Brain Fog Vs Cognitive Impairment

[duncan]

Not to minimize all these good descriptions of brain fog, but it is idiomatic, and that is a huge strike against us using it. I doubt we can pull it into mainstream jargon, any more than we can divest ourselves of "fatigue". The best we can hope for is something synonomous, but I'm thinking we'd have to watch reruns of Cheech & Chong movies to come up with anything relevant and useful.

When I say "brain fog", I can almost hear the doctor or researcher click into a different gear, and it's a shift that is decidedly dismissive.

This is still an excellent discussion, I'm just trying to point out what you'all probably know already. Ok, I'll shut up now....

 

[SDSue]

When I say "brain fog", I can almost hear the doctor or researcher click into a different gear, and it's a shift that is decidedly dismissive.

I must agree with you on this. "Brain fog" may be widely used, but it doesn't do justice to my severe loss of working memory, my inability to do simple math, my new-onset dyslexia, etc. These things were the first to happen and only after being sick for a few years did I experience what one might call brain fog, which for me is a slowing of my senses and cognition as if I'm drugged.

The brain fog and the cognitive dysfunction are two completely separate issues for me, and, as @Hip alludes to, probably reflect inflammation (or damage) to different areas of the brain and or spinal cord. (as do paresthesias, dysautonomia, emotional lability, and perhaps dozens of other things that plague PWME), which is why the name ME is appropriate (but let's not get into all that lol).

 

[MeSci]

Perhaps an important aspect of brain fog is that we are acutely aware of when it's happening, and trying to fight it? It is for me. It can start very suddenly with me, but I think that it wears off more slowly. It's like my brain's version of muscle fatigue, and includes inability to remember a line of text even if I re-read it numerous times, and I just have to give up and do something manual instead. I can't do arithmetic when I'm fogged. I get absent-minded and put things in the wrong places. I can't find words. There is often an associated 'disconnectedness' where I feel I can't see or hear the 'outside' world properly. I tend to moan and wave my arms in frustration, and often get my swear words wrong too!

I created an A5 leaflet to show guests for understanding how ME affects me, and how they can help me, which includes this about my short-term sudden-onset brain fog which can arise during conversation:

"...I will be unable to absorb anything other than very simple information, or to explain anything clearly, for a few minutes."

I do also get more long-lasting brain fog (e.g. a few hours) which may come on more slowly.

 

[duncan]

Brain fog is an amalgam of sorts for me. It's partially like just waking from a deep sleep, it's partly like having a reduced cognitive arsenal, it's a bit also like someone injected novacain into the front of my head. I can feel the numbness, just as I can feel a tooth get numb when it is injected with novacain. Brain fog means not just reduced clarity, but some 'other" in place of the clarity that is heavy and blurring. There is a lag element built into Brain fog. With it too come blinders and tunnel vision. On a real bad brain fog day, my other symptoms get nastier, too. Symptoms like peripheral neuropathies. On a bad brain fog day, I know early that my whole symptom cluster is more likely to take a nose dive - which to me suggests there is a trigger, and the first place the hammer falls is in my head.

 

[MeSci]

With it too come blinders and tunnel vision.

What are blinders?

 

[duncan]

Blinders? The eye guards racers put on horses to force their vision forward, so the horse can only see what is directly in front of it? They reduce peripheral vision distractions?

For me, it means I can't chew gum and walk at the same time. I am single tasking. I am pretty poor at anticipating too. So I am usually singular in my focus, looking only at what is directly in front of me.

Blinders.

 

[MeSci]

Blinders? The eye guards racers put on horses to force their vision forward, so the horse can only see what is directly in front of it? They reduce peripheral vision distractions?

For me, it means I can't chew gum and walk at the same time. I am single tasking. I am pretty poor at anticipating too. So I am usually singular in my focus, looking only at what is directly in front of me.

Blinders.

Oh right, thanks. I know those as blinkers. Same as tunnel vision then?

 

[duncan]

Yes, same as tunnel vision.

 

[Jon_Tradicionali]

Although a psych term, it describes the symptoms perfectly in my case.

