[en] Object: It is frequently reported that cognitive complaints accompany the chronic fatigue syndrome (CFS). However, studies on cognition in CFS have yielded conflicting results. The neuropsychological literature on this subject is plagued by methodological difficulties, including, for example, the existence of comorbid depression, which is also associated with cognitive impairments.
Patients and Methods: Twenty-five patients with CFS, 25 patients with major depressive disorder (MDD), and 25 healthy control subjects were given standardized tests of attention, working memory, and verbal and visual episodic memory, and were also tested for effects related to lack of effort/simulation, suggestibility, and fatigue.
Results: Patients with CFS had slower phasic alertness, and also had impaired working, visual and verbal episodic memory compared to controls. They were, however, no more sensitive than the other groups to suggestibility or to fatigue induced during the cognitive session. Cognitive impairments in MDD patients were strongly associated with depression and subjective fatigue; in patients with CFS, there was a weaker correlation between cognition and depression (and no correlation with fatigue).
Conclusions: This study confirms the presence of an objective impairment in attention and memory in patients with CFS but with good mobilization of effort and without exaggerated suggestibility.
Disciplines :
Neurosciences & behavior
Author, co-author :
Constant, Eric
Adam, Stéphane ; Université de Liège - ULiège > Département de personne et société > Psychologie de la sénescence
Gillain, Benoît
Lambert, Michel
Masquelier, Etienne
Seron, Xavier
Language :
English
Title :
Cognitive deficits in patients with chronic fatigue syndrome compared to those with major depressive disorder and healthy controls
K. Fukuda, S.E. Straus, I. Hickie, M.C. Sharpe, J.G. Dobbins, A. Komaroff International Chronic Fatigue Syndrome Study Group The chronic fatigue syndrome: a comprehensive approach to its definition and study Ann Intern Med 121 12 1994 953 959 (Pubitemid 24370860)
G.P. Holmes, J.E. Kaplan, N.M. Gantz, A.L. Komaroff, L.B. Schonberger, and S.E. Straus Chronic fatigue syndrome: a working case definition Ann Intern Med 108 3 1988 387 389
H. Cope, A. Pernet, B. Kendall, and A. David Cognitive functioning and magnetic resonance imaging in chronic fatigue Br J Psychiatry 167 1 1995 86 94 (Pubitemid 26124580)
J. DeLuca, S.K. Johnson, and B.H. Natelson Information processing efficiency in chronic fatigue syndrome and multiple sclerosis Arch Neurol 50 3 1993 301 304 (Pubitemid 23069617)
J. Grafman, V. Schwartz, J.K. Dale, M. Scheffers, C. Houser, and S.E. Straus Analysis of neuropsychological functioning in patients with chronic fatigue syndrome J Neurol Neurosurg Psychiatry 56 6 1993 684 689 (Pubitemid 23203769)
E. McDonald, H. Cope, and A. David Cognitive impairment in patients with chronic fatigue: a preliminary study J Neurol Neurosurg Psychiatry 56 7 1993 812 815 (Pubitemid 23232544)
C. Ray, L. Phillips, and W.R. Weir Quality of attention in chronic fatigue syndrome: subjective reports of everyday attention and cognitive difficulty, and performance on tasks of focused attention Br J Clin Psychol 32 Pt (3) 1993 357 364 (Pubitemid 23288222)
M. Riccio, C. Thompson, B. Wilson, D.J. Morgan, and A.F. Lant Neuropsychological and psychiatric abnormalities in myalgic encephalomyelitis: a preliminary report Br J Clin Psychol 31 Pt (1) 1992 111 120
H.T. Altay, B.B. Toner, H. Brooker, S.E. Abbey, I.E. Salit, and P.E. Garfinkel The neuropsychological dimensions of postinfectious neuromyasthenia (chronic fatigue syndrome): a preliminary report Int J Psychiatry Med 20 2 1990 141 149 (Pubitemid 20296008)
