Is UNconscious cognition more impaired than conscious cognition in ME/CFS?

[Seven7]

I feel like it's the level of brain inflammation that is going on ...............on any given day is that is making the difference. High inflammation days equals short-circuiting in brain.

Agreed! But there are also other factors with plp with POTs for example, standing makes you slower brain and also if you have been standing for too long....

 

[pattismith]

I do have problems with my automatic pilot as well.

If I am driving on a freeway, at the speed limit, I very often miss the exit I wanted to take.

When I was 24 years old, I happened to fall asleep two times when driving on freeways on the middle of the day.

So I had to find strategies to manage these problems and to stay conscious of the road.

-Driving over the speed limit is a good way for me, I have to go above 92 miles/hour to keep aware of what I am doing.
I know it sounds crazy, but it is much safer for me than driving on automatic pilot (although it is very costly because of the penalties).
(It may be that my brain is missing adrenalin/epinephrin and that it can work only if I find a way to stimulate release of this mediator. Adrenals lack of stimulation by pituitary could be the culprit.)

-Eating while driving is the other thing that works, so I eat apples, carots and nuts during hours if I need to drive long ways.

I have the same problem while reading a book, I usually start reading and then my automatic pilot takes control and i can't even remember what I have read a second before. So I read again and again and finally I give up.
Very often I fall asleep when I try to read a book too.

 

[pattismith]

This paper says that the basal ganglia and thalamus are involved.
The basal ganglia is a brain area found to be working under par in ME/CFS.

These data suggest that symptoms of fatigue in CFS subjects were associated with reduced responsivity of the basal ganglia, possibly involving the disruption of projections from the globus pallidus to thalamic and cortical networks.

We already know that adenosine is low in CFS/ME, and ATP is high outside the cells.

Release of ATP into the extracellular space can initiate a multitude of signaling events, and these downstream signals are specific to the particular purinergic receptor (or receptors) expressed, and whether enzymes are present to hydrolyze ATP to its derivatives adenosine diphosphate and adenosine, each of which can activate their own unique downstream signaling cascades.

This could be the result of CD73 downregulation/expression (5 nucleotidase that converts AMP to adenosine)

The interesting thing is that adenosine activates basal ganglia:

Adenosine receptors are G-protein coupled P1 purinergic receptors that are broadly expressed in the peripheral immune system, vasculature, and the central nervous system (CNS). Within the immune system, adenosine 2A (A2A) receptor-mediated signaling exerts a suppressive effect on ongoing inflammation.

In healthy CNS, A2A receptors are expressed mainly within the neurons of the basal ganglia.

Alterations in A2A receptor function and expression have been noted in movement disorders, and in Parkinson's disease pharmacological A2A receptor antagonism leads to diminished motor symptoms. Although A2A receptors are expressed only at a low level in the healthy CNS outside striatum, pathological challenge or inflammation has been shown to lead to upregulation of A2A receptors in extrastriatal CNS tissue, and this has been successfully quantitated using in vivo positron emission tomography (PET) imaging and A2A receptor-binding radioligands. Several radioligands for PET imaging of A2A receptors have been developed in recent years, and A2A receptor-targeting PET imaging may thus provide a potential additional tool to evaluate various aspects of neuroinflammation in vivo. This review article provides a brief overview of A2A receptors in healthy brain and in a selection of most important neurological diseases and describes the recent advances in A2A receptor-targeting PET imaging studies.

More about basal ganglia diseases in this thread:

https://forums.phoenixrising.me/ind...ith-fibromyalgia-syndrome.62536/#post-1018603


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[jesse's mom]

There are two things I can do from bed that I enjoy, writing, and knitting. On days where my inflammation is high, and my CFS and pain are bad I cannot write easily, and I have completely forgotten how to knit. I had to watch youtube videos to remind myself, and I never relearned complicated stitches. At one time this was all muscle memory...

I laid out my nighttime meds and supplements two nights ago, then went to get a glass of water. I tossed and turned till 3am and found that I never took them... took them and overslept!

I ran a house as a single mom and owned my own small business and still was a hands on hairdresser. Plus raced sailboats and was an active sailing mom. Mostly on autopilot. I can't imagine how I did it all when I look back!

 

[Hip]

The interesting thing is that adenosine activates basal ganglia:

Interesting, although I imagine it will be adenosine receptor antagonists rather than agonists which will activate the basal ganglia. Caffeine for example is an adenosine receptor antagonist, and its blocking of the adenosine receptor has stimulant effects. This makes sense because it is the build-up of adenosine in the brain during the day that plays a role in creating tiredness and sleep.

Although for anyone suffering any psychosis-type symptoms, adenosine A2A antagonists may make it worse. Whereas adenosine A2A agonists may have antipsychotic effects.

 

[pattismith]

Interesting, although I imagine it will be adenosine receptor antagonists rather than agonists which will activate the basal ganglia. Caffeine for example is an adenosine receptor antagonist, and its blocking of the adenosine receptor has stimulant effects. This makes sense because it is the build-up of adenosine in the brain during the day that plays a role in creating tiredness and sleep.

