Niveles de cortisol sérico y alteraciones neuropsicológicas en pacientes con diagnóstico de Fibromialgia
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Fecha
2018
Autores
Barceló-Martinez, Ernesto
Gelves-Ospina, Melissa
Navarro Lechuga, Edgar
Allegri, Ricardo F.
Orozco-Acosta, Erick
Benítez-Agudelo, Juan C.
León-Jacobus, Alexandra
Román, Néstor F.
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Fundación Dialnet
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Objetivo: Describir la relación entre variables neuropsicológicas y niveles de cortisol sérico; como una medida de estrés fisiológico; en pacientes con fibromialgia.
Metodología: Se seleccionó intencionalmente una muestra de 60 mujeres: 30 con diagnóstico de Fibromialgia y 30 controles normales. Se determinaron los niveles de cortisol mediante dos muestras de sangre (AM y PM) y se realizó una batería neuropsicológica y emocional, con un protocolo estandarizado en población colombiana para evaluar diferentes dominios cognitivos. Se hicieron análisis comparativo y correlacional no paramétrico, un análisis de regresión múltiple para determinar influencias entre las variables.
Resultados: Se encontraron diferencias significativas entre los grupos de estudio en las variables neuropsicológicas (atención, memoria, lenguaje, praxis viso-constructiva y funciones ejecutivas (FE), (p<0,05), obteniendo mejores puntajes el grupo control. Se hallaron correlaciones significativas entre el perfil de cortisol, con falsos reconocimientos del test de aprendizaje auditivo verbal de Rey y con errores perseverativos del test de Wisconsin. El análisis de regresión múltiple predice la influencia de las variables de memoria y FE en el perfil de cortisol en un 88,7%.
Conclusiones: Los hallazgos demuestran que, en pacientes con FM, existen alteraciones neuropsicológicas, principalmente en funcionamiento ejecutivo (flexibilidad cognitiva) y memoria episódica (evocación y almacenamiento). Igualmente, la disfunción ejecutiva está relacionada con el estrés fisiológico de manera recíproca y a su vez son condicionadas por alteraciones emocionales como síntomas de depresión, lo cual soporta el modelo neurofisiológico que compromete el eje hipotálamo-hipófisis-adrenal y la corteza pre-frontal, rica en receptores de córticoesteroides.
Objective: Describe the relation between neuropsychological variables and serum cortisol levels, as a measure of physiological stress, in patients with fibromyalgia. Methodology: A sample of 60 women was intentionally selected: 30 with fibromyalgia diagnosis and 30 with normal controls. Levels of cortisol were determined through two blood sample (AM y PM) and a neuropsychological and emotional battery was applied, with a standardized protocol in Colombian population to evaluate different cognitive domains. A non-parametric comparative and correlational analysis, a multiple regression analysis, were used to determine influences among the variables. Results: Significant differences were found between the study groups in the neuropsychological variables (attention, memory, language, visual-constructive praxis and executive functions (EF)), (p <0.05), obtaining better scores in the control group. Significant correlations were found between the cortisol profile, with false acknowledgments of Rey auditory-verbal learning test and with persevering errors of the Wisconsin test. The multiple regression analysis predicts the influence of memory and EF variables on the cortisol profile by 88.7%. Conclusions: The findings demonstrate that in patients with FM, there are neuropsychological alterations, mainly in executive functioning (cognitive flexibility) and episodic memory (evocation and storage). Likewise, executive dysfunction is related to physiological stress reciprocally and at the same time are conditioned by emotional alterations such as depression, which supports the neurophysiological model that compromises the hypothalamic-pituitary-adrenal axis and the prefrontal cortex, which is rich in corticosteroid receptors.
Objective: Describe the relation between neuropsychological variables and serum cortisol levels, as a measure of physiological stress, in patients with fibromyalgia. Methodology: A sample of 60 women was intentionally selected: 30 with fibromyalgia diagnosis and 30 with normal controls. Levels of cortisol were determined through two blood sample (AM y PM) and a neuropsychological and emotional battery was applied, with a standardized protocol in Colombian population to evaluate different cognitive domains. A non-parametric comparative and correlational analysis, a multiple regression analysis, were used to determine influences among the variables. Results: Significant differences were found between the study groups in the neuropsychological variables (attention, memory, language, visual-constructive praxis and executive functions (EF)), (p <0.05), obtaining better scores in the control group. Significant correlations were found between the cortisol profile, with false acknowledgments of Rey auditory-verbal learning test and with persevering errors of the Wisconsin test. The multiple regression analysis predicts the influence of memory and EF variables on the cortisol profile by 88.7%. Conclusions: The findings demonstrate that in patients with FM, there are neuropsychological alterations, mainly in executive functioning (cognitive flexibility) and episodic memory (evocation and storage). Likewise, executive dysfunction is related to physiological stress reciprocally and at the same time are conditioned by emotional alterations such as depression, which supports the neurophysiological model that compromises the hypothalamic-pituitary-adrenal axis and the prefrontal cortex, which is rich in corticosteroid receptors.
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Dolor, Fibromialgia, Cortisol, Alteraciones neuropsicológicas, Pain, Fibromyalgia, Neuropsychological impairments