Depersonalization (or depersonalisation) is an anomaly of self-awareness. It consists of a feeling of watching oneself act, while having no control over a situation.[1] Subjects feel they have changed, and the world has become vague, dreamlike, less real, or lacking in significance. It can be a disturbing experience, since many feel that, indeed, they are living in a "dream".

.......

Individuals who experience depersonalization feel divorced from their own personal physicality by sensing their body sensations, feelings, emotions and behaviors as not belonging to the same person or identity.[4] Often a person who has experienced depersonalization claims that things seem unreal or hazy. Also, a recognition of self breaks down (hence the name). Depersonalization can result in very high anxiety levels, which further increase these perceptions.[5]Individuals with depersonalization often find it hard to remember anything they saw or experienced while in third person.


http://en.m.wikipedia.org/wiki/Depersonalization

 

[Woolie]

During such times my capacity for exercise also goes into the stratosphere. [I]I can do stuff. [/I]This fades with mental capacity.

I think this is important, as it shows that in at least a subset whatever is stuffing us up is dynamic, and if we can figure it out we can shut it down.

@alex3619, I think this variability is common to many of us, and its the most encouraging aspect, as it suggests we probably don't have any permanent damage to the brain, rather a mix of substances (maybe cytokines?) floating around impeding our cognitive performance just as it does our physical. Its interesting that your physical and cognitive symptoms wax and wane in synchrony too.

This is way out there, but I've read a lot in the literature lately about "sickness behaviour". The term is often used in animal model studies, and refers to the way animals go into an immobile, resting state when they have an infection. Its considered to be an adaptive thing, a way the organism gives itself time to heal. Subjectively, its probably signalled by awful flu-like and/or fatigued feelings like we get when we're ill. We know that similar adaptions occur when a person has severe brain damage - the brain stem (@Hip, the RAS) even if completely undamaged, seems to inititate the coma response, as if it is shutting brain activity down to promote healing. I wonder if we are producing signalling substances in overabundance, and many of our symtpoms are in obedience to those?

 

[Jon_Tradicionali]

@alex3619, I think this variability is common to many of us, and its the most encouraging aspect, as it suggests we probably don't have any permanent damage to the brain, rather a mix of substances (maybe cytokines?) floating around impeding our cognitive performance just as it does our physical. Its interesting that your physical and cognitive symptoms wax and wane in synchrony too.

This is way out there, but I've read a lot in the literature lately about "sickness behaviour". The term is often used in animal model studies, and refers to the way animals go into an immobile, resting state when they have an infection. Its considered to be an adaptive thing, a way the organism gives itself time to heal. Subjectively, its probably signalled by awful flu-like and/or fatigued feelings like we get when we're ill. We know that similar adaptions occur when a person has severe brain damage - the brain stem (@Hip, the RAS) even if completely undamaged, seems to inititate the coma response, as if it is shutting brain activity down to promote healing. I wonder if we are producing signalling substances in overabundance, and many of our symtpoms are in obedience to those?

This isn't "way out there" at all. Entirely credible and plausible.

http://www.actionforme.org.uk/Resou.../research/cmrc-report-plenary-session-one.pdf
--------------------------------------------
The key steps leading to sickness behaviour are:

1. White blood cells recognise invading pathogens.(At this point,the cells use receptors that identify generic ‘foreign’ markers, such as bacterial cells walls,
   rather than recognising specific bugs such as the flu virus.)
   
   
2. The white blood cells release cytokines in the body.
   
   
3. Immune-to-brain communication takes signal to the brain(either via the blood,or the nerves innervating the site of the body in which the inflammatory response takes place.
   
   
4. This activates microglia-the brain’s innate immune cells-which release more cytokines into the brain. So activation of immune cells in the body leads to activation of immune cells in the brain.
   
   
5. This leads to more biological changes and,ultimately,to sickness behaviour,
   including fatigue.
   
   --------------------------------------------

 

[lansbergen]

And if the adaptive response does not kick in (enough) you are stuck with it.

 

[Jon_Tradicionali]

And if the adaptive response does not kick in (enough) you are stuck with it.

Hole in one.

I'd expand on reasons why the immune response could have been insufficient but I don't want to hijack the thread.