Although for anyone suffering any psychosis-type symptoms, adenosine A2A antagonists may make it worse. Whereas adenosine A2A agonists may have antipsychotic effects.

Yes, Adenosine agonists are relevant in neurological disease linked to Basal Ganglia, some of them with anhedonia symptoms, like Schizophrenia.
Inosine is a non selective Adenosine agonist, but Adenosine reuptake inhibitors like Nimodipine, Dipyridamole may be interesting too

 

[Dichotohmy]

There are indeed some interesting ideas about unconscious or automatic cognition here that I have pondered myself.

Quite often I find myself having done a task with little-to-no recollection of having performed such a task. For instance, having driven for an hour or more with little-no recollection of what I had seen during this time of autopilot. Likewise, zoning out on vacuuming the floor, or doing the dishes, wherein 30 minutes will pass and I come to suddenly realizing I am done with the task. This might sound like spontaneous dissociation, and I think it might be. In my case, I dissociate like this and go on autopilot when faced with a boring or monotonous task. Boredom to me is and has always been very uncomfortable, even painful, and maybe this is an unconscious adaptation?

Likewise, my muscle memory seem to be intact. For instance, I find myself with no apparent loss of form in skills like throwing a punch, riding a motorcycle, or shooting and wielding a gun - all things heavily dependent on muscle memory. Sure, the act of doing such physical tasks exhausts me dramatically more quickly, but I can still do them with intact skilled form at least for a few minutes.

What I can say has suffered very badly is my ability to switch between an automatic process to a conscious one. For instance, things like cooking, paying attention to TV or a movie, or talking on the phone - IE, things that can largely be done without conscious consideration but that do require some thinking and conscious scanning for "cues." I think the divide here might actually be a deficit in switching between unconscious neural actions and conscious higher-order thinking. Often, I find myself OK just listening on the phone for instance, or going through the motions while cooking, but if some unexpected event comes up, I go blank and have trouble forming a conscious response. For instance, the person I'm talking on the phone with asks an open-ended, non black-or-white question.

While this might sound like I don't have a greater problem with unconscious cognition, I actually do, because I only find it possible to do automatic/unconscious cognitive things as long as there is enough energy there that the conscious side doesn't have to take over to get things done. Both doing things on autopilot, like driving, or doing things that require a conscious "flow" like state, like writing, obviously require large amounts of attention and energy - just likely via different neural regions and pathways. When my energy is depleted, I do indeed find myself having to think a lot more about simple actions. To that end, being low energy creates another problem in that, in having to think about the minutiae of what I'm doing, the task, which I'm otherwise capable of doing unconsciously, becomes incredibly boring and tedious. In turn, when the energy for unconscious cognition isn't there, I gravitate towards activities that require conscious thought, but are stimulating.

So, perhaps counter-intuitively, I try to do the really easy tasks, like housework, errands, and the like, for the early time of day where my energy is the highest.

 

[Wishful]

I don't think I have the problem of switching states, but I totally agree with the problem of tasks requiring thinking through steps being incredibly boring/tedious. I think that's my main issue with ME: that I mostly just don't have the mental energy to even start such tasks. When my mental energy is low, I do the automatic stuff, such as going for a walk, sawing firewood, etc. No zoning out though; just aware of not having to think. When my mental energy is really low, I can't even read for long; my mind just sort of drifts off.

 

[SmokinJoeFraz93]

ME/CFS patients sometimes have days when their cognitive dysfunction (aka: clouding of consciousness or brain fog) substantially abates. On the rare occasions when I have a day of greatly reduced brain fog, I notice that I become more able to perform ordinary household tasks unconsciously, ie, on "automatic".

Whereas when my brain fog is more severe, I find I tend to approach even simple routine tasks with conscious attention (or what remains of my conscious attention). When brain fog is present, of necessity I perform the tasks with as much conscious attention as I can muster in the haze of brain fog; this is because with brain fog, I notice that it is harder for me to perform tasks in an automatic and unconscious way.

Could it be that the brain fog of ME/CFS impairs unconscious mental functioning more than conscious functioning?



We are all aware that humans are able to perform tasks both consciously and unconsciously.

For example, experienced drivers will usually navigate through the traffic unconsciously, by using unconscious cognition and unconscious physical responses. That is to say, normal healthy people usually drive on "automatic", often focusing their conscious attention on something else while driving (such as planing in their mind what to do later in the evening). Only if a hairy situation crops up while driving do drivers instantly bring their full conscious attention to bear on the road.

And the same applies to simple routine tasks in the home, like cooking, cleaning, brushing your teeth, etc: healthy people will invariably perform these tasks using unconscious mental processes, while thinking about something else more interesting, or while talking to others. Most of the routine tasks humans do each day are delegated to the unconscious to fulfill.



Could it be that brain fog significantly hampers unconscious cognition, such that ME/CFS patients are then forced to laboriously perform tasks using conscious cognition?

If so, this may explain why even simple tasks can often seem tiring and laborious to ME/CFS patients, because we have to consciously think through every step of the way, rather than delegating the task to our unconscious mind to perform effortlessly and automatically, while our conscious mind is focussed on more interesting or important matters.

