Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun;15(6):e70603.
doi: 10.1002/brb3.70603.

Neuropsychological Function and the Relationship Between Subjective Cognition, Objective Cognition, and Symptoms in Hypermobile Ehlers-Danlos Syndrome

Amber Sousa  1 , Min-Kyung Jung  1 , Arline Allera  1 , Bernadette Riley  1
Affiliations

Neuropsychological Function and the Relationship Between Subjective Cognition, Objective Cognition, and Symptoms in Hypermobile Ehlers-Danlos Syndrome

Amber Sousa et al. Brain Behav. 2025 Jun.

Abstract

Introduction: Hypermobile Ehlers-Danlos syndrome (hEDS), a subtype of the Ehlers-Danlos syndromes, is a connective tissue disorder that is associated with a number of cognitive and psychological symptoms. Very little research has directly examined the neuropsychological functioning profile in hEDS, but some research has found associations of hypermobility with cognitive difficulties, psychological symptoms, and structural brain differences.

Methods: The current research compared a 12-matched-pairs sample of individuals with hEDS to healthy controls on a comprehensive neuropsychological test battery, as well as measures of mood, pain levels, fatigue, subjective cognition, and ability to perform social activities. Participants were matched for age, gender, and years of education. A second analysis was completed for a larger group of 18 participants with hEDS to examine associations of cognition and other symptoms with subjective cognition.

Results: Our results did not reveal significant cognitive differences between the two groups for most cognitive measures. However, individuals with hEDS had lower scores for delayed verbal memory recall. In the larger hEDS sample, correlations between subjective cognition, objective cognitive test performance, and other clinical variables revealed significant correlations between subjective cognition and visuospatial planning and construction, working memory, and set-shifting. Additionally, subjective cognition was associated with anxiety, depression, fatigue, pain, and the ability to participate in social activities.

Conclusion: We conclude that cognitive difficulties reported by individuals with hEDS are likely fluctuating and may correspond with fluctuating symptoms including dysautonomia, pain, and sleep difficulties. Furthermore, subjective cognition appears to be especially correlated with other related symptoms of mood, pain, and fatigue.

Keywords: cognition; hypermobile Ehlers‐Danlos syndrome; memory; neuropsychology; subjective cognition.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Similar articles

See all similar articles

References

    1. Amtmann, D. , Cook K. F., Jensen M. P., et al. 2010. “Development of a PROMIS item bank to measure pain interference.” Pain, 146, no. 1‐2: 173–182. 10.1016/j.pain.2009.08.007. - DOI - PMC - PubMed
    1. Baeza‐Velasco, C. , Bourdon C., Polanco‐Carrasco R., et al. 2017. “Cognitive Impairment in Women With Joint Hypermobility Syndrome/Ehlers‐Danlos Syndrome Hypermobility Type.” Rheumatology International 37, no. 6: 937–939. - PubMed
    1. Baeza‐Velasco, C. , Bulbena A., Polanco‐Carrasco R. , and Jaussaud R.. 2019. “Cognitive, Emotional, and Behavioral Considerations for Chronic Pain Management in the Ehlers‐Danlos Syndrome Hypermobility‐Type: A Narrative Review.” Disability and Rehabilitation 41, no. 9: 1110–1118. - PubMed
    1. Baeza‐Velasco, C. , Cohen D., Hamonet C., et al. 2018. “Autism, Joint Hypermobility‐Related Disorders and Pain.” Frontiers in Psychiatry 9: 656. - PMC - PubMed
    1. Benjamini, Y. , and Hochberg Y.. 1995. “Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing.” Journal of the Royal Statistical Society, Series B 57, no. 1: 289–300.

LinkOut - more resources