Our primary hypothesis

Our primary hypothesis was that FM patients would perform more like older adults than their age-matched controls on many cognitive tasks. And the reason we gave them three blocks of tasks is that patients frequently complain about fatigue and we had the idea that maybe in the first block the patients would look very much like their age-matched controls but by the third block when fatigue set in they would look much more like older adults. However, I’ll tell you that they were insensitive to that and there are no differences in the FM patients or the young or old patients across the blocks, so I actually won’t be talking about the blocking variable. I’ll just be talking about the performance average across the different blocks.

Let me tell you a little bit about the tasks that we gave these patients, and I do have samples of these as we go along. First we measured speed of processing. This is a very simple task. I’ll show it to you in a moment. But it basically measures how rapidly people can process information and I believe that is a fundamental building block of all cognition that predicts on complex memory function, complex decision-making. Speed of processing is important. It is very easily measured and it is very age-sensitive. And I’ll show you how age-sensitive it is in a moment. Vocabulary is an estimate of world knowledge. You know, we gave people three tasks – synonyms, simple vocabulary and antonyms – that is not age-sensitive. People tend to continue their knowledge across the life-span and it measures their vocabulary and other measures of knowledge did not show age-related declines. Third very central measures that we use is something that we call “working memory”. Think of working memory as your online processing capacity. It’s how much information you can manipulate and store at any given time. It’s sort of the horsepower of your cognitive system. How much mental energy you bring to bear to a situation. We did expect the FM patients to be impaired on working memory and certainly older adults. That particular task is very sensitive to frontal function is a task where you give people three letters, F,A and F one at a time and you ask them in 60 seconds or two minutes to generate as many words as they can think of that begin with the letter F.

Performance on that task goes down with age, fairly dramatically. It’s also a measure of the ability to coordinate and retrieve information. The subject’s list of words and you later ask them to remember those words. That requires both organization, frontal function again, as well as consolidation and storage, so it’s hippocampal. And then finally recognition memory is primary sensitive to hippocampal function. Subjects just simply see a list of words that they study and then they see another list and they are asked to say yes or no to each word that they see. Did they see it before? So they don’t actively have to retrieve anything. They just have to say if the work appears familiar. So that’s just sort of an overall battery of tests that we gave the subjects.

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