Background/Purpose: Fibromyalgia patients are reported to have central sensitization and abnormal central processing of sensory input. Fibromyalgia patients also  have more neurocognitive complaints and abnormalities on certain types of neurocognitive testing, especially the Stroop test for naming speed and a distraction test, the Auditory Consonant Trigram.  To evaluate other possible central nervous system dysfunction, we asked fibromyalgia patients and patients with other rheumatic diseases in a questionnaire whether or not they had symptoms and features of a learning disability.

Methods: Office patients and controls were asked to complete a questionnaire about difficulties in reading, writing, body awareness/spatial relationships, and oral expressive language. A score consisting of the percentage of items for which the respondent reported difficulty was obtained for each of these areas. Four diagnosis groups were compared with respect to questionnaire responses: 85 FMS patients, 39 RA patients, 21 SLE patients, and 14 controls without rheumatic diseases. The Kruskal-Wallis and Mann-Whitney tests were used to compare scores and the chi-square test of association was used to compare percentages, with a 0.05 significance level.

Results: Compared to controls, FMS patients had significantly worse reading and oral expressive language scores (p = 0.001). FMS patients had significantly worse scores for all four areas than the RA and SLE groups (p < 0.001-0.007). There were no statistically significant differences between the RA, SLE, and control groups with respect to any of the scores. FMS patients were significantly more likely to report the following difficulties: making mistakes when reading like skipping words or lines (FMS 43%, controls 0%, RA 3%, SLE 5%, p < 0.001); reading the same line twice (FMS 57%, controls 14%, RA 15%, SLE 19%, p < 0.001); problems remembering what was read (FMS 59%, controls 0%, RA 11%, SLE 24%, p < 0.001); difficulty understanding the main idea or identifying the important details from a story (FMS 27%, controls 0%, RA 5%, SLE 14%, p = 0.007); problems with grammar or punctuation (FMS 28%, controls 14%, RA 8%, SLE 0%, p = 0.004); tendency to be clumsy or uncoordinated (FMS 41%, controls 7%, RA 10%, SLE 10%, p < 0.001); difficulty with eye-hand coordination (FMS 27%, controls 7%, RA 5%, SLE 5%, p = 0.004); difficulty expressing self in words (FMS 42%, controls 7%, RA 8%, SLE 5%, p < 0.001); trouble finding the right words to say in a conversation (FMS 57%, controls 8%, RA 11%, SLE 24%, p < 0.001); and trouble talking about a subject or getting to the point of a conversation (FMS 43%, controls 7%, RA 5%, SLE 5%, p < 0.001).

Conclusion: Fibromyalgia patients, compared to rheumatic disease controls, are found to have  problems in reading, writing, body awareness,and spatial relationships and problems in oral expressive language.  Fibromyalgia patient responses suggested frequent symptoms of a learning disability. 

Learning disability may be another part of central nervous system dysfunction in fibromyalgia patients.  Patients, practitioners and educators should be made aware of the association between fibromyalgia and learning disabilities.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/learning-disability-in-fibromyalgia-patients-fms-patients-report-more-language-and-spatial-difficulties/