J. DeLuca, S.K. Johnson, D. Beldowicz, and B.H. Natelson Neuropsychological impairments in chronic fatigue syndrome, multiple sclerosis, and depression J Neurol Neurosurg Psychiatry 58 1 1995 38 43
L.B. Krupp, M. Sliwinski, D.M. Masur, F. Friedberg, and P.K. Coyle Cognitive functioning and depression in patients with chronic fatigue syndrome and multiple sclerosis Arch Neurol 51 7 1994 705 710 (Pubitemid 24201891)
C.A. Sandman, J.L. Barron, K. Nackoul, J. Goldstein, and F. Fidler Memory deficits associated with chronic fatigue immune dysfunction syndrome Biol Psychiatry 33 8-9 1993 618 623 (Pubitemid 23201666)
E. Joyce, S. Blumenthal, and S. Wessely Memory, attention, and executive function in chronic fatigue syndrome J Neurol Neurosurg Psychiatry 60 5 1996 495 503 (Pubitemid 26147889)
D. Prasher, A. Smith, and L. Findley Sensory and cognitive event-related potentials in myalgic encephalomyelitis J Neurol Neurosurg Psychiatry 53 3 1990 247 253 (Pubitemid 20101751)
L.A. Tiersky, S.K. Johnson, G. Lange, B.H. Natelson, and J. DeLuca Neuropsychology of chronic fatigue syndrome: a critical review J Clin Exp Neuropsychol 19 4 1997 560 586 (Pubitemid 27452011)
M.K. Scheffers, R. Johnson Jr., J. Grafman, J.K. Dale, and S.E. Straus Attention and short-term memory in chronic fatigue syndrome patients: an event-related potential analysis Neurology 42 9 1992 1667 1675
K.B. Schmaling, J.D. DiClementi, C.M. Cullum, and J.F. Jones Cognitive functioning in chronic fatigue syndrome and depression: a preliminary comparison Psychosom Med 56 5 1994 383 388
B. Ravnkilde, P. Videbech, K. Clemmensen, A. Egander, N.A. Rasmussen, and R. Rosenberg Cognitive deficits in major depression Scand J Psychol 43 3 2002 239 251
N.I. Landro, T.C. Stiles, and H. Sletvold Neuropsychological function in nonpsychotic unipolar major depression Neuropsychiatry Neuropsychol Behav Neurol 14 4 2001 233 240 (Pubitemid 33051500)
N. Afari, and D. Buchwald Chronic fatigue syndrome: a review Am J Psychiatry 160 2 2003 221 236 (Pubitemid 41110447)
P.S. Marshall, M. Forstot, A. Callies, P.K. Peterson, and C.H. Schenck Cognitive slowing and working memory difficulties in chronic fatigue syndrome Psychosom Med 59 1 1997 58 66 (Pubitemid 27061221)
A.P. Smith, P.O. Behan, W. Bell, K. Millar, and M. Bakheit Behavioural problems associated with the chronic fatigue syndrome Br J Psychol 84 Pt (3) 1993 411 423
D. Schrijvers, F. Van Den Eede, Y. Maas, P. Cosyns, W. Hulstijn, and B.G. Sabbe Psychomotor functioning in chronic fatigue syndrome and major depressive disorder: a comparative study J Affect Disord 115 1-2 2009 46 53
V. Michiels, and R. Cluydts Neuropsychological functioning in chronic fatigue syndrome: a review Acta Psychiatr Scand 103 2 2001 84 93 (Pubitemid 32147128)
K. Short, M. McCabe, and G. Tooley Cognitive functioning in chronic fatigue syndrome and the role of depression, anxiety, and fatigue J Psychosom Res 52 6 2002 475 483 (Pubitemid 34752342)
V. Michiels, R. Cluydts, B. Fischler, G. Hoffmann, O. Le Bon, and K. De Meirleir Cognitive functioning in patients with chronic fatigue syndrome J Clin Exp Neuropsychol 18 5 1996 666 677 (Pubitemid 26395894)
J.H. Vercoulen, C.M. Swanink, J.F. Fennis, J.M. Galama, J.W. van der Meer, and G. Bleijenberg Prognosis in chronic fatigue syndrome: a prospective study on the natural course J Neurol Neurosurg Psychiatry 60 5 1996 489 494 (Pubitemid 26147888)
G. Ostlund, K. Borg, and A. Wahlin Cognitive functioning in post-polio patients with and without general fatigue J Rehabil Med 37 3 2005 147 151 (Pubitemid 40775153)
