Disentangling interoception and its links to cognitive functioning in fibromyalgia

Patients with fibromyalgia experience pain, cognitive dysfunction, and atypical interoception. However, it is still unclear whether the changes in interoceptive processes have consequences in managing cognitive tasks. The current study investigates the relationship between interoception and cognition in fibromyalgia. Twenty-nine fibromyalgia patients completed clinical questionnaires, the Digit-span, and the Stroop test. Interoceptive Accuracy (IAc) was measured by the heartbeat detection task, Interoceptive Awareness (IAw) via confidence ratings, and Interoceptive Sensibility (IS) via the Multidimensional Assessment of Interoceptive Awareness questionnaire. IAc was found to be positively associated with Digit-span forward (p = 0.008), total (p = 0.004), and Stroop scores (all p ≤ 0.045). IS correlated negatively with Digit-span backward (p ≤ 0. ≤ 0.022) while IAw was negatively associated with Digit-span forward (p ≤ 0.034), total (p ≤ 0.008), and Stroop scores (all p ≤ 0.038). Moderation analysis revealed that IAc predicts Digit-span backward as symptom severity increases (p = 0.045). Despite the absence of a control group, this study provides evidence of the detailed relationships between interoception and cognitive abilities in fibromyalgia. While detecting and efficiently using body signals may be an essential tool for self-regulation in managing cognitive tasks, a higher ability to regulate body signals may exhaust cognition and predispose the patients to lower cognitive performance.