Cognitive slowing and working memory difficulties in chronic fatigue syndrome

Abstract:

OBJECTIVE: Patients with chronic fatigue syndrome (CFS) commonly report problems with attention, memory, learning, and speed of cognitive processing. This study attempted to evaluate these complaints using objective test criteria.

METHOD: A test battery composed of six tests assessing these cognitive functions was given on two consecutive days. Twenty CFS patients were compared with 20 healthy control subjects and 14 patients with a history of major depression or dysthymia matched by age, intelligence, education level, and sex.

RESULTS: Compared with control subjects, CFS patients consistently scored lower on tests in which motor and cognitive processing speeds were a critical factor, eg, reaction-time tasks. They also had more difficulty on working-memory tests in which rapid cognitive processing speed is also an important factor. The effort made on the first day of testing did not result in a decline in cognitive function on the following day. CFS patients did not qualify as having affective disorder by several different diagnostic criteria. Nonetheless, CFS patients’ test performances did not differ from patients with a history of major depression or dysthymia.

CONCLUSIONS: It is concluded that, although CFS and major depression and dysthymia have distinct clinical features, these disorders have slowed motor and cognitive processing speed in common.

Comment in: Cognitive slowing in chronic fatigue syndrome (CFS) [Psychosom Med. 1997]

 

Source: Marshall PS, Forstot M, Callies A, Peterson PK, Schenck CH. Cognitive slowing and working memory difficulties in chronic fatigue syndrome. Psychosom Med. 1997 Jan-Feb;59(1):58-66. http://www.ncbi.nlm.nih.gov/pubmed/9021867

 

Neuropsychological deficits in chronic fatigue syndrome: artifact or reality?

Chronic fatigue syndrome is an illness characterised by extreme fatigue of uncertain origin which has been present for at least six months. The fatigue should have a sudden onset and be severe enough to substantially reduce the patient’s day to day activities. A number of other symptoms are associated with chronic fatigue syndrome including complaints of impaired memory, difficulty making decisions, poor attention, and reduced concentration. Many patients complain that it is these cognitive symptoms which cause them the greatest frustration and disability.

You can read the rest of this article here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC486357/pdf/jnnpsyc00017-0004.pdf

 

Source: Moss-Morris R, Petrie KJ, Large RG, Kydd RR. Neuropsychological deficits in chronic fatigue syndrome: artifact or reality? J Neurol Neurosurg Psychiatry. 1996 May;60(5):474-7. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC486357/

 

An assessment of cognitive function and mood in chronic fatigue syndrome

Abstract:

Data were gathered regarding the associates of chronic fatigue syndrome (CFS) with: (1) speed of cognitive processing, (2) motor speed, (3) ability to sustain attention, and (4) mood. Patients were given a brief neuropsychological test battery before and after double-blind treatment with terfenadine or placebo and completed a daily mood rating scale (Positive and Negative Affect Schedule) during the study.

CFS patients exhibited slower cognitive processing and motor speed and lower positive affect, as compared to data reported from previous studies of healthy subjects and other patient groups; however, CFS patients did not exhibit deficits in sustained attention in comparison to other groups.

The CFS patients’ ability to attend to verbal versus figural stimuli and mood ratings were different from those reported in studies of patients with depression. Because of methodological limitations, these findings are preliminary, but they encourage further assessment of cognitive dysfunction and mood in CFS.

 

Source: Marshall PS, Watson D, Steinberg P, Cornblatt B, Peterson PK, Callies A, Schenck CH. An assessment of cognitive function and mood in chronic fatigue syndrome. Biol Psychiatry. 1996 Feb 1;39(3):199-206. http://www.ncbi.nlm.nih.gov/pubmed/8837981

 

Neuropsychological impairments in chronic fatigue syndrome, multiple sclerosis, and depression

Abstract:

To examine the degree and nature of cognitive impairments in chronic fatigue syndrome, a comprehensive neuropsychological battery was given to patients with chronic fatigue syndrome, multiple sclerosis, depressed patients, and healthy controls. The battery included tests of attention and concentration, information processing speed, verbal and visual memory, intellectual ability, and concept formation. Measures of depression and anxiety were also obtained.

The chronic fatigue syndrome group did not differ from the depressed group in overall neuropsychological performance, but differed from the multiple sclerosis and control groups. The most significant impairment was in information processing speed in the chronic fatigue syndrome group. Depression and anxiety were not related to neuropsychological performance. The influence of reduced information processing on other areas of cognition is discussed.

