Professor & patients' paper on the solvable biological challenge of ME/CFS: reader-friendly version
Simon McGrath provides a patient-friendly version of a peer-reviewed paper which highlights some of the most promising biomedical research on ME/CFS ...
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A unifying theory for cognitive abnormalities in functional neurological disorders, fibromyalgia CFS

Discussion in 'Latest ME/CFS Research' started by Murph, May 9, 2018.

  1. Murph

    Murph :)

    A unifying theory for cognitive abnormalities in functional neurological disorders, fibromyalgia and chronic fatigue syndrome: systematic review.
    Teodoro T1,2,3, Edwards MJ1,2, Isaacs JD1,2.
    Author information

    Functional cognitive disorder (FCD) describes cognitive dysfunction in the absence of an organic cause. It is increasingly prevalent in healthcare settings yet its key neuropsychological features have not been reported in large patient cohorts. We hypothesised that cognitive profiles in fibromyalgia (FM), chronic fatigue syndrome (CFS) and functional neurological disorders (FNDs) would provide a template for characterising FCD.

    We conducted a systematic review of studies with cognition-related outcomes in FM, CFS and FND.

    We selected 52 studies on FM, 95 on CFS and 39 on FND. We found a general discordance between high rates of subjective cognitive symptoms, including forgetfulness, distractibility and word-finding difficulties, and inconsistent objective neuropsychological deficits. Objective deficits were reported, including poor selective and divided attention, slow information processing and vulnerability to distraction. In some studies, cognitive performance was inversely correlated with pain, exertion and fatigue. Performance validity testing demonstrated poor effort in only a minority of subjects, and patients with CFS showed a heightened perception of effort.

    The cognitive profiles of FM, CFS and non-cognitive FND are similar to the proposed features of FCD, suggesting common mechanistic underpinnings. Similar findings have been reported in patients with mild traumatic brain injury and whiplash. We hypothesise that pain, fatigue and excessive interoceptive monitoring produce a decrease in externally directed attention. This increases susceptibility to distraction and slows information processing, interfering with cognitive function, in particular multitasking. Routine cognitive processes are experienced as unduly effortful. This may reflect a switch from an automatic to a less efficient controlled or explicit cognitive mode, a mechanism that has also been proposed for impaired motor control in FND. These experiences might then be overinterpreted due to memory perfectionism and heightened self-monitoring of cognitive performance.

    © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
    lafarfelue and Runner5 like this.
  2. alex3619

    alex3619 Senior Member

    Logan, Queensland, Australia
    Presumed absence of an organic cause. FCD, as described this way, is a broad definition with no proven existence. There is no doubt there are issues with functioning in the cognitive capacities, but it not the same thing to say this. Their model blames psychological causation, whereas the evidence is growing for a deep biochemical dysfunction. We can measure the biochemistry problems, but the fact we have yet to discover the cause allows these nebulous and speculative hypotheses to be promoted as though they are factual.
    Sidny, adambeyoncelowe, FMMM1 and 3 others like this.
  3. adambeyoncelowe


    Yeah, this study is weak.
    Murph likes this.
  4. Neunistiva

    Neunistiva Senior Member


    I bet people with ME/CFS have lowered self-monitoring. We have to to stay sane. Any healthy person would call an ambulance in a second if they felt half of what I'm feeling right now. And here I am, calmly typing away on a forum.
    adambeyoncelowe, CreativeB and Mel9 like this.
  5. alex3619

    alex3619 Senior Member

    Logan, Queensland, Australia
    My thoughts exactly. I cope by ignoring things. Probably too much, leading to the other issue that I might be considered a non-compliant patient because I am not seeking out medical help for everything. Yet its not easy determining when something needs attention, and when it can be ignored. There is always risk.

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