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The impact of chronic fatigue syndrome on cognitive functioning in adolescents

Discussion in 'Latest ME/CFS Research' started by Tom Kindlon, Sep 4, 2015.

  1. Tom Kindlon

    Tom Kindlon Senior Member

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    http://link.springer.com/article/10.1007/s00431-015-2626-1
    Free full text: http://link.springer.com/content/pdf/10.1007/s00431-015-2626-1.pdf

     
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  2. Tom Kindlon

    Tom Kindlon Senior Member

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    I found this paper to be generally fair.

    I have two quibbles.
    One is their talk about patients needing prompt treatment (i.e. CBT) when we have no data that this would reverse the problem.

    Also this paragraph:
    The grey matter study of CBT had no CFS control group as I discussed in my published letter:
    The changes seen could be due to the passage of time (patients are more likely to improve than disimprove over time particularly after they have been diagnosed).
     
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  3. Esther12

    Esther12 Senior Member

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  4. Tom Kindlon

    Tom Kindlon Senior Member

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    Yes, they discuss it first in the introduction as part justification for the study and then in light of the findings:
     
  5. Esther12

    Esther12 Senior Member

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    That seems fair... although it's still rather a shame research funding was spent on this.
     
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  6. Valentijn

    Valentijn Senior Member

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    "School levels" probably refers to the different types of Dutch high schools: pre-university, pre-college, and pre-tradeschool.

    So the students made it into one of those levels based on their test scores and a teacher review at age 11-12. Then they apparently began underperforming later, compared to other students at the same type/level of high school, following CFS onset.
     
  7. MesnaG

    MesnaG

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    Appropriate treatment, what is that supposed to mean? I really wish there were appropriate treatment to prevent kids from loosing their education. The cognitive impairment is obvious for us parents of kids with ME. Both my kids could read at the age of 4-5, now they seem to have dyslexia. Math is even worse.
     
  8. Snow Leopard

    Snow Leopard Hibernating

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    I think this study was worthwhile because they showed objectively that cognitive performance declines as a result of this illness.

    I just don't agree that CBT will necessarily prevent or reverse this decline as there is no evidence that CBT leads to better cognitive performance, despite being investigated in several studies.
     
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  9. Esther12

    Esther12 Senior Member

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    Yeah... but it does really just show us that people who report being exhausted are less good at taking IQ tests than they were before they started reported feeling exhausted. It's a bit of a shame that we're at the point where it's worth spending finding on things like that, and I think that the ill-founded speculations of Chalder and her colleagues have played a role in that.
     
    Last edited: Sep 5, 2015
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  10. user9876

    user9876 Senior Member

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    I see particular issues with short term memory which make learning hard.

    With my child I've also noticed that her ability to do maths and remember the techniques she was learning varies with how well she is feeling.
     
  11. user9876

    user9876 Senior Member

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    An interesting control would be to test healthy people with IQ tests under different conditions. For example, after a lot of activity or when they have a bug or when they are in severe pain (maybe not ethical!). It seems to me that there is a need to test the stability of IQ tests under different conditions before any conclusions can be made.
     
  12. Tom Kindlon

    Tom Kindlon Senior Member

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    Yes, that's it.
     
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  13. alex3619

    alex3619 Senior Member

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    What, more than 17 million patients couldn't have told them this? Sigh. I think we need studies in adults too, with controls matched for age and other factors.
     
  14. Tom Kindlon

    Tom Kindlon Senior Member

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    Participants were assessed at baseline for the FITNET trial, so not as expensive and the study being done on its own.
     
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  15. Bob

    Bob

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    Unfortunately, the bold text is a bit of a sticking point at the current time.
     
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  16. Kyla

    Kyla ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ

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    Agreed. I've read the whole article and they do not specify whether they mean Pacing, CBT/GET or something else.

    There is one reference to a dubious study showing improvements after CBT.
     
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  17. leokitten

    leokitten Senior Member

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    It's not just the Dutch, I believe most if not all continental European countries have this system.

    In all my years studying and working in Europe and teaching undergraduate and graduate students at university I found this to be one of the most barbaric and idiotic concepts. It's decided at the young age of 11 what a child's entire life potential is and if they are worthy enough to go to university (or technical college or trade school). From that point on children go to different schools, effectively segregating them forever based on some crude measurement of their intelligence and potential at that age. This further impacts childrens' potentials because lower achieving kids don't interact or form friendships anymore with higher achievers. And even though it's theoretically possible once you've been on a track to jump up to a higher one almost no one does it because it requires years of extra schooling and testing, putting them years behind everyone else. This system effectively puts people into classes for the rest of their lives and perpetuates a classist society.

    How many people in my life do i know or have met who were terrible students when they were young only to be excellent scientists/doctors/lawyers/engineers/professionals with advanced university degrees? Tons...

    For all the terrible flaws in the American system this is something they get right. Almost all kids go to the same school system from K-12 and interact and form friendships with each other. While being in the same school kids are put on different subject tracks based on testing and achievement in that subject, which is much more granular and modeled after how people are in the real world. Some people excel at certain subjects and not others. In America only the top 1-5% students achieve high enough that it's determined they are beyond the subject tracks and need to go to a special gifted school with a particular focus.
     
    Last edited: Sep 12, 2015
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  18. Valentijn

    Valentijn Senior Member

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    Theoretically it might work educationally - by age 11 or 12 it might be clear which kids are better at handling the types of abstract thinking which is eventually needed for university degrees. As far as segregation ... yes bad on one level, but also good on the level that the smart kids aren't isolated in large schools and treated like socially inferior freaks.

    My major problem with that system in the Netherlands is that there is a lot of racism and anti-immigrant sentiment here. Most of it isn't overt (though overt racism is generally tolerated), but there are huge problems with the CVs (resumes) of minorities not getting nearly as many responses as white CVs with identical qualifications, for example. That lower level of bias is almost certainly affecting at least some teachers who will view some children based on preconceived stereotypes instead of actual capabilities, and recommend a lower level of education than is warranted.
     
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  19. SOC

    SOC

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    Including educational level. I'm constantly being told that my cognition is no worse than the average person's (it is in a number of ways, but I don't usually argue with these people), but what's really significant to me is that my cognition is nowhere near what it was. I might test okay compared to a population average, but I'd fail dismally compared to people at an educational level similar to mine. I've lost a lot, and that is what is important if we're trying to evaluate the impact of the illness.
     
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  20. alex3619

    alex3619 Senior Member

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    @SOC, quite so. In an interview, on a good day, I can come across as much smarter than the interviewer. So people might jump to the conclusion that there is nothing wrong with my cognition, and that it has not degraded. Someone who is super fit before getting ME might still be able to do tons. A loss of even 75% capacity might still put them with higher physical capacity than most people. I think cognitive function is similar.

    However with cognitive function there are parts of my brain that seem to operate on zombie level, and indeed if zombies existed they might be smarter than me in those capacities. As I get sicker more and more of my brain goes into zombie mode, I lose more capacities, and as I improve the opposite happens. Its not a broad loss of capacities so much as specific losses. It more resembles repeated micro-strokes rather than dementia.
     
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