 

Source: DeLuca J, Johnson SK, Beldowicz D, Natelson BH. Neuropsychological impairments in chronic fatigue syndrome, multiple sclerosis, and depression. J Neurol Neurosurg Psychiatry. 1995 Jan;58(1):38-43. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1073266/ (Full article)

 

Behavioural problems associated with the chronic fatigue syndrome

Abstract:

Disturbances of memory, concentration and motor function are often reported by patients with the chronic fatigue syndrome (CFS). The present study objectively evaluated these behavioural problems using a computerized test battery measuring memory, attention and motor skills.

Fifty-seven CFS patients were compared with 19 matched controls and all subjects completed the performance test battery and filled in questionnaires measuring psychopathology and mood. The patients reported significantly higher levels of depression, anxiety, physical symptoms and cognitive failures than the controls. Similarly, they reported more negative affect at the time of testing.

The patients were slower on psychomotor tasks, showed increased visual sensitivity and impaired attention. Digit span and free recall were not impaired but retrieval from semantic memory and logical reasoning were slower. None of the performance differences between patients and controls could be attributed to differences in psychopathology. These results agree with recent findings from other laboratories, and it is now time to consider the nature of the neurological dysfunction underlying these effects.

 

Source: Smith AP, Behan PO, Bell W, Millar K, Bakheit M. Behavioural problems associated with the chronic fatigue syndrome. Br J Psychol. 1993 Aug;84 ( Pt 3):411-23. http://www.ncbi.nlm.nih.gov/pubmed/8401992

 

Attention and short-term memory in chronic fatigue syndrome patients: an event-related potential analysis

Abstract:

We recorded event-related brain potentials (ERPs) from 13 patients with chronic fatigue syndrome (CFS) and 13 matched normal controls. To assess attentional and memory deficits in CFS patients, we used a short-term memory task in which events occurred in different spatial locations and the patients made a rapid-response (RT) when a letter in a relevant location matched a letter in the prememorized set (Attention paradigm).

Time-on-task effects on the ERP and behavioral measures were assessed over the 2 1/4-hour duration of this task. Both groups also performed a visual Oddball paradigm, with an RT, before and after the Attention paradigm. The patients’ RTs were much more variable and, in nine of 13 cases, slower than the mean RT of the controls in both paradigms.

The patients’ memory performance was not significantly different from that of the controls and there were no group differences in the overall amplitude, latency, or scalp distribution of the N1, P2, N2, or P300 components of the ERP in either paradigm. The ERP and performance data from both paradigms suggest that perceptual, attentional, and short-term memory processes were unaffected in CFS patients and that the differences were limited to response-related processes.

 

Source: Scheffers MK, Johnson R Jr, Grafman J, Dale JK, Straus SE. Attention and short-term memory in chronic fatigue syndrome patients: an event-related potential analysis. Neurology. 1992 Sep;42(9):1667-75. http://www.ncbi.nlm.nih.gov/pubmed/1513453

 

Sensory and cognitive event-related potentials in myalgic encephalomyelitis

Abstract:

Myalgic Encephalomyelitis (ME) is a form of post viral fatigue syndrome resulting in myalgia and fluctuating fatiguability. Symptoms reflecting central nervous system dysfunction are common and include muscle weakness, headache, sensory disturbances, poor short term memory and impairment of concentration.

In view of the fact that sensory and cognitive disturbances are experienced by many patients objective evidence was sought with multi-modality sensory evoked potentials and auditory event-related cognitive potentials in a group of ME patients both with and without the enteroviral antigen, VP1 test positive.

The auditory brainstem, median nerve somatosensory and pattern reversal checkerboard visual potentials were normal for all 37 patients tested. In contrast to the sensory potentials significant differences in the mean latencies of the cognitive potential N2 and P3 were found. Reaction times were also significantly prolonged but the performance in terms of error was not significantly affected. No significant difference emerged in any of the parameters for the VP1 test. P3 was abnormal in latency or amplitude in 36% of the VP1 positive patients for the frequency discrimination task and 48% for the more difficult duration discrimination task.

The abnormalities indicate attentional deficits in some patients and slower speed of information processing in others. The prolonged latencies observed in these patients have not been observed in patients with depression in many other studies.

 

Source: Prasher D, Smith A, Findley L. Sensory and cognitive event-related potentials in myalgic encephalomyelitis. J Neurol Neurosurg Psychiatry. 1990 Mar;53(3):247-53. http://www.ncbi.nlm.nih.gov/pubmed/2324756

Note: You can read the full article here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1014138/