Impairments in cognition in CFS unrelated to depression but associate with autonomic dysfunction.

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PLoS One. 2019 Feb 5;14(2):e0210394. doi: 10.1371/journal.pone.0210394. eCollection 2019.
Impairments in cognitive performance in chronic fatigue syndrome are common, not related to co-morbid depression but do associate with autonomic dysfunction.
Robinson LJ1, Gallagher P2, Watson S3, Pearce R4, Finkelmeyer A2, Maclachlan L4, Newton JL4,5.
Author information

Abstract
OBJECTIVES:
To explore cognitive performance in chronic fatigue syndrome (CFS) examining two cohorts. To establish findings associated with CFS and those related to co-morbid depression or autonomic dysfunction.

METHODS:
Identification and recruitment of participants was identical in both phases, all CFS patients fulfilled Fukuda criteria. In Phase 1 (n = 48) we explored cognitive function in a heterogeneous cohort of CFS patients, investigating links with depressive symptoms (HADS). In phase 2 (n = 51 CFS & n = 20 controls) participants with co-morbid major depression were excluded (SCID). Furthermore, we investigated relationships between cognitive performance and heart rate variability (HRV).

RESULTS:
Cognitive performance in unselected CFS patients is in average range on most measures. However, 0-23% of the CFS sample fell below the 5th percentile. Negative correlations occurred between depressive symptoms (HAD-S) with Digit-Symbol-Coding (r = -.507, p = .006) and TMT-A (r = -.382, p = .049). In CFS without depression, impairments of cognitive performance remained with significant differences in indices of psychomotor speed (TMT-A: p = 0.027; digit-symbol substitution: p = 0.004; digit-symbol copy: p = 0.007; scanning: p = .034) Stroop test suggested differences due to processing speed rather than inhibition. Both cohorts confirmed relationships between cognitive performance and HRV (digit-symbol copy (r = .330, p = .018), digit-symbol substitution (r = .313, p = .025), colour-naming trials Stroop task (r = .279, p = .050).

CONCLUSION:
Cognitive difficulties in CFS may not be as broad as suggested and may be restricted to slowing in basic processing speed. While depressive symptoms can be associated with impairments, co-morbidity with major depression is not itself responsible for reductions in cognitive performance. Impaired autonomic control of heart-rate associates with reductions in basic processing speed.

PMID:

30721241

DOI:

10.1371/journal.pone.0210394
 

anni66

mum to ME daughter
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Julia Newton specialises in fatigue and POTS/ OI.

Would have perhaps been better testing again during PEM to determine degree of difference. My daughter' s brain fog increases significantly during PEM.

Fukada does not necessarily correlate to ME

HADS scale is perhaps too much of a blunt instrument - is this scale not often capable of conflating fatigue with depression? ( I could be wrong on this, relying on underperforming memory)
 

taniaaust1

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"Cognitive difficulties in CFS may not be as broad as suggested and may be restricted to slowing in basic processing speed."

I know I have far more than just slower thinking going on... and my ability to use my brain further declines when Im upright or crashing.
 

percyval577

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Seems to be a helpful article, thank you @Murph. When I read the abstract I was a bit astoneshed though:

Cognitive difficulties in CFS may not be as broad as suggested
?
and may be restricted to slowing in basic processing speed.
??? - what else? Depression??
restricted
I hope that it doesn´t get the meaning of "quantitively restricted".

I beg researchers, it must be easily possible to get the idea of an operative impairment of information processing which in itself is in not invovlved in any motivation or mood, in which direction ever.

While depressive symptoms can be associated with impairments, co-morbidity with major depression is not itself responsible for reductions in cognitive performance. Impaired autonomic control of heart-rate associates with reductions in basic processing speed.
Finaly the scientific community may have an idea of logical possibilities. Thank you for pointing (halfway) out of course.

Don´t know if this in particuliar could be reliable. I personally wouldn´t think that impaired autonomic functions would be the cause for cognitive impairment, and one would only need to treat the autonomic impairment. If it would be an influence it would be nice of course.
 
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Fogbuster

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Thanks for this find @Murph. Brilliant timing as I discovered Dr Nemechek's work only a week or so ago. Are you familiar with it? He seems to be helping a decent amount of people who have autonomic dysfunction with his protocol and his understanding of addressing gut/brain issues is quite impressive. I might have give it a trial soon.

Has anyone here had any success following his recommendations?
 
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Thanks for this find @Murph. Brilliant timing as I discovered Dr Nemechek's work only a week or so ago. Are you familiar with it? He seems to be helping a decent amount of people who have autonomic dysfunction with his protocol and his understanding of addressing gut/brain issues is quite impressive. I might have give it a trial soon.

Has anyone here had any success following his recommendations?
I know nothing about it? Links?
 

boolybooly

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Thanks @Murph my take on this is the conclusions have been nobbled by someone with a psychology careerist bias.

The evidence points to a subset of Fukuda CFS having a different illness from depressive illness but the conclusions refuse to acknowledge this when it stands out like a sore thumb. Instead the conclusion avoids distinguishing ME from affective disorders, which just ain't right.