title: Cognitive dysfunction and mental fatigue in childhood chronic fatigue syndrome--a 6-month follow-up study.
abstract: OBJECTIVE
  Cognitive function was investigated in patients with childhood type chronic fatigue syndrome (CCFS) using the modified advanced trail making test (mATMT).
  
  
  METHODS
  mATMT was performed on 19 patients with CCFS and 25 healthy controls of comparable age and sex. The effectiveness of combined treatment with cognitive behavioral therapy (CBT) and pharmacotherapy and its relationship to cognitive function was investigated by evaluation of Chalder's fatigue scale and behavior state before and after treatment for 6 consecutive months.
  
  
  RESULTS
  All three tasks (motor skill, selective and alternative attention, and spatial working memory) of the mATMT, especially the difference in reaction time of the alternative attention task, could discriminate CCFS patients from control subjects with 70.5% accuracy (P=0.007). CCFS patients showed significantly lower alternative attention and Chalder's fatigue score before treatment (P=0.037 and 0.002, respectively). A significant improvement in performance status scores was found during the 6 months follow-up period with combined treatment with CBT and medication (P<0.001). Improvement of their cognitive symptoms was significantly correlated with improvement of alternative attention (r=0.653, P=0.002).
  
  
  CONCLUSIONS
  Higher-order level cognitive dysfunction affects CCFS pathogenesis. Alternative attention performance evaluated by the mATMT may be used to monitor improvement in patients with CCFS. Combined treatment with CBT and medication may be effective to improve poor attention characteristics associated with CCFS.
authors.affiliation: Department of Child Development, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Kawatani
authors.forename: Kei
authors.initials: K
authors.lastname: Mizuno
authors.forename: Seishi
authors.initials: S
authors.lastname: Shiraishi
authors.forename: Miyuki
authors.initials: M
authors.lastname: Takao
authors.forename: Takako
authors.initials: T
authors.lastname: Joudoi
authors.forename: Sanae
authors.initials: S
authors.lastname: Fukuda
authors.forename: Yasuyoshi
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Akemi
authors.initials: A
authors.lastname: Tomoda
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D015673:Fatigue Syndrome, Chronic / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D005222:Mental Fatigue / Q000175:diagnosis / Q000209:etiology*; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires