Wortinger, Wyller et al: Emotional conflict processing in adolescent CFS: A pilot study using fMRI

[mango]

Emotional conflict processing in adolescent chronic fatigue syndrome: A pilot study using functional magnetic resonance imaging

Wortinger LA1,2, Endestad T2, Melinder AM3, Øie MG2,4, Sulheim D5,6, Fagermoen E7, Wyller VB1.

Author information
1 Department of Pediatrics , Akershus University Hospital , Nordbyhagen , Norway.
2 Department of Psychology , University of Oslo , Oslo , Norway.
3 Cognitive Developmental Research Unit, Department of Psychology , University of Oslo , Oslo , Norway.
4 Research Department , Innlandet Hospital Trust , Lillehammer , Norway.
5 Department of Pediatrics , Oslo University Hospital , Oslo , Norway.
6 Department of Pediatrics , Innlandet Hospital Trust , Lillehammer , Norway.
7 Department of Anesthesiology and Critical Care , Oslo University Hospital , Oslo , Norway.

J Clin Exp Neuropsychol. 2016 Sep 20:1-14. [Epub ahead of print]
DOI: 10.1080/13803395.2016.1230180

Abstract
INTRODUCTION:
Studies of neurocognition suggest that abnormalities in cognitive control contribute to the pathophysiology of chronic fatigue syndrome (CFS) in adolescents, yet these abnormalities remain poorly understood at the neurobiological level. Reports indicate that adolescents with CFS are significantly impaired in conflict processing, a primary element of cognitive control.

METHOD:
In this study, we examine whether emotional conflict processing is altered on behavioral and neural levels in adolescents with CFS and a healthy comparison group. Fifteen adolescent patients with CFS and 24 healthy adolescent participants underwent functional magnetic resonance imaging (fMRI) while performing an emotional conflict task that involved categorizing facial affect while ignoring overlaid affect labeled words.

RESULTS:
Adolescent CFS patients were less able to engage the left amygdala and left midposterior insula (mpINS) in response to conflict than the healthy comparison group. An association between accuracy interference and conflict-related reactivity in the amygdala was observed in CFS patients. A relationship between response time interference and conflict-related reactivity in the mpINS was also reported. Neural responses in the amygdala and mpINS were specific to fatigue severity.

CONCLUSIONS:
These data demonstrate that adolescent CFS patients displayed deficits in emotional conflict processing. Our results suggest abnormalities in affective and cognitive functioning of the salience network, which might underlie the pathophysiology of adolescent CFS.

KEYWORDS: Adolescents; Chronic fatigue syndrome; Cognitive control; Conflict; Emotion; Functional MRI.

http://www.ncbi.nlm.nih.gov/pubmed/27647312

 

[adreno]

Sigh.

 

[flybro]

more bollox

 

[Hutan]

Worse than the usual questionnaire-type bollocks though, it's gussied up with fancy terms, some of which don't mean quite what a normal person would expect them to, and expensive equipment.

What I'd like to see is the performance of an extra control group that was required to eat nothing all day and then run 10 km and then do the test - seems to me that lack of energy for brain function could easily explain a difficulty in making categorising decisions in the face of conflicting but extraneous data.

It's not the findings themselves that are the problem, it's the words used to describe it and the interpretation.

 

[Sidereal]

Trash.

 

[Effi]

 

[Woolie]

This paper got the kids to judge the expressions of faces they were shown (e.g., happy, angry, etc). In the conflict condition, the wrong word was written over the face (e.g., angry face with happy written on it). In the control condition, the word and the face matched (e.g., both angry). CFS kids didn’t seem to be quite as slowed as regular kids when the face and word disagreed, and for the disagreeing (conflict) faces, they didn’t show as much activation in some areas involved in emotion (e.g., the right amygdala and left insula).

I am utterly exasperated.

First of all, if you want to make a claim about the causes of an illness, you need a control group that is similarly physically affected, but from a cause you think is different. This way, you control for the effects of the illness itself on performance. How difficult is that to understand?

Oh wait, it gets worse, they didn’t even show what they said they did:

There was very strong evidence of response time slowing for incongruent trials, compared to congruent trials, in the comparison group (incongruent response time = 785 ms, SD = 89; congruent response time = 748 ms, SD = 87), t(23)= 5.63, p < .001. This effect was not observed in the patient group (incongruent response time = 749 ms, SD = 75; congruent response time = 730 ms, SD = 77), t(14)= 1.66, p = .120.

This is not the proper way to show differences between groups – you need to demonstrate a significant interaction between the groups and the manipulation of interest (degree of “emotional conflict”).

But even of they had shown that, the results are in the wrong direction – the CFS kids were better at resolving the conflict (less slowed by the conflicting emotional information). They're also slightly faster overall, including the no conflict condition. Probably not significant, but hard to argue for a deficit when the kids are actually faster.

Oh, and WTF, then this:

the left amygdala revealed a significant decrease in conflict-related activity in CFS patients compared to the comparison group.. The right amygdala did not show group differences in responses to conflict. (goes onto say CFS patients also showed a significant decrease in activity of the left midposterior insula, but there was no difference in the other areas of interest).

These data just show us what we know from the RTs – that CFS kids managed the conflict stimuli (relatively to no conflict stimuli) better than controls. All they add is that the kids seemed to also use fewer resources to do so.

And finally:

There were no associations between brain activity and depressive and anxiety symptoms. The CFS group did not produce a negative affect bias.

Didn't get what they were looking for, poor souls.

OMG:

However, the absence of a response time conflict effect within patients indicates inefficient response time processing and suggests that the emotional information in the stimuli did not aid in cognitive processing on congruent trials and/or did not interfere in cognitive processing on incongruent trials, as observed in healthy adolescents.

No, you dimwits! It shows the opposite – CFS patients were just faster and more efficient at processing the stimuli while not being distracted by the conflicting information (but even that isn't statistically reliable).

Who writes this stuff?!

I’m sorry to be so mean and critical to researchers, but your shoddy research has the potential to do us real harm. So stop it please and go and work on another bunch of victims!

 

[Hutan]

Oh, well done @Woolie

I've been caught before, just reading the abstract and, between the vagueness of the abstract and my biases, getting things quite wrong. I assumed the CFS adolescents would be slower and rationalised accordingly.

(from the abstract)

These data demonstrate that adolescent CFS patients displayed deficits in emotional conflict processing. Our results suggest abnormalities in affective and cognitive functioning of the salience network,

It's like these researchers write the abstract when they write the research plan. And then it really doesn't matter what results turn up.

So despite what the abstract says, instead the CFS adolescents were faster, better able to ignore irrelevant conflicting information and to quickly identify emotions on faces.

Still, I can rationalise anything in any direction.

The CFS adolescents performed better than the non-CFS adolescents?

in pro-BPS mode: Oh, must be because they are high achieving perfectionists who are so anxious about what people think that they work hard on a test and are overly sensitive to the emotions of others.

in creative anti-BPS mode: The adolescents with CFS that make it into an fMRI trial are more likely to have smart parents who are trying to understand what has happened to their children and nature and nurture means that their children are also smart (whereas the adolescents with CFS with more stupid, apathetic parents have decided they must just be lazy and are settling in on the couch).

Of course, it could just be a tiny sample size with random results but that is much less fun for everyone....

I promise I'll read the whole paper before I post next time.

 

[Woolie]

Is this study the scientific equivalent of a witch hunt? When you "know" your suspicious are right and your "tests" will prove it whatever way the results go?

 

[daisybell]

@Woolie you're very good at this kind of critique. Have you considered a reply/letter to the journal??