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Language Impairment in Fibromyalgia & Chronic Fatigue Syndrome

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Updated August 23, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

The Symptom of Language Impairment:

Do you find yourself searching your brain for simple words that you can't remember? Do you have problems writing or understanding language? You're not alone! Language impairment is a symptom of fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS). It's part of a cluster of symptoms known as "fibro fog" or brain fog.

We don't have evidence that our language impairment is tied to known disorders, but it's similar to those associated with a speech disorder called dysphasia (or aphasia if it's severe.) Some fibromyalgia research shows a specific delay in name recall, similar to nominal dysphasia, which involves nouns.

Causes of Language Impairment:

Researchers don't yet know why people with FMS or ME/CMS may have language impairment. Dysphasia and aphasia are generally linked to brain injury or degeneration, such as from a stroke. However, we don't have evidence that FMS or ME/CFS can cause this type of degeneration.

Experts have several theories about possible contributing factors:

  • Lack of restorative sleep
  • Abnormal cranial blood flow or volume
  • Brain abnormalities
  • Premature brain aging
  • Mental distraction due to pain

Treating Language Impairment:

Brain fog symptoms generally improve when pain and fatigue levels are well-treated. However, if you're having problems managing your condition, you do have several options for alleviating cognitive symptoms. For information on supplements, dietary changes, and cognitive training, see:

Impact on Your Life:

Language problems can cause frustration and embarrassment. They tend to be unpredictable and can disrupt conversation at any time. They're often worse when we're under stress.

When you can't communicate effectively, it can be hard to maintain relationships or hold down a job. Sometimes, people may think we're drunk, disoriented, or just not very smart. It's possible to become fearful of communication, and the anxiety that causes can make the problem worse. It's important to manage your stress levels and learn to stay calm when your brain falters.

Coping With Language Impairment:

Finding effective ways to cope with language impairment can help relieve some of the emotional and social impact. For example, if you find it's easier to write than speak, you might have an easier time communicating via email or text whenever possible.

Make sure the people closest to you understand this symptom so they can be patient or help you out when you're struggling to find a word. At work, you can request reasonable accommodation, such as getting instructions in writing instead of verbally.

With time, proper treatment and management, and effective coping strategies, language impairments can become less of a problem. The key is to keep working and celebrate each small step forward.

Sources:

Burgmer M, et al. NeuroImage. 2009 Jan 15;44(2):502-8. Altered brain activity during pain processing in fibromyalgia.

Centers for Disease Control and Prevention. "Symptoms".

Cicerone et al., Evidence-based cognitive rehabilitation: Updated Review of the literature from 1998 to 2002. Archives of Physical Medicine and Rehabilitation 2005 Vol 86; 1681-1692.

Cook DB, et al. NeuroImage. 2007 May 15;36(1):108-22. Functional neuroimaging correlates of mental fatigue induced by cognition among chronic fatigue syndrome patients and controls.

Emad Y, et al. The Journal of Rheumatology. 2008 Jul;35(7):1371-7. Hippocampus dysfunction may explain symptoms of fibromyalgia syndrome.

Jordan Lori and Hillis Argye. Disorders of speech and language: aphasia, apraxia and dysarthria. Current Opinion in Neurology 2006 19 (6): 580-585.

Leavitt F, Katz RS. Speed of mental operations in fibromyalgia: a selective naming speed deficit. Journal of Clinical Rheumatology. 2008 Aug;14(4):214-8.

Luerding R, et al. Brain: A Journal of Neurology. 2008 Dec;131(Pt 12):3222-31.Working memory performance is correlated with local brain morphology in the medial frontal and anterior cingulate cortex in fibromyalgia patients.

Mountz JM, et al. Arthritis and Rheumatism. 1995 Jul;38(7):926-38.Fibromyalgia in women. Abnormalities of regional cerebral blood flow in the thalamus and the caudate nucleus are associated with low pain threshold levels.

Schmidt-Wilcke T, et al. Pain. 2007 Nov;132 Suppl 1:S109-16. Striatal grey matter increase in patients suffering from fibromyalgia--a voxel-based morphometry study.

Starlanyl, Devin J. "Fibromyalgia and Chronic Myofascial Pain For Doctors and Other Health Care Providers."

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