J.D. DiClementi, K.B. Schmaling, and J.F. Jones Information processing in chronic fatigue syndrome: a preliminary investigation of suggestibility J Psychosom Res 51 5 2001 679 686 (Pubitemid 34007447)
H. Spiegel, and D. Spiegel Trance and treatment clinical uses of hypnosis 1978 American Psychiatric Press Washington, DC
M.B. First, R.L. Spitzer, and M. Gibbon Structured clinical interview for DSM-IV axis I disorders (SCID), clinical version 1996 American Psychiatric Press Washington, DC
C.D. Spielberger Manual for the state trait anxiety inventory (form A-Y) 1983 Consulting Psychologists Press Palo Alto, CA
A.T. Beck, C.H. Ward, M. Mendelson, J. Mock, and J. Erbaugh An inventory for measuring depression Arch Gen Psychiatry 4 1961 561 571
J. Delay, P. Pichot, T. Lemperiere, and R. Mirouze The nosology of depressive states. Relation between Etiology and semeiology. 2. Results of Beck's Questionnaire Encephale 52 1963 497 504
T.L. Brink Proper scoring of the geriatric depression scale J Am Geriatr Soc 37 8 1989 819 820
L.B. Krupp, N.G. LaRocca, J. Muir-Nash, and A.D. Steinberg The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus Arch Neurol 46 10 1989 1121 1123 (Pubitemid 19246303)
P. Zimmermann, and B. Fimm Tests d'évaluation de l'attention: version 1.5 (TEA): Psychologische Testsysteme 1994
M.C. Diehr, R.K. Heaton, W. Miller, and I. Grant The paced auditory serial addition task (PASAT): norms for age, education, and ethnicity Assessment 5 4 1998 375 387 (Pubitemid 128457952)
P. Green, L. Allen, and K. Astner Manual for computerised word memory test, for windows® user's manual - revised June 2005 1995 Green's Publishing INC Edmonton
A.D. Baddeley, H. Emslie, and I. Nimmo-Smith Doors and people: a test of visual and verbal recall and recognition 1994 Thames Valley Test Company Bury St Edmunds
S. Schagen, B. Schmand, S. de Sterke, and J. Lindeboom Amsterdam short-term memory test: a new procedure for the detection of feigned memory deficits J Clin Exp Neuropsychol 19 1 1997 43 51 (Pubitemid 27122102)
P. Green, G.L. Iverson, and L. Allen Detecting malingering in head injury litigation with the word memory test Brain Injury 13 10 1999 813 819 (Pubitemid 29488208)
L. Pankratz, and L.M. Binder Malingering on intellectual and neuropsychological measures R. Rogers, Clinical assessment of malingering and deception 2nd ed. 1997 The Guilford Press New York 223 236
J. DeLuca, S.K. Johnson, S.P. Ellis, and B.H. Natelson Cognitive functioning is impaired in patients with chronic fatigue syndrome devoid of psychiatric disease J Neurol Neurosurg Psychiatry 62 2 1997 151 155 (Pubitemid 27090933)
S. Ross, B. Fantie, S.F. Straus, and J. Grafman Divided attention deficits in patients with chronic fatigue syndrome Appl Neuropsychol 8 1 2001 4 11 (Pubitemid 32458555)
P.W. Gold, and G.P. Chrousos Organization of the stress system and its dysregulation in melancholic and atypical depression: high vs low CRH/NE states Mol Psychiatry 7 3 2002 254 275 (Pubitemid 34280634)
R.D. Levitan, F.J. Vaccarino, G.M. Brown, and S.H. Kennedy Low-dose dexamethasone challenge in women with atypical major depression: pilot study J Psychiatry Neurosci 27 1 2002 47 51 (Pubitemid 34478369)
F. Van Den Eede, G. Moorkens, W. Hulstijn, B. Van Houdenhove, P. Cosyns, and B.G. Sabbe Combined dexamethasone/corticotropin-releasing factor test in chronic fatigue syndrome Psychol Med 38 7 2008 963 973
D.B. Cook, P.J. O'Connor, G. Lange, and J. Steffener Functional neuroimaging correlates of mental fatigue induced by cognition among chronic fatigue syndrome patients and controls Neuroimage 36 1 2007 108 122 (Pubitemid 46617953)