{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:20:24Z","timestamp":1788441624190,"version":"build-2803163510"},"reference-count":112,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T00:00:00Z","timestamp":1655164800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Spanish Ministry of Science","award":["RTI2018-095830-B-I00\/ AEI\/10.13039\/501100011033"],"award-info":[{"award-number":["RTI2018-095830-B-I00\/ AEI\/10.13039\/501100011033"]}]},{"name":"FEDER","award":["RTI2018-095830-B-I00\/ AEI\/10.13039\/501100011033"],"award-info":[{"award-number":["RTI2018-095830-B-I00\/ AEI\/10.13039\/501100011033"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The high prevalence of obesity and overweight in fibromyalgia (FM) may be an important factor in the well-known cognitive deficits seen in the disorder. This study analyzed the influence of body mass index (BMI) and primary clinical symptoms of FM (pain, fatigue, insomnia, anxiety, and depression) on attention, memory, and processing speed in FM. Fifty-two FM patients and thirty-two healthy participants completed cognitive tasks assessing selective, sustained, and divided attention; visuospatial and verbal memory; and information processing speed. Furthermore, they were evaluated in terms of the main clinical symptoms of the disorder. FM patients showed a marked reduction of cognitive performance in terms of selective, sustained, and divided attention; visuospatial memory; and processing speed, but no group differences were observed in verbal memory. BMI negatively affects sustained and selective attention, verbal memory, and processing speed and is the main predictor of performance in these basic cognitive domains. Our findings confirm the presence of cognitive deficits with respect to attention and visual memory, as well as slower processing speed, in FM. Moreover, the results support a role of BMI in the observed cognitive deficits. Interventions increasing physical activity and promoting cognitive stimulation could be useful for strengthening cognitive function in FM patients.<\/jats:p>","DOI":"10.3390\/jcm11123404","type":"journal-article","created":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T23:50:14Z","timestamp":1655250614000},"page":"3404","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Fibromyalgia Syndrome and Cognitive Decline: The Role of Body Mass Index and Clinical Symptoms"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9172-7058","authenticated-orcid":false,"given":"Cristina","family":"Mu\u00f1oz Ladr\u00f3n de Guevara","sequence":"first","affiliation":[{"name":"Department of Psychology, University of Ja\u00e9n, 23071 Ja\u00e9n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2188-8673","authenticated-orcid":false,"given":"Gustavo A.","family":"Reyes del Paso","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Ja\u00e9n, 23071 Ja\u00e9n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6158-237X","authenticated-orcid":false,"given":"Mar\u00eda Jos\u00e9","family":"Fern\u00e1ndez Serrano","sequence":"additional","affiliation":[{"name":"Department of Methodology for Behavioral Science, University of Granada, 18071 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4145-8600","authenticated-orcid":false,"given":"Casandra I.","family":"Montoro","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Ja\u00e9n, 23071 Ja\u00e9n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1007\/s11916-013-0356-5","article-title":"Worldwide epidemiology of fibromyalgia","volume":"17","author":"Queiroz","year":"2013","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1002\/acr.20140","article-title":"The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity","volume":"62","author":"Wolfe","year":"2010","journal-title":"Arthritis Care Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1111\/papr.12302","article-title":"The comparative burden of chronic widespread pain and fibromyalgia in the United States","volume":"16","author":"Schaefer","year":"2016","journal-title":"Pain Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1127\/anthranz\/2018\/0900","article-title":"Cognitive functions, emotions and personality in woman with fi-bromyalgia","volume":"75","author":"Bartkowska","year":"2018","journal-title":"Anthropol. Anz."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Galvez-S\u00e1nchez, C.M., de la Coba, P., Colmenero, J.M., Reyes Del Paso, G.A., and Duschek, S. (2021). Attentional function in fibromyalgia and rheumatoid arthritis. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0246128"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.jpsychores.2004.09.004","article-title":"Memory beliefs and function in fibromyalgia patients","volume":"58","author":"Glass","year":"2005","journal-title":"J. Psychosom. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1136\/jnnp-2017-317823","article-title":"A unifying theory for cognitive abnormalities in functional neurologi-cal disorders, fibromyalgia and chronic fatigue syndrome: Systematic review","volume":"89","author":"Teodoro","year":"2018","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.pec.2008.06.005","article-title":"Patient perspectives on the impact of fibromyalgia","volume":"73","author":"Arnold","year":"2008","journal-title":"Patient Educ. Couns."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.comppsych.2011.02.001","article-title":"Validity and reliability of the clock drawing test as a screening tool for cognitive impairment in patients with fibromyalgia","volume":"53","author":"Can","year":"2012","journal-title":"Compr. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1097\/01.rhu.0000120895.20623.9f","article-title":"The prevalence and clinical impact of reported cognitive difficulties (fibrofog) in patients with rheumatic disease with and without fibromyalgia","volume":"10","author":"Katz","year":"2004","journal-title":"J. Clin. Rheumatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/s00482-009-0872-8","article-title":"Schmerz und Aufmerksamkeit: Kognitive Defizite bei Fibrom-yal giepatienten","volume":"24","author":"Wood","year":"2010","journal-title":"Schmerz"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"66","DOI":"10.3109\/10582452.2011.558989","article-title":"Perceived cognitive dysfunction in fibromyalgia syndrome","volume":"19","author":"Williams","year":"2011","journal-title":"J. Musculoskelet. Pain"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1007\/s00296-014-3208-7","article-title":"Fibrofog and fibromyalgia: A narrative review and implications for clinical practice","volume":"35","author":"Kravitz","year":"2015","journal-title":"Rheumatol. Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2318","DOI":"10.3899\/jrheum.090367","article-title":"OMERACT Fibromyalgia Wor-king Group. Fibromyalgia syndrome module at OMERACT 9: Domain construct","volume":"36","author":"Mease","year":"2009","journal-title":"J. Rheumatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/1477-7525-9-71","article-title":"The comparative bur-den of mild, moderate and severe fibromyalgia: Results from a cross-sectional survey in the United States","volume":"9","author":"Schaefer","year":"2011","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Mu\u00f1oz Ladr\u00f3n de Guevara, C., Fern\u00e1ndez-Serrano, M.J., Reyes Del Paso, G.A., and Duschek, S. (2018). Executive function impairments in fibromyalgia syndrome: Relevance of clinical variables and body mass index. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0196329"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"206","DOI":"10.4081\/reumatismo.2012.206","article-title":"Fibromyalgia dyscognition: Concepts and issues","volume":"64","author":"Ambrose","year":"2012","journal-title":"Reumatismo"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1093\/geronb\/gbs122","article-title":"Cognitive performance in women aged 50 years and older with and without fibromyalgia","volume":"69","author":"Cherry","year":"2014","journal-title":"J. Gerontol. B Psychol. Sci. Soc. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1080\/08964289.2012.708684","article-title":"Implicit memory function in fibromyalgia syn-drome","volume":"39","author":"Duschek","year":"2013","journal-title":"Behav. Med."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Gelonch, O., Garolera, M., Valls, J., Castell\u00e0, G., Varela, O., Rossell\u00f3, L., and Pifarre, J. (2018). The effect of depressive symp-toms on cognition in patients with fibromyalgia. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0200057"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1093\/pm\/pnab024","article-title":"Facial emotion recognition and executive functions in fibromyalgia","volume":"22","author":"Duschek","year":"2021","journal-title":"Pain Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1002\/acr.22403","article-title":"Are fibromyalgia patients cognitively impaired? Objective and subjective neuropsychological evidence: Cognitive impairment in FM","volume":"67","author":"Tesio","year":"2015","journal-title":"Arthritis Care Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.jpsychores.2016.06.004","article-title":"Cognitive functioning in fibromyalgia: The central role of effort","volume":"87","author":"Gal","year":"2016","journal-title":"J. Psychosom. