Using an interleukin-6 challenge to evaluate neuropsychological performance in chronic fatigue syndrome.
BACKGROUND
Individuals with acute infections experience a range of symptoms including fatigue, malaise, muscle aches, and difficulties with concentration and memory that are usually self-limited. This cluster of symptoms is otherwise, similar to those that characterize chronic fatigue syndrome (CFS). The goal of the present study was to evaluate the cognitive and psychological functioning of CFS patients and normal controls (NCs) when they both were experiencing acute influenza-like symptoms. To induce influenza-like symptoms, we administered interleukin-6 (IL-6), a cytokine that temporarily activates the acute phase immunological and endocrine responses.


METHODS
Nineteen patients who met the 1994 International CFS Study Group Criteria and ten normal controls (NCs) completed routine clinical evaluations, neuropsychological tests of short-term memory, selective attention, and executive control, and self-ratings of somatic symptoms and psychological mood before, shortly following, and 1 day after IL-6 administration.


RESULTS
CFS patients consistently reported more somatic symptoms, even when both groups perceived that they were ill. Both groups somatic symptoms increased during the IL-6 challenge, but the CFS patients symptoms increased more rapidly than controls. In general, the CFS patients performed similarly to NCs on the cognitive measures before, during, and after the IL-6. In contrast to predictions, IL-6 provocation did not impair the cognitive performance of either CFS patients or NCs.


CONCLUSIONS
The IL-6 provocation exacerbated the patients self-reported symptoms but did not reveal notable cognitive impairments between patients and controls during cytokine-induced acute influenza-like symptoms.
Arnold
M C
MC
National Institute of Neurological Disorders and Stroke, National Institute of Child Health and Human Development and National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892-1440, USA.
Papanicolaou
D A
DA
O'Grady
J A
JA
Lotsikas
A
A
Dale
J K
JK
Straus
S E
SE
Grafman
J
J
D000328:Adult; D000339:Affect; D003072:Cognition Disorders / Q000139:chemically induced / Q000175:diagnosis / Q000523:psychology; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D015850:Interleukin-6; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D013647:Task Performance and Analysis
D015850:Interleukin-6