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Neurocognitive complaints and functional status among patients with CFS and fibromyalgia

Bob

Senior Member
Messages
16,455
Location
England (south coast)
Neurocognitive complaints and functional status among patients with chronic fatigue syndrome and fibromyalgia
Karen B. Schmaling, Karran L. Betterton
15 Oct 2015
Quality of Life Research
DOI: 10.1007/s11136-015-1160-y
http://link.springer.com/article/10.1007/s11136-015-1160-y




Abstract
Purpose
The purpose of this study was to conduct a longitudinal examination of cognitive complaints and functional status in patients with chronic fatigue syndrome (CFS) alone and those who also had fibromyalgia (CFS/FM).

Methods
A total of 93 patients from a tertiary care fatigue clinic were evaluated on four occasions, each 6 months apart. Each evaluation included a tender point assessment, and self-reported functional status and cognitive complaints.

Results
Patients with CFS/FM reported significantly worse physical functioning, more bodily pain, and more cognitive difficulties (visuo-perceptual ability and verbal memory) than patients with CFS alone. Over time, bodily pain decreased only for participants with CFS alone. Verbal memory problems were associated with more bodily pain for both patient groups, whereas visuo-perceptual problems were associated with worse functional status for patients with CFS alone.

Conclusions
This study adds to the literature on functional status, longitudinal course, and cognitive difficulties among patients with CFS and those with CFS and FM. The results suggest that patients with CFS/FM are more disabled, have more cognitive complaints, and improve more slowly over time than patients with CFS alone. Specific cognitive difficulties are related to worse functional status, which supports the addition of cognitive difficulties to the FM case criteria.

 

duncan

Senior Member
Messages
2,240
"...and improve more slowly over time..."

Ok, ignoring the "over time" thing, this implies we are all going to improve, just at different rates. Yes?

They do opine "This study adds to the literature...". They at least got that right.
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
"...and improve more slowly over time..."

Ok, ignoring the "over time" thing, this implies we are all going to improve, just at different rates. Yes?
I think that's what they mean, but they are referring to average outcomes in their study. i.e. on average, the patients (that they studied) improved over time. And "over time" seems to be an 18 month period for this study, if I've interpreted the abstract correctly.
 
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duncan

Senior Member
Messages
2,240
Sorry, @Bob , I disagree. Please refer to the second sentence under "Conclusions." It reads, "The results suggest...etc." They are extrapolating from this particular study's results, hence the word "suggest."
 

Chrisb

Senior Member
Messages
1,051
My interpretation, for what it is worth, is that the results section has nothing to say about improvements except in respect of bodily pain in patients with CFS. Whatever the conclusions are based on it is not on the information presented in the abstract. If they discovered anything they are not keen on sharing it. Or just lack the presentational skills necessary for the job.
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
Sorry, @Bob , I disagree. Please refer to the second sentence under "Conclusions." It reads, "The results suggest...etc." They are extrapolating from this particular study's results, hence the word "suggest."
Yes, I agree that they are extrapolating the results. I think I misunderstood your question.
 

duncan

Senior Member
Messages
2,240
@Bob, I wrote my point poorly.

Neurocognitive deficits is an appropriate subject; I seem to have dwindling anticipation when it comes to writing - I can't see what my readers will see. One casualty would be segues. I also struggle with prepositions and spelling and word choice and...
 
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duncan

Senior Member
Messages
2,240
I wonder about brain damage. Like many others I look to inflammation, but I wonder about demonstrable damage. I know MRIs aren't the best vehicles to uncover the damage. SPECT scans are really frowned upon these days, at least in the US. I was scheduled for two SPECTS, but at the last minute was denied them.

Which leaves PET scans. So expensive and hard to justify. I had one done for a study, but was refused access to the results (it was deemed solely for research and study participants were excluded from the results.)
 
Messages
3,263
I know MRIs aren't the best vehicles to uncover the damage.
Structural MRI (the standard type you get in doctors' referrals) is probably the best way to reveal actual damage. They're pretty high resolution these days. The other things you mention all focus on function, not structural damage. These functional measures are hard to interpret, because any changes in function could be a cause of ME, or they could be a consequence of it.

In fact, fMRI results have been used int he past to support a psychosomatic view of the disorder (they look for overactivity in any area thought to be involved in any way with emotion - and hey, presto! you have your evidence!).