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RecruitingNCT06948903Updated Sep 12, 2025

Relationship Between Central Sensitization Symptoms and Cognitive Dysfunction in Fibromyalgia

An observational study in Fibromyalgia, Cognitive Dysfunction and Central Sensitisation, sponsored by Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey. Recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2025-09-12.

Sponsored by Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey · Observational

From the registry’s dates

  • Started Jan 2023; still recruiting 3 years 8 months later.
Study type
Observational
Model
Case-only
Time perspective
Cross-sectional
Enrollment
100
Ages
18 Years to 65 Years
Sex
All
01

Study summary

The aim of the study is to investigate the relationship between central sensitization parameters and cognitive dysfunction in patients with fibromyalgia.The main questions it aims to answer are:

Do central sensitization symptoms affect cognitive dysfunction in patients with fibromyalgia? To what extent do central sensitization symptoms affect objective and subjective cognitive complaints in fibromyalgia patients? How do cognitive complaints relate to other clinical parameters, including disease severity, in these patients?

Read the detailed description

Central sensitization is defined as an increase in pain sensitivity with amplification of neuron-derived signals in the central nervous system. Fibromyalgia is a disease characterized by chronic widespread pain, and although its etiology and pathophysiology are still not fully known, it is considered a major member of the group of diseases known as central sensitivity syndromes, which progress with impaired pain regulation.

Fibromyalgia negatively affects the patient's functionality in various ways. One of these is cognitive dysfunction, and previous studies have shown that fibromyalgia patients experience significant deterioration in all parameters related to cognitive function compared to healthy controls. Central sensitization has been shown to be associated with comorbidities such as depression, anxiety, sleep disorders and fatigue in many disease groups, including fibromyalgia, and data on its effect on cognitive dysfunction are limited.

A study found that impaired conditioned pain modulation, one of the methods used in the evaluation of central sensitization in fibromyalgia patients, was associated with cognitive dysfunction.In addition, cognitive impairment in these patients is associated with a decrease in the quality of life of the patients and is suggested to be one of the important clinical findings of the disease. Considering all these data, it seems likely that central sensitization negatively affects cognitive function in fibromyalgia, and this study aimed to examine in detail the relationship between central sensitization and cognitive dysfunction in fibromyalgia patients.

02

Conditions studied

  • Fibromyalgia
  • Cognitive Dysfunction
  • Central Sensitisation

Keywords

  • Fibromyalgia
  • Cognitive Dysfunction
  • Central Sensitisation
03

In context

Fibromyalgia

1,338 studies on the registry are indexed under Fibromyalgia; 268 are open to participants now.

This study's planned enrollment of 100 is close to the median of 100 across 270 observational studies indexed under Fibromyalgia.

Browse Fibromyalgia studies →

Lead sponsor

Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey is the lead sponsor of 104 studies on the registry; 28 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

Patients with Fibromyalgia

Inclusion criteria

  • Being diagnosed with fibromyalgia according to American College of Rheumatology 2016 criteria
  • Being between 18-65 years old
  • Being literate
  • Accepting to participate in the study

Exclusion criteria

Exclusion Criteria:

  • Concomitant systemic inflammatory disease, central nervous system disease (cortical involvement), active infection and malignancy history
  • History of illness that may lead to cognitive impairment
  • Being \<18 and >65 years old
  • Being illiterate
  • Not accepting to participate in the study
05

Study design

Observational model
Case-only
Time perspective
Cross-sectional
Enrollment
100 participants (estimated)
Patient registry
No

Groups and cohorts

  • Patients

    Patients with fibromyalgia

    Diagnostic Test: Central Sensitization Inventory · Diagnostic Test: The Montreal Cognitive Assessment · Diagnostic Test: Cognitive Symptom Severity Scale-Extended · Other: Fibromyalgia Impact Questionnaire · Other: Numeric rating scale · Other: Hospital Anxiety and Depression Scale

Interventions

  • Diagnostic testCentral Sensitization Inventory

    The Central Sensitization Inventory is used by some researchers to investigate pain sensitivity through symptoms associated with central sensitization and related comorbidities. It can help determine the severity of central sensitization. The scale was developed to detect central sensitization in patients with chronic pain and consists of two sections: Section A and Section B. For scoring purposes, only Section A is used. A score of 40 or higher out of 100 is associated with an increased likelihood of central sensitization.

