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Neuropsychological performance in patients with chronic fatigue syndrome: Results from a population-based study.

Majer M, Welberg LAM, Capuron L, Miller AH, Pagnoni G, Reeves WC
Psychosomatic Medicine doi: 10.1097/PSY.0b013e31817b9793

Summary

This is an extremely important publication that confirms and extends our previous publication of differences in cognitive function between persons with CFS and well controls (to view this study: http://www.cdc.gov/cfs/publications/causes_29.htm). The previously published study was conducted during the Wichita Clinical Study (to view this study: http://www.cdc.gov/cfs/publications/casedef_10.htm) and showed persons with CFS had decreased working memory and increased cognitive fatigability. This new study involved participants in the Georgia Surveillance Program (to view this study: http://www.cdc.gov/cfs/publications/surveillance_6.htm). We used the Cambridge Neuropsychological Test Automated Battery (CANTAB) to measure cognitive function in 58 people with CFS and 104 well controls. The CANTAB is a group of validated computer administered tests (language and culture independent) designed to examine specific components of cognition. Compared to well controls people with CFS: exhibited significant decreases in motor speed (slower response times in the simple and choice reaction time task); and, alterations in working memory. This may indicate functional alterations of motor and premotor cortices and midbrain structures regulating the general level of arousal and alterations in basal ganglia circuits that interact with cortical brain regions. The current in-patient study of CFS at Emory University is designed, in part, to evaluate this hypothesis.

Abstract

Objective: To examine the neuropsychological function characterized in subjects with chronic fatigue syndrome (CFS) at the same time controlling for relevant confounding factors. CFS is associated with symptoms of neuropsychological dysfunction. Objective measures of neuropsychological performance have yielded inconsistent results possibly due to sample selection bias, diagnostic heterogeneity, comorbid psychiatric disorders, and medication usage.

Method: CFS subjects (n = 58) and well controls (n = 104) from a population-based sample were evaluated, using standardized symptom severity criteria. Subjects who had major psychiatric disorders or took medications known to influence cognition were excluded. Neuropsychological function was measured using the Cambridge Neuropsychological Test Automated Battery (CANTAB).

Results: Compared with controls, CFS subjects exhibited significant decreases in motor speed as measured in the simple and five-choice movement segments of the CANTAB reaction time task. CFS subjects also exhibited alterations in working memory as manifested by a less efficient search strategy on the spatial working memory task, fewer % correct responses on the spatial recognition task, and prolonged latency to a correct response on the pattern recognition task. A significantly higher percentage of CFS subjects versus controls exhibited evidence of neuropsychological impairment (defined by performance 1 standard deviation below the CANTAB normative mean) in tasks of motor speed and spatial working memory. Impairment in CFS subjects versus control subjects ranged from 20% versus 4.8% in five-choice movement time (p = .002) to 27.8% versus 10.6% in search strategy on the spatial working memory task (p = .006).

Conclusions: These results confirm and quantify alterations in motor speed and working memory in CFS subjects independent of comorbid psychiatric disease and medication usage.

Page last modified on September 1, 2008

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