On the very occasional days where my brain fog does transiently improve, I notice that I start performing routine tasks in a more effortless and unconscious way, which feels much more efficient, as it releases my conscious mind to simultaneously work on more interesting things (or just allows me to daydream on something nice, while my unconscious performs the humdrum routine task automatically for me).

So I am wondering whether in the brain fog of ME/CFS, there might be a specific brain dysfunction that impedes unconscious cognition, more than it does conscious cognition?

Or alternatively, maybe it is just the impairments of working memory, task switching and divided attention functioning found in ME/CFS that force patients to focus consciously and intently even on simple mundane tasks, just in order to be able to do the task. Maybe unconscious cognition does not work very well when your memory and task switching is impaired.



This impairment of unconscious cognition that I suggest might be occurring in ME/CFS could explain the general feeling I get with ME/CFS, which is that this disease imprisons or straightjackets your mind in a way that makes your world seems narrow and limited. Perhaps this feeling of mental limitation comes from ME/CFS patients' cognition being only capable of focusing on one consciously performed task at a time; whereas healthy people are able to focus on multiple activities at once, using both conscious and unconscious cognition, and so experience a more airy cognitive landscape of greater dimension.

I know on those occasional days when my brain fog substantially improves, I can walk into a room while thinking about some matter, and unconsciously (subliminally) observe that that the room is a bit untidy and that items need to be put back into their cupboards or draws, and I will unconsciously start clearing up the mess, while still engaged in my thought processes on other matters. In this way, the healthy brain is always multidimensional and multitasking in its functioning.

But when my brain fog is significant, I will not even notice that there is a mess, let alone be able to clear up the mess in this automatic and unconscious way while thinking about something else.



What parts of the brain are involved unconscious cognition and unconscious motor control?

This paper says that the basal ganglia and thalamus are involved. The basal ganglia is a brain area found to be working under par in ME/CFS.

And this article says:




If ME/CFS brain fog involves not just problems in conscious cognition, but also an impairment of unconscious cognition and unconscious motor action, this could help explain why brain fog is such an all-encompassing debilitating condition.

Geez! I was about to write a post on the same topic as this and I found this! I’m amazed that it didn’t even cross my mind that this was related to brain fog! I have noticed that within the last year I have found myself consciously thinking or visualising what I need to do on a daily basis (small tasks around my flat etc etc) and I don’t know why.

One thing I have noticed is then the feedback that my brain produces when thinking about doing something. For example, I’ll consciously think about vacuuming one small room in my flat. My physical body is feeling okay and it’s definitely up to to performing the task. HOWEVER, once I’ve thought about performing this task or visualised it, my brain will then produce a sensation within my brain that kind of sends a fatigue/tiredness sensation throughout my body. I’ve constantly told people that it’s like having an overprotective partner who’s controlling so to speak.

Very strange.

 

[Wishful]

HOWEVER, once I’ve thought about performing this task or visualised it, my brain will then produce a sensation within my brain that kind of sends a fatigue/tiredness sensation throughout my body.

Hmmm, I think that happens to me too. I'll have to pay closer attention to how it works. I thought I was just realizing how tedious the task would be and that I didn't think I had enough energy to deal with it. I'm not sure whether the fatigue was there before, or how long it remains after the visualization process.

 

[tima]

I'm not sure how relevant this is, but I'll throw it out there.

I've been looking for some objective way of measuring the effects of CFS in myself, rather than subjective self-assessment. Dr Myhill suggests brain fog is related to synapse speed, so I found somewhere (can't immediately find where) that a test involving clicking four coloured squares was used, responding to a coloured word like "red" on the screen. I can't actually remember precisely what it was used to help diagnose... My scores are affected (presumably) by muscular fatigue, but when I'm not thinking too hard about the task, I seem to do better.

I've also been using a 6x6 Schulte table, with similar sorts of results - oddly when I feel fogged, I can sometimes produce better results by not thinking too hard about the task (clicking, in order, the randomly placed numbers 1-36)

Is the "left brain, right brain" theory of things (left deals with logical, rigid things, right is more arty / flowery) of any application here?

Personally, I have very little episodic memory, although I can reconstruct things that I know have happened. I seem to file a lot of information as "not immediately useful" and stick it in the recycle bin. Things I have read & learned, say, 10 years ago, come far more readily to mind than things that I've tried to remember more recently. Concepts seem to stick easier than details. I find it hard to consciously work through a problem. I did some programming a few years ago, and solutions came more from staring really hard at the code until the solution arrived in my front brain than from any rigorous approach.

 

[Hip]

I've been looking for some objective way of measuring the effects of CFS in myself, rather than subjective self-assessment.

That's something I have been interested in also. If there were an objective way to measure brain fog, it would help make studies on possible ME/CFS drug treatments more rigorous, and it would also help in one's own personal tests of drugs and supplements, when you want to know whether a medication you are trialing might be working for you.

I started a thread on the subject how you might go about testing brain fog levels:

How to best gauge levels of brain fog & fatigue