  • Diagnostic testThe Montreal Cognitive Assessment

    The Montreal Cognitive Assessment was initially developed as a test for mild cognitive impairment, but has also been determined to match qualities of the mini mental state examination 80. It assesses seven areas of cognition for a total possible score of 30 points. A score of 21 or less is indicative of cognitive impairment in Turkish population.

  • Diagnostic testCognitive Symptom Severity Scale-Extended

    The Cognitive Symptom Severity Scale extends the scale of the original cognitive symptom severity scale. Participants are asked to rate their cognitive symptoms related to concentration and memory on a single scale ranging from 1-5, rather than the original 1-3, where higher scores indicate greater severity.

  • OtherFibromyalgia Impact Questionnaire

    The Fibromyalgia Impact Questionnaire is composed of 10 items. The first item contains 11 questions related to physical functioning - each question is rated on a 4 point Likert type scale. Items 2 and 3 ask the patient to mark the number of days they felt well and the number of days they were unable to work (including housework) because of fibromyalgia symptoms. Items 4 through 10 are horizontal linear scales marked in 10 increments on which the patient rates work difficulty, pain, fatigue, morning tiredness, stiffness, anxiety and depression. The maximum scale score is 100, with higher scores associated with increasing disability.

  • OtherNumeric rating scale

    Numeric Rating Scale will be used to determine pain intensity during assessments. Participants will be asked to rate their pain intensity by selecting a value between 0 and 10. Higher scores are associated with increased pain severity.

  • OtherHospital Anxiety and Depression Scale

    This scale is used to assess anxiety and depression symptoms and consists of 14 items (7 items for anxiety, 7 items for depression). For each subscale, scores range from 0 to 21: • 0-7 points: No symptoms or very mild symptoms • 8-10 points: Moderate symptoms • 11 points or higher

06

What researchers measure

Primary outcomes

  1. Central Sensitization Inventory

    The Central Sensitization Inventory is used by some researchers to investigate pain sensitivity through symptoms associated with central sensitization and related comorbidities. It can help determine the severity of central sensitization. The scale was developed to detect central sensitization in patients with chronic pain and consists of two sections: Section A and Section B. For scoring purposes, only Section A is used. A score of 40 or higher out of 100 is associated with an increased likelihood of central sensitization.

    Time frame: 6 months

  2. Montreal Cognitive Assessment

    The Montreal Cognitive Assessment was initially developed as a test for mild cognitive impairment, but has also been determined to match qualities of the mini mental state examination 80. It assesses seven areas of cognition for a total possible score of 30 points. A score of 21 or less is indicative of cognitive impairment in Turkish population.

    Time frame: 6 months

Secondary outcomes

  1. Cognitive Symptom Severity Scale-Extended

    The Cognitive Symptom Severity Scale extends the scale of the original cognitive symptom severity scale. Participants are asked to rate their cognitive symptoms related to concentration and memory on a single scale ranging from 1-5, rather than the original 1-3, where higher scores indicate greater severity.

    Time frame: 6 months

  2. Fibromyalgia Impact Questionnaire

    This scale is composed of 10 items. The first item contains 11 questions related to physical functioning - each question is rated on a 4 point Likert type scale. Items 2 and 3 ask the patient to mark the number of days they felt well and the number of days they were unable to work (including housework) because of fibromyalgia symptoms. Items 4 through 10 are horizontal linear scales marked in 10 increments on which the patient rates work difficulty, pain, fatigue, morning tiredness, stiffness, anxiety and depression. The maximum scale score is 100, with higher scores associated with increasing disability.

    Time frame: 6 months

  3. Hospital Anxiety and Depression Scale

    This scale is used to assess anxiety and depression symptoms and consists of 14 items (7 items for anxiety, 7 items for depression). For each subscale, scores range from 0 to 21: • 0-7 points: No symptoms or very mild symptoms • 8-10 points: Moderate symptoms • 11 points or higher

    Time frame: 6 months

  4. Numeric rating scale

    Numeric Rating Scale will be used to determine pain intensity during assessments. Participants will be asked to rate their pain intensity by selecting a value between 0 and 10. Higher scores are associated with increased pain severity.

