADHD positive. Some of the individuals with ADHD understood at some point that they had a difficulty disclosing cognitive dysfunction in greater numbers than those without the illness that affected them. The results of this study have appeared in November 2017 in the journal Pain Medicine.
Evidence suggests the involvement of the central nervous system
Increasing evidence indicates the involvement of the central nervous system in both cases, particularly neurotransmitters of adrenaline and dopamine. Furthermore, case studies indicate that treatment with the ADHD drug atomoxetine, which does not increase levels of neither adrenaline outside cells, is an effective strategy for relieving fibromyalgia-related pain. Research has suggested that it is highly prevalent in patients with fibromyalgia as regards impulsive behavior, but the available data are still sparse.
The researchers evaluated 78 people in control group with fibromyalgia (mean age 40.3 years) and 54 healthy individuals. Symptoms of fibromyalgia had been present at a similar degree for at least three months, including severe pain.
The results showed that 23 patients with fibromyalgia (29.5 percent) and four healthy controls (7.4 percent) had ADHD. Interestingly, in adulthood, 66 percent of people diagnosed with ADHD still had the condition. Importantly, 33.3 percent of patients with fibromyalgia but only 11.1 percent of controls already had ADHD in infancy and adolescence, as gleaned from the subjects ‘ details.
The findings also found that patients with fibromyalgia had higher scores than controls in tests of attention deficit, hyperactivity and impulsiveness, through an adult self-report evaluation. While there were no differences in impulsiveness defined as acting without thinking patients with fibromyalgia scored higher in specific sub-scales due to lack of planning
Both adult and childhood ADHD are quite common in female fibromyalgia patients
“The present study has shown that in female patients with fibromyalgia, both adult and childhood ADHD are quite common,” the researchers wrote. “The high frequency of both childhood and adult ADHD among patients with fibromyalgia indicates that ADHD could be a predictor of future development of fibromyalgia,” they added.
Although they acknowledged that the correlation indicates that at least one fibromyalgia subgroup may share the same causes as ADHD, the scientists said it would be important in future research to determine whether the fibromyalgia-impulsiveness is correlated with ADHD.
Ask your doctor for a screening test
The researchers say you should be tested for adult ADHD if you have fibromyalgia. “The significant impact of likely adult ADHD suggests that all FMS patients should be tested for a comorbid adult ADHD,” concludes the report. The WHO screening questionnaire can be provided by your primary care provider. If you test positive, a neurologist or psychiatrist would then evaluate you before you receive a formal diagnosis.
Treatments can help
There are methods people with ADHD can use to compensate for some of their cognitive issues, according to the nonprofit organization Children and Adults with Attention-Deficit / Hyperactivity Disorder. Some of these include arranging your workspace regularly to eliminate distractions or break each task into smaller steps and rewarding yourself for completing one. Adults with ADHD often benefit from cognitive behavioral therapy or from hiring a personal trainer to help set realistic goals.
Medicinal drugs including stimulants or antidepressants may help with ADHD. Van Rensburg states that some case studies show that in addition to enhancing cognitive symptoms, the psychostimulant Ritalin (methylphenidate) also tends to support fibromyalgia pain. Clinical trials are required to confirm this, but you may wish to discuss this drug with your doctor.
A study with those findings, “Attention-deficit hyperactivity disorder and impulsivity in female patients with fibromyalgia,” was published in the journal Neuropsychiatric Disease and Treatment.
ADHD More Common in Women with Fibromyalgia, Study Shows BY JOSE MARQUES LOPES, PHD via Fibromyalgia News Today