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1002\/art.10800","article-title":"Attentional functioning in fibromyalgia, rheumatoid arthritis, and musculoskeletal pain patients","volume":"47","author":"Dick","year":"2002","journal-title":"Arthritis Rheum."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.pain.2008.06.017","article-title":"Disruption of cognitive function in fibromyalgia syndrome","volume":"139","author":"Dick","year":"2008","journal-title":"Pain"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1080\/08870446.2010.525639","article-title":"Exploring attentional disruption in fibromyalgia using the attentional blink","volume":"26","author":"Harker","year":"2011","journal-title":"Psychol. Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1007\/s00296-010-1762-1","article-title":"Spatial versus verbal memory impairments in patients with fibromyalgia","volume":"32","author":"Kim","year":"2012","journal-title":"Rheumatol. Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1037\/neu0000138","article-title":"Ab-errant cerebral blood flow responses during cognition: Implications for the understanding of cognitive deficits in fibromyalgia","volume":"29","author":"Montoro","year":"2015","journal-title":"Neuropsychology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1080\/13803395.2015.1023265","article-title":"Reaction time, cerebral blood flow, and heart rate responses in fibromyalgia: Evidence of alterations in attentional control","volume":"37","author":"Montoro","year":"2015","journal-title":"J. Clin. Exp. Neuropsychol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1111\/sjop.12706","article-title":"Memory complaints and cognitive performance in fibromyalgia and chronic pain: The key role of depression","volume":"62","author":"Castel","year":"2021","journal-title":"Scand. J. Psychol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1076\/jcen.21.4.477.876","article-title":"Concentration and memory deficits in patients with fibromyalgia syndrome","volume":"21","author":"Grace","year":"1999","journal-title":"J. Clin. Exp. Neuropsychol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1002\/art.24559","article-title":"Normalizing memory recall in fibromyalgia with rehearsal: A distraction-counteracting effect","volume":"61","author":"Leavitt","year":"2009","journal-title":"Arthritis Rheum."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1080\/08870446.2010.493611","article-title":"Attentional deficits in fibromyalgia and its relationships with pain, emotional distress and sleep dysfunction complaints","volume":"26","author":"Hita","year":"2011","journal-title":"Psychol. Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1007\/s00296-007-0487-2","article-title":"Automated neuropsychiatric measurements of information processing in fibromyalgia","volume":"28","author":"Walitt","year":"2008","journal-title":"Rheumatol. Int."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1080\/13803395.2017.1422699","article-title":"Meta-analysis of cognitive performance in fibromyalgia","volume":"40","author":"Bell","year":"2018","journal-title":"J. Clin. Exp. Neuropsychol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Galvez-S\u00e1nchez, C.M., Mu\u00f1oz Ladr\u00f3n de Guevara, C., Montoro, C.I., Fern\u00e1ndez-Serrano, M.J., Duschek, S., and Reyes del Paso, G.A. (2018). Cognitive deficits in fibromyalgia syndrome are associated with pain responses to low intensity pressure stimulation. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0201488"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1111\/j.1526-4637.2006.00212.x","article-title":"The relationship between pain and mental flexibility in older adult pain clinic patients","volume":"7","author":"Karp","year":"2006","journal-title":"Pain Med."},{"key":"ref_38","first-page":"427","article-title":"Neuropsicolog\u00eda de los pacientes con s\u00edndrome de fibromialgia: Relaci\u00f3n con dolor y ansiedad","volume":"20","year":"2008","journal-title":"Psicothema"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1002\/j.1532-2149.2011.00032.x","article-title":"Cognitive impairment in fibromyalgia syndrome: The impact of cardiovascular regulation, pain, emotional disorders and medication: Cognitive impairment in fibromyalgia syndrome","volume":"16","author":"Pulgar","year":"2012","journal-title":"Eur. J. Pain"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1093\/arclin\/acp014","article-title":"Executive function and decision-making in women with fibromyalgia","volume":"24","author":"Calandre","year":"2009","journal-title":"Arch. Clin. Neuropsychol."