Tag: Natelson

Neuropsychiatric status of patients with chronic fatigue syndrome: an overview

Abstract:

Chronic fatigue syndrome (CFS) is an illness that results in debilitating fatigue as well as rheumatological, infectious, and neuropsychiatric symptoms. The present paper is a brief overview of the neuropsychological and psychiatric research on CFS. Studies from our laboratory contrasting CFS with patients with multiple sclerosis, depression, and healthy controls are detailed. Our hypothesis of neuropsychological impairments in CFS is discussed.

 

Source: Deluca J, Johnson SK, Natelson BH. Neuropsychiatric status of patients with chronic fatigue syndrome: an overview. Toxicol Ind Health. 1994 Jul-Oct;10(4-5):513-22. http://www.ncbi.nlm.nih.gov/pubmed/7778111

 

High titers of anti-Epstein-Barr virus DNA polymerase are found in patients with severe fatiguing illness

Abstract:

Forty-one patients with chronic fatigue syndrome (CFS), 76 healthy controls matched with the patient group for age range, sex, race, and socioeconomic class, and 22 symptomatic patients with seasonal affective disorder (SAD) had serum sampled for antibodies against 2 Epstein-Barr virus (EBV) replicating enzymes.

Abnormal titers of antibodies were found twice as often in CFS patients as controls (34.1% vs. 17.1%), with SAD patients having an intermediate frequency (27.3%). Stratifying for disease severity sharpened the differences considerably, with the sicker CFS and SAD patients having 52% and 50% abnormal tests, respectively; more mildly afflicted CFS and SAD patients had a frequency of abnormal tests in the normal range.

Antibodies to EBV DNA polymerase (DNAP) were the more sensitive of the two tests in that they were positive in all cases but one. These findings suggest that antibodies against EBV DNAP may be a useful marker in delineating a subset of patients with severe fatiguing illness for appropriate treatment trials and for monitoring their outcomes.

 

Source: Natelson BH, Ye N, Moul DE, Jenkins FJ, Oren DA, Tapp WN, Cheng YC. High titers of anti-Epstein-Barr virus DNA polymerase are found in patients with severe fatiguing illness. J Med Virol. 1994 Jan;42(1):42-6. http://www.ncbi.nlm.nih.gov/pubmed/8308519

 

Cognitive functioning of patients with chronic fatigue syndrome

Abstract:

Neuropsychological problems are a distressing and frequent component of the symptom complex associated with chronic fatigue syndrome. Objective assessment of these difficulties is essential to understanding the nature of this illness. Results of the studies discussed in this paper suggest that impaired information processing, rather than primary memory dysfunction, may be at the root of the cognitive problems that afflict so many patients with CFS.

 

Source: Johnson SK, DeLuca J, Fiedler N, Natelson BH. Cognitive functioning of patients with chronic fatigue syndrome. Clin Infect Dis. 1994 Jan;18 Suppl 1:S84-5. http://www.ncbi.nlm.nih.gov/pubmed/8148459

 

A controlled study of brain magnetic resonance imaging in patients with the chronic fatigue syndrome

Abstract:

Two neuroradiologists compared the brain MR scans of 52 patients with the CDC criteria for the chronic fatigue syndrome (CFS) with those of 52 age and sex matched controls who had undergone imaging because of histories of head trauma or headache.

CFS patients had significantly more abnormal scans than controls–27% vs 2%. Abnormalities seen were foci of increased white matter T2 signal in 9 CFS patients and one control and ventricular or sulcal enlargement in 5 CFS patients. Follow up of patients with subcortical signal hyperintensities revealed 3 who had symptoms suggestive of other known medical causes of what appeared to be CFS.

The data indicate that some CFS patients have some organic problem manifesting itself on neuroimaging. But, finding MR abnormalities should warn the physician that the patient’s symptoms may be secondary to some other medical illness and not simply primary CFS.

