Neuropsychological performance in persons with chronic fatigue syndrome: results from a population-based study.
OBJECTIVE
To examine the neuropsychological function characterized in subjects with chronic fatigue syndrome (CFS) at the same time controlling for relevant confounding factors. CFS is associated with symptoms of neuropsychological dysfunction. Objective measures of neuropsychological performance have yielded inconsistent results possibly due to sample selection bias, diagnostic heterogeneity, comorbid psychiatric disorders, and medication usage.


METHODS
CFS subjects (n = 58) and well controls (n = 104) from a population-based sample were evaluated, using standardized symptom severity criteria. Subjects who had major psychiatric disorders or took medications known to influence cognition were excluded. Neuropsychological function was measured using the Cambridge Neuropsychological Test Automated Battery (CANTAB).


RESULTS
Compared with controls, CFS subjects exhibited significant decreases in motor speed as measured in the simple and five-choice movement segments of the CANTAB reaction time task. CFS subjects also exhibited alterations in working memory as manifested by a less efficient search strategy on the spatial working memory task, fewer % correct responses on the spatial recognition task, and prolonged latency to a correct response on the pattern recognition task. A significantly higher percentage of CFS subjects versus controls exhibited evidence of neuropsychological impairment (defined by performance 1 standard deviation below the CANTAB normative mean) in tasks of motor speed and spatial working memory. Impairment in CFS subjects versus control subjects ranged from 20% versus 4.8% in five-choice movement time (p = .002) to 27.8% versus 10.6% in search strategy on the spatial working memory task (p = .006).


CONCLUSIONS
These results confirm and quantify alterations in motor speed and working memory in CFS subjects independent of comorbid psychiatric disease and medication usage.
Majer
Matthias
M
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.
Welberg
Leonie A M
LA
Capuron
Lucile
L
Miller
Andrew H
AH
Pagnoni
Giuseppe
G
Reeves
William C
WC
D000293:Adolescent; D000328:Adult; D001288:Attention; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D008570:Memory, Short-Term; D005222:Mental Fatigue / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011597:Psychomotor Performance; D011930:Reaction Time; D021641:Recognition, Psychology; D013647:Task Performance and Analysis; D055815:Young Adult