},{"key":"ref_41","first-page":"1371","article-title":"Hippocampus dysfunction may explain symptoms of fibromyalgia syndrome. A study with single-voxel magnetic resonance spectroscopy","volume":"35","author":"Emad","year":"2008","journal-title":"J. Rheumatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1097\/PSY.0000000000000575","article-title":"Cognitive impairment in fibromyalgia: A meta-analysis of case\u2013control studies","volume":"80","author":"Wu","year":"2018","journal-title":"Psychosom. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.comppsych.2016.01.002","article-title":"Executive function in fibromyalgia: Comparing subjective and objective measures","volume":"66","author":"Gelonch","year":"2016","journal-title":"Compr. Psychiatry"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/S0022-3999(02)00628-1","article-title":"Neuropsychological impairment in fibromyalgia: Relation to depression, fatigue, and pain","volume":"55","author":"Suhr","year":"2003","journal-title":"J. Psychosom. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e5907","DOI":"10.7717\/peerj.5907","article-title":"Broad cognitive complaints but subtle objective working memory impairment in fibromyalgia patients","volume":"6","author":"Andrade","year":"2018","journal-title":"PeerJ"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.mayocpiqo.2021.12.007","article-title":"Predictive bidirectional relations between pain, fatigue, and dyscognition in fibromyalgia","volume":"6","author":"Ranum","year":"2022","journal-title":"Mayo Clin. Proc. Innov. Qual. Outcomes"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1080\/08964289.2013.818932","article-title":"Recognition of facially expressed emotions in patients with fibromyalgia syndrome","volume":"39","author":"Winkelmann","year":"2013","journal-title":"Behav. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1212\/01.wnl.0000238082.13860.50","article-title":"Relation between body mass index and cognitivefunction in healthy middle-aged men and women","volume":"67","author":"Cournot","year":"2006","journal-title":"Neurology"},{"key":"ref_49","first-page":"296","article-title":"Body mass index acrossmidlife and cognitive change in late life","volume":"37","author":"Dahl","year":"2013","journal-title":"Int. J."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/S1474-4422(17)30084-4","article-title":"Neurological consequences of obesity","volume":"16","author":"Hinder","year":"2017","journal-title":"Lancet Neurol."},{"key":"ref_51","unstructured":"WHO Consultation on Obesity, Division of Noncommunicable Diseases, and Programme of Nutrition, Family and Reproductive Health (1998). Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation on Obesity, Geneva, 3\u20135 June 1997."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"683","DOI":"10.2337\/dc19-1642","article-title":"The preva-lence and determinants of cognitive deficits and traditional diabetic complications in the severely obese","volume":"43","author":"Callaghan","year":"2020","journal-title":"Diabetes Care"},{"key":"ref_53","first-page":"61","article-title":"Executive functioning in obese individuals waiting for clinical treatment","volume":"29","author":"Gameiro","year":"2017","journal-title":"Psicothema"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Restivo, M.R., McKinnon, M.C., Frey, B.N., Hall, G.B., Syed, W., and Taylor, V.H. (2017). The impact of obesity on neuropsychological functioning in adults with and without major depressive disorder. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0176898"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.semarthrit.2021.02.007","article-title":"Fibromyalgia and obesity: A com-prehensive systematic review and meta-analysis","volume":"51","author":"Ciaffi","year":"2021","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s10067-009-1094-2","article-title":"Evaluaci\u00f3n de la obesidad en la fibromialgia: Biomarcadores neuroendocrinos, s\u00edntomas y funciones","volume":"8","author":"Okifuji","year":"2009","journal-title":"Clin. Rheumatol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1080\/02640414.2015.1136069","article-title":"Association of physical fitness and fatness with cognitive function in women with fibromyalgia","volume":"34","author":"Artero","year":"2016","journal-title":"J. Sports Sci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"377","DOI":"10.3389\/fpsyg.2018.00377","article-title":"Cognitive impairments in fibromyalgia syndrome: Associations with positive and negative affect, alexithymia, pain catastrophizing and selfesteem","volume":"9","author":"Duschek","year":"2018","journal-title":"Front. Psychol."