Background/Purpose:   The Stroop Word-Naming Test has demonstrated decreased word-naming speed in many patients with fibromyalgia who experience the symptoms of fibrofog.  The slower processing of information may disturb the synchrony of other neural circuits and lead to some of the symptoms of cognitive dysfunction termed “fibrofog.” 

Methods:   We administered this test to rheumatic disease patients in a rheumatology office practice.  Impairment of concentration due to distraction is present in many fibromyalgia patients, particularly using the auditory consonant trigram of neuropsychological tests.  We have attempted to treat fibromyalgia patients with fibrofog symptoms with stimulants, including methylphenidate, Adderall, and Vyvanse.

Results: 18 rheumatic disease patients in a rheumatology office practice were given the Stroop Word-Naming Test.  The test was administered by a rheumatology nurse.  13 of 18 (72%) patients had a diagnosis of fibromyalgia and met the 2010 ACR criteria.  5 of 18 patients (28%) had other rheumatic diseases.  Of the patients with fibromyalgia, 7 of 13 were taking stimulant medication, including methylphenidate, Adderall (amphetamine and dextroamphetamine), or Vyvanse (lisdexamfetamine).  The 5 rheumatic disease controls were not taking stimulant medication.  Of the fibromyalgia patients, 12 were female and 1 was male.  In the control group, 3 were female and 2 were male.  The mean age of the fibromyalgia group was 52 years old (32-68).  The mean age of the control group was 35 years old

(32-43).  The education level of the participants was 5 high school graduates, 7 had some college experience, 3 had a bachelor’s degree, 2 had a master’s degree, and 1 had a law degree.

In the fibromyalgia patients not taking a stimulant for fibrofog, the mean Stroop score was 70.8 (47-89).  In the fibromyalgia patients taking methylphenidate, amphetamine and dextroamphetamine, or lisdexamfetamine, the mean Stroop score was 80.7 (range 53-113).  The control group without fibromyalgia, none of whom were taking an ADHD type stimulant medication, had a mean Stroop score was 93.4 (83-111).

Conclusion: Fibromyalgia patients have reduced word-naming speed based on the Stroop Word-Naming Test.  This test is simple to administer.  Those fibromyalgia patients taking stimulant medication usually reserved for ADHD, but used clinically for some patients with fibrofog symptoms because of a significant effect of distraction on their cognitive ability, performed better than the fibromyalgia group not taking ADHD type medication, but still performed worse than the control group. 

Fibromyalgia patients appear to be a beat behind in their cognitive functioning.  This slower processing of certain kinds of information can be assessed through the Stroop Word-Naming Test.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-stroop-word-naming-test-in-fibromyalgia-patients/