    Time frame: 6 months

07

Study locations

1 of 1 sites recruiting
  • Health Sciences University
    Istanbul, Uskudar 34100, Turkey (Türkiye)
    • Feyza Yücel, M.D. · Contact · dr.fny28@gmail.com · (0216) 542 20 00
    • Sefa Kurt, M.D. · Sub investigator
    Recruiting
08

References and documents

Publications

  • Akinci A, Al Shaker M, Chang MH, Cheung CW, Danilov A, Jose Duenas H, Kim YC, Guillen R, Tassanawipas W, Treuer T, Wang Y. Predictive factors and clinical biomarkers for treatment in patients with chronic pain caused by osteoarthritis with a central sensitisation component. Int J Clin Pract. 2016 Jan;70(1):31-44. doi: 10.1111/ijcp.12749. Epub 2015 Nov 11. PubMed 26558538 ↗
  • Bell T, Trost Z, Buelow MT, Clay O, Younger J, Moore D, Crowe M. Meta-analysis of cognitive performance in fibromyalgia. J Clin Exp Neuropsychol. 2018 Sep;40(7):698-714. doi: 10.1080/13803395.2017.1422699. Epub 2018 Feb 1. PubMed 29388512 ↗
  • Coppieters I, Ickmans K, Cagnie B, Nijs J, De Pauw R, Noten S, Meeus M. Cognitive Performance Is Related to Central Sensitization and Health-related Quality of Life in Patients with Chronic Whiplash-Associated Disorders and Fibromyalgia. Pain Physician. 2015 May-Jun;18(3):E389-401. PubMed 26000686 ↗
  • Bertolucci PH, de Oliveira FF. Cognitive impairment in fibromyalgia. Curr Pain Headache Rep. 2013 Jul;17(7):344. doi: 10.1007/s11916-013-0344-9. PubMed 23709236 ↗
  • Elkana O, Yaalon C, Raev S, Sobol N, Ablin JN, Shorer R, Aloush V. A modified version of the 2016 ACR fibromyalgia criteria cognitive items results in stronger correlations between subjective and objective measures of cognitive impairment. Clin Exp Rheumatol. 2021 May-Jun;39 Suppl 130(3):66-71. doi: 10.55563/clinexprheumatol/403mpp. Epub 2021 Mar 16. PubMed 33734966 ↗
  • Duzce Keles E, Birtane M, Ekuklu G, Kilincer C, Caliyurt O, Tastekin N, Is EE, Ketenci A, Neblett R. Validity and reliability of the Turkish version of the central sensitization inventory. Arch Rheumatol. 2021 Oct 18;36(4):518-526. doi: 10.46497/ArchRheumatol.2022.8665. eCollection 2021 Dec. PubMed 35382371 ↗
  • Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005 Apr;53(4):695-9. doi: 10.1111/j.1532-5415.2005.53221.x. PubMed 15817019 ↗
  • Kaya Y, Aki OE, Can UA, Derle E, Kibaroglu S, Barak A. Validation of Montreal Cognitive Assessment and Discriminant Power of Montreal Cognitive Assessment Subtests in Patients With Mild Cognitive Impairment and Alzheimer Dementia in Turkish Population. J Geriatr Psychiatry Neurol. 2014 Jun;27(2):103-9. doi: 10.1177/0891988714522701. Epub 2014 Feb 26. PubMed 24578463 ↗
  • Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int. 2000 Dec;20(1):9-12. doi: 10.1007/s002960000077. PubMed 11149662 ↗

Individual participant data

Plan to share: No — Data sharing not planned

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 12, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06948903
Lead sponsor
Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
Responsible party
Sponsor
First posted
Apr 29, 2025
Start date
Jan 10, 2023
Primary completion
Aug 1, 2025
Completion
Oct 1, 2025 (estimated)
Last update
Sep 12, 2025

Study contacts

Feyza Yücel, M.D.
Contact
dr.fny28@gmail.com
(0216) 542 20 00 ext. +90
Feyza Yücel
study chair · Saglik Bilimleri Universitesi

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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