title: Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome.
abstract: The ability to divide one's attention deteriorates in patients with childhood chronic fatigue syndrome (CCFS). We conducted a study using a dual verbal task to assess allocation of attentional resources to two simultaneous activities (picking out vowels and reading for story comprehension) and functional magnetic resonance imaging. Patients exhibited a much larger area of activation, recruiting additional frontal areas. The right middle frontal gyrus (MFG), which is included in the dorsolateral prefrontal cortex, of CCFS patients was specifically activated in both the single and dual tasks; this activation level was positively correlated with motivation scores for the tasks and accuracy of story comprehension. In addition, in patients, the dorsal anterior cingulate gyrus (dACC) and left MFG were activated only in the dual task, and activation levels of the dACC and left MFG were positively associated with the motivation and fatigue scores, respectively. Patients with CCFS exhibited a wider area of activated frontal regions related to attentional resources in order to increase their poorer task performance with massive mental effort. This is likely to be less efficient and costly in terms of energy requirements. It seems to be related to the pathophysiology of patients with CCFS and to cause a vicious cycle of further increases in fatigue.
authors.affiliation: Pathophysiological and Health Science Team, RIKEN Center for Life Science Technologies, 6-7-3 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan ; Department of Medical Science on Fatigue, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka City, Osaka 545-8585, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Mizuno
authors.affiliation: Department of Physiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka City, Osaka 545-8585, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Cerebral Research, Division of Cerebral Integration, National Institute for Physiological Sciences, 38 Nishigonaka, Myodaiji, Okazaki, Aichi 444-8585, Japan ; Department of Psychology, Graduate School of Environmental Studies, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8601, Japan.
authors.forename: Hiroki C
authors.initials: HC
authors.lastname: Tanabe
authors.affiliation: Department of Child Development, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Kumamoto City, Kumamoto 860-8556, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Joudoi
authors.affiliation: Department of Child Development, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Kumamoto City, Kumamoto 860-8556, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Kawatani
authors.affiliation: Department of Physiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka City, Osaka 545-8585, Japan.
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Shigihara
authors.affiliation: Department of Child Development, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Kumamoto City, Kumamoto 860-8556, Japan ; Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-shimoaiduki, Eiheiji-cho, Fukui 910-1193, Japan.
authors.forename: Akemi
authors.initials: A
authors.lastname: Tomoda
authors.affiliation: Department of Child Development, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Kumamoto City, Kumamoto 860-8556, Japan ; Hyogo Children's Sleep and Development Medical Research Center, 1070 Akebono-cho, Nishi-ku, Kobe, Hyogo 651-2181, Japan.
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Miike
authors.affiliation: Department of School Psychology, Developmental Science and Health Education, Hyogo University of Teacher Education, Graduate School in Science of School Education, 942-1 Shimokume, Kato, Hyogo 673-1494, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Imai-Matsumura
authors.affiliation: Department of Cerebral Research, Division of Cerebral Integration, National Institute for Physiological Sciences, 38 Nishigonaka, Myodaiji, Okazaki, Aichi 444-8585, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Sadato
authors.affiliation: Pathophysiological and Health Science Team, RIKEN Center for Life Science Technologies, 6-7-3 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan ; Department of Physiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka City, Osaka 545-8585, Japan.
authors.forename: Yasuyoshi
authors.initials: Y
authors.lastname: Watanabe
mesh_terms: D000293:Adolescent; D001288:Attention / Q000502:physiology*; D001931:Brain Mapping; D002648:Child; D032882:Comprehension / Q000502:physiology; D015673:Fatigue Syndrome, Chronic / Q000503:physiopathology*; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009042:Motivation / Q000502:physiology*; D011932:Reading
keywords: Children and adolescents; Chronic fatigue syndrome; Cognitive compensation; Divided attention; Frontal cortex; Functional magnetic resonance imaging