},{"key":"ref_59","unstructured":"First, M., Spitzer, R., Gibbon, M., and Williams, J. (1999). Entrevista Cl\u00ednica Estructurada para los Trastornos del Eje I del DSM-IV (SCIDI), Masson."},{"key":"ref_60","first-page":"145","article-title":"The development of a Spanish questionnaire for assessing pain: Preliminary data concerning reliability and validity","volume":"10","author":"Bosch","year":"1994","journal-title":"Eur. J. Psychol. Assess."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/S0304-3959(99)00300-0","article-title":"Some empirical evidence regarding the validity of the Spanish version of the McGill Pain Questionnaire (MPQ-SV)","volume":"85","author":"Masedo","year":"2000","journal-title":"Pain"},{"key":"ref_62","first-page":"239","article-title":"Adaptaci\u00f3n espa\u00f1ola del Inventario para la Depresi\u00f3n de Beck-II (BDI-II): I. Propiedades psicom\u00e9tricas en estudiantes universitarios","volume":"29","author":"Sanz","year":"2003","journal-title":"An\u00e1lisis Y Modif. Conducta"},{"key":"ref_63","unstructured":"Spielberger, C.D., Gorsuch, R.L., and Lushene, R.E. (1986). Cuestionario de Ansiedad Estado-Rasgo (STAI): Manual, TEA Ediciones."},{"key":"ref_64","unstructured":"Bulbena, A., Berrios, G.E., and De Larrinoa, F. (2000). Medici\u00f3n Cl\u00ednica en Psiquiatr\u00eda y Psicolog\u00eda, Masson."},{"key":"ref_65","first-page":"107","article-title":"Propiedades psicom\u00e9tricas del cuestionario Oviedo de sue\u00f1o","volume":"12","author":"Bobes","year":"2000","journal-title":"Psicothema"},{"key":"ref_66","unstructured":"Brickenkamp, R. (1962). Aufmerksamkeits-Belastungs-Test (Test d2), Hogrefe."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Delis, D.C., Kaplan, E., and Kramer, J.H. (2001). Delis-Kaplan Executive Function System (D-KEFS), The Psychological Corporation.","DOI":"10.1037\/t15082-000"},{"key":"ref_68","unstructured":"Spreen, S., and Strauss, E. (1991). A Compendium of Neuropsychological Test: Administration, Norms and Commentary, Oxford University Press."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"271","DOI":"10.2466\/pms.1958.8.3.271","article-title":"Validity of the trail making test as an indicator of organic brain damage","volume":"8","author":"Reitan","year":"1958","journal-title":"Percept. Mot. Ski."},{"key":"ref_70","unstructured":"Rey, A. (1964). L\u2019examen Clinique en Psychologie (The Clinical Examination in Psychology), Presse Universitaires de France."},{"key":"ref_71","unstructured":"Sed\u00f3, M. (2007). Test de los Cinco D\u00edgitos, TEA Ediciones."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1590\/2237-6089-2016-0060","article-title":"The Five Digits Test in the assessment of older adults with low formal education: Construct validity and reliability in a Brazilian clinical sam-ple","volume":"39","author":"Oliveira","year":"2017","journal-title":"Trends Psychiatry Psychother."},{"key":"ref_73","unstructured":"Benedet, M.J., and Alejandre, M.A. (1998). TAVEC: Test de Aprendizaje Verbal. Espa\u00f1a-Complutense, TEA Ediciones."},{"key":"ref_74","first-page":"101","article-title":"Cognition and perception deficits in fibromyalgia and rheumatoid arthritis","volume":"3","author":"Cimadevilla","year":"2007","journal-title":"Reumatol. Cl\u00edn."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.jpain.2012.02.011","article-title":"Intact cognitive inhibition in patients with fibromyalgia but evidence of declined processing speed","volume":"13","author":"Veldhuijzen","year":"2012","journal-title":"J. Pain"},{"key":"ref_76","first-page":"358","article-title":"Cognitive performance and memory complaints in chronic patients: With fibromyalgia versus without fibromyalgia","volume":"15","author":"Castel","year":"2008","journal-title":"Rev. Soc. Espa\u00f1ola Dolor"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.pain.2010.09.022","article-title":"Understanding chronic pain in older adults: Abdominal fat is where it is at","volume":"152","author":"Somers","year":"2011","journal-title":"Pain"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1210\/er.2017-00111","article-title":"Obesity pathogenesis: An endocrine society scientific statement","volume":"38","author":"Schwartz","year":"2017","journal-title":"Endocr. Rev."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"399","DOI":"10.2147\/JPR.S55598","article-title":"The association between chronic pain and obesity","volume":"8","author":"Okifuji","year":"2015","journal-title":"J. Pain Res."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"375","DOI":"10.3389\/fnins.2014.00375","article-title":"Obesity and cognitive decline: Role of inflammation and vascular changes","volume":"8","author":"Nguyen","year":"2014","journal-title":"Front. Neurosci."