Verbal fluency

Verbal fluency, also another highly frontal task in terms of cortex. This is, to remind you, where subjects are given a letter like F and told to produce as many words as they can think of that begin with the letter F. They had three tasks like this and you can see again that very much like older adults FM patients performed more poorly than age-matched controls.

Finally, recognition is a more passive test that doesn’t engage the central executive dorsal lateral frontal cortex and it’s more hippocampal and passive in nature. Here you can see – just to remind you, subjects are given lists of words to study and then they are given another list, some of which with the words they’ve studied and some of which are what we call “lures” or “false alarmed” words. And they have to say if they saw that word before. No one shows any deficits on this test. The older adults, there’s no active retrieval required here. The older adults do fine. As to the fibromyalgia patients, no one is performing at ceiling. So it’s not that they are getting everything correct. This is a sensitive task but all the groups are performing the same on it.

Finally, this is a puzzling finding. You’ll recall that I showed that across the life span vocabulary scores remain intact. That was about the one set of lines that were level or actually went up a little bit with age. Interestingly, the fibromyalgia patients performed more poorly on the vocabulary tasks than either the older controls or the age-matched controls. And I was sufficiently surprised by this finding that I thought there must be something wrong with our sampling. I just wanted to show you – I don’t know if you can see this – how carefully matched these subjects are. That they are absolutely precisely matched, not only in terms of age but also in terms of years of education. So these are the 20 subjects and each young control and old control was very precisely matched, so I cannot find any basis for interpreting the poor vocabulary of the fibromyalgia patients as being due to some kind of artifact of our sampling. These patients will spontaneously report that they have a lot of word finding difficulties, that they have trouble using vocabulary. So this may square with some of your clinical experiences.

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