 

Source: Natelson BH, Cohen JM, Brassloff I, Lee HJ. A controlled study of brain magnetic resonance imaging in patients with the chronic fatigue syndrome. J Neurol Sci. 1993 Dec 15;120(2):213-7. http://www.ncbi.nlm.nih.gov/pubmed/8138812

 

Information processing efficiency in chronic fatigue syndrome and multiple sclerosis

Abstract:

OBJECTIVE: To compare the cognitive performance of subjects with chronic fatigue syndrome (CFS), multiple sclerosis (MS), and healthy controls. All subjects were matched for age, education, and verbal intelligence, as previous neuropsychological studies of CFS had not used appropriate control groups.

DESIGN: Case-control design. All subjects were given a neuropsychological battery and the test scores were compared among the groups.

SETTING: Subjects with CFS and subjects with MS were recruited from private and institutional practice and from the community. Healthy subjects were recruited from the community.

PATIENTS/OTHER PARTICIPANTS: Twelve subjects (all female) with CFS participated in the study. Chronic fatigue syndrome was diagnosed in these patients in accordance with the requirements outlined by the Centers for Disease Control as modified subsequently to not exclude patients with concurrent depression and/or anxiety. All subjects with CFS were referred for a neuropsychological examination to assess persistent cognitive complaints. Eleven subjects (10 female, one male) with the diagnosis of clinically stable MS were chosen from clinics and the community because of complaints of mild to moderate cognitive impairment. The subjects with MS and 11 healthy volunteers (10 female, one male) were matched to the group with CFS by age, education, and estimated verbal intelligence (based on the Vocabulary subtest of the Wechsler Adult Intelligence Scale-Revised). The subjects with MS had a mean Kurtzke Expanded Disability Status Scale score of 4.95 (SD, 1.95; range, 2.0 to 7.5). As a result of the matching procedure, there were no differences among the three groups in age (F[2,31] = 0.32), education (F[2,31] = 0.80), and verbal intelligence (F[2,31] = 0.31).

INTERVENTIONS: None.

MAIN OUTCOME MEASURES: These measures included the Beck Depression Inventory (BDI), the Paced Auditory Serial Addition Test (PASAT), Digit Span Test, and the Similarities Test of Verbal Abstract Reasoning.

RESULTS: The mean number of correctly identified responses collapsed across the four PASAT trials was significantly different across groups (F[2,31] = 4.03; P < .05). While the CFS and MS groups did not differ from each other, subjects with CFS (SEM, 124.2 +/- 6.4) and subjects with MS (SEM, 112.9 +/- 10.9) scored significantly below controls (SEM, 146.4 +/- 6.4) (Fisher’s Protected Least Significant Difference test; P < .05). There were significant differences among the three groups on mean Digit Span Test performance (F[2,31] = 5.5; P < .01). While the CFS and MS group did not differ significantly from each other, only the CFS group was significantly lower than control (Fisher’s Protected Least Significant Difference test; P < .05). Mean performance on the Similarities test did not differ among the three groups (F = 0.58). In addition, there were significant differences among the three groups in mean BDI scores (F[2,31] = 7.6; P < .01). The CFS and MS groups did not differ significantly from each other, and both groups showed a statistically significantly elevated mean BDI score relative to the control group (Fisher’s Protected Least Significant Difference test; P < .05). No significant correlations were found between BDI scores and PASAT total scores (CFS, r = -.21; MS, r = .13; control, r = .27), or between BDI and Digit Span Test (CFS, r = -.32; MS, r = -.40; control, r = -.19). Results of the PASAT and Digit Span Test were significantly correlated in the CFS group (r = .71; P < .01), but not in the MS (r = .06) or control groups (r = .49).

CONCLUSIONS: These results indicate that subjects with CSF and subjects with MS show significant impairment on a test of complex concentration when compared with appropriate controls. The data suggest that subjects with CFS and subjects with MS have difficulty on tasks that require the simultaneous processing of complex cognitive information. Selective impairment in information processing efficiency may lie at the root of other cognitive complaints made by patients with CFS.

 

Source: DeLuca J, Johnson SK, Natelson BH. Information Processing Efficiency in Chronic Fatigue Syndrome and Multiple Sclerosis.Arch Neurol. 1993;50(3):301-304. doi:10.1001/archneur.1993.00540030065016. http://archneur.jamanetwork.com/article.aspx?articleid=592247