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"3372","DOI":"10.1007\/s11695-021-05386-x","article-title":"Memory and executive function in adolescent and young adult females with moderate to severe obesity before and after weight loss surgery","volume":"31","author":"Baskaran","year":"2021","journal-title":"Obes. Surg."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1111\/cob.12058","article-title":"Uncontrolled eating is associated with reduced executive functioning: Uncontrolled eating and cognitive function","volume":"4","author":"Calvo","year":"2014","journal-title":"Clin. Obes."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/s40200-015-0211-9","article-title":"Study of relationship between obesity and executive functions among high school students in Bushehr, Iran","volume":"14","author":"Qavam","year":"2015","journal-title":"J. Diabetes Metab. Disord."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Sarg\u00e9nius, H.L., Lydersen, S., and Hestad, K. (2017). Neuropsychological function in individuals with morbid obesity: A cross-sectional study. BMC Obes., 4.","DOI":"10.1186\/s40608-017-0143-7"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1982","DOI":"10.1016\/j.euroneuro.2014.03.002","article-title":"Obesity and dementia: Adipokines interact with the brain","volume":"24","author":"Arnoldussen","year":"2014","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"97","DOI":"10.3389\/fnagi.2013.00097","article-title":"The impact of obesity and exercise on cognitive aging","volume":"5","author":"Chan","year":"2013","journal-title":"Front. Aging Neurosci."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1179\/1476830513Y.0000000092","article-title":"Damaging effects of a high-fat diet to the brain and cognition: A review of proposed mechanisms","volume":"17","author":"Freeman","year":"2014","journal-title":"Nutr. Neurosci."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.arr.2010.04.007","article-title":"Metabolic-cognitive syndrome: A cross-talk between metabolic syndrome and Alzheimer\u2019s disease","volume":"9","author":"Frisardi","year":"2010","journal-title":"Ageing Res. Rev."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1097\/PSY.0b013e31825ff1de","article-title":"Indirect effects of elevated body mass index on memory performance through altered cerebral metabolite concentrations","volume":"74","author":"Gonzales","year":"2012","journal-title":"Psychosom. Med."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.neurobiolaging.2005.08.017","article-title":"High-fat diets, insulin resistance and declining cognitive function","volume":"26","author":"Greenwood","year":"2005","journal-title":"Neurobiol. Aging"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1111\/j.1467-789X.2011.00920.x","article-title":"A review of the association between obesity and cognitive function across the lifespan: Implications for novel approaches to prevention and treatment","volume":"12","author":"Smith","year":"2011","journal-title":"Obes. Rev."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"111","DOI":"10.2174\/156720507780362263","article-title":"Relation of obesity to cognitive function: Importance of central obesity and synergistic influence of concomitant hypertension. The Framingham Heart Study","volume":"4","author":"Wolf","year":"2007","journal-title":"Curr. Alzheimer Res."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1055\/s-2005-872851","article-title":"Association of interleukin-6,C-reactive protein, interleukin-10 and adiponectin plasma concentrations with measures of obesity, insulin sensitivity and glucose metabolism","volume":"113","author":"Bluher","year":"2005","journal-title":"Exp. Clin. Endocrinol. Diabetes"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1093\/schbul\/sbw029","article-title":"Fond Chronic peripheral inflammation is associated with cognitive impairment in schizophrenia: Results from the multicentric FACE-SZ dataset Schizophr","volume":"42","author":"Bulzacka","year":"2016","journal-title":"Schizophr. Bull."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1089\/jwh.2015.5509","article-title":"Association of Leptin with body pain in women","volume":"25","author":"Younger","year":"2016","journal-title":"J. Womens Health"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/S0304-3940(00)00942-3","article-title":"Binding and internalization of leptin by porcine choroid plexus cells in culture","volume":"283","author":"Peiser","year":"2000","journal-title":"Neurosci. Lett."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1210\/endo.141.4.7435","article-title":"Differential regulation of leptin transport by the choroid plexus and blood-brain barrier and high affinity transport systems for entry into hypothalamus and across the blood-cerebrospinal fluid barrier","volume":"141","author":"Zlokovic","year":"2000","journal-title":"Endocrinology"},{"key":"ref_98","first-page":"511","article-title":"Cerebral magnetic resonance changes associated with fibromyalgia syndrome. Cambios en la resonancia magn\u00e9tica cerebral asociados al s\u00edndrome de fibromialgia","volume":"148","author":"Murga","year":"2017","journal-title":"Med. Cl\u00edn."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1080\/030097400750001743-1","article-title":"Neuroendocrine and hormonal perturbations and relations to the serotonergic system in fibromyalgia patients","volume":"29","author":"Neeck","year":"2000","journal-title":"Scand. J. Rheumatol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.jsams.2014.07.007","article-title":"Physical activity and cognition in adolescents: A systematic review","volume":"18","author":"Sallis","year":"2015","journal-title":"J. Sci. Med. Sport"},{"key":"ref_101","first-page":"419","article-title":"Muscle strength and endurance compared to aerobic capacity in primary fibromyalgia syndrome","volume":"10","author":"Jacobsen","year":"1992","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"15022","DOI":"10.1038\/nrdp.2015.22","article-title":"Fibromyalgia","volume":"1","author":"Ablin","year":"2015","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_103","first-page":"CD005381","article-title":"Physical activity and enhanced fit-ness to improve cognitive function in older people without known cognitive impairment","volume":"16","author":"Angevaren","year":"2008","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1097\/PSY.0b013e3181d14633","article-title":"Aerobic exercise and neurocognitive performance: A meta-analytic review of randomized controlled trials","volume":"72","author":"Smith","year":"2010","journal-title":"Psychosom. Med."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1111\/bjhp.12128","article-title":"Men and women with fibromyalgia: Relation between attentional function and clinical symptoms","volume":"20","author":"Prados","year":"2015","journal-title":"Br. J. Health Psychol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1037\/0033-295X.91.2.153","article-title":"Personality, motivation, and performance: A theory of the relationship between individual differences and information processing","volume":"91","author":"Humphreys","year":"1984","journal-title":"Psychol. Rev."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"4037","DOI":"10.1097\/00001756-200012180-00027","article-title":"Harvan The effect of autonomic arousal on attentional focus","volume":"11","author":"Tracy","year":"2000","journal-title":"Neuroreport"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.1002\/1529-0131(200109)44:9<2125::AID-ART365>3.0.CO;2-1","article-title":"Cognitive function in fibromyalgia patients","volume":"44","author":"Park","year":"2001","journal-title":"Arthritis Rheum."},{"key":"ref_109","first-page":"12905","article-title":"A Review on the Cognitive Impairment caused by Anti-epileptics and their Management","volume":"8","author":"Nivitha","year":"2021","journal-title":"NVEO-Nat. Volatiles Essent. Oils J. NVEO"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"135","DOI":"10.2165\/00023210-199809020-00005","article-title":"Bodyweight gain induced by psychotropic drugs: Incidence, mechanisms and management","volume":"9","author":"Ackerman","year":"1998","journal-title":"CN Drugs"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1686","DOI":"10.1176\/ajp.156.11.1686","article-title":"Antipsychotic-induced weight gain: A comprehensive research synthesis","volume":"156","author":"Allison","year":"1999","journal-title":"Am. J. Psychiatry"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s11926-006-0036-0","article-title":"Cognitive dysfunction in fibromyalgia and chronic fatigue syndrome: New trends and future directions","volume":"8","author":"Glass","year":"2006","journal-title":"Curr. Rheumatol. Rep."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/12\/3404\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:30:56Z","timestamp":1760139056000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/12\/3404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,14]]},"references-count":112,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["jcm11123404"],"URL":"https:\/\/doi.org\/10.3390\/jcm11123404","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,14]]}}}