title: Emotional conflict processing in adolescent chronic fatigue syndrome: A pilot study using functional magnetic resonance imaging.
abstract: BACKGROUND
  Studies of neurocognition suggest that abnormalities in cognitive control contribute to the pathophysiology of chronic fatigue syndrome (CFS) in adolescents, yet these abnormalities remain poorly understood at the neurobiological level. Reports indicate that adolescents with CFS are significantly impaired in conflict processing, a primary element of cognitive control.
  
  
  METHODS
  In this study, we examine whether emotional conflict processing is altered on behavioral and neural levels in adolescents with CFS and a healthy comparison group. Fifteen adolescent patients with CFS and 24 healthy adolescent participants underwent functional magnetic resonance imaging (fMRI) while performing an emotional conflict task that involved categorizing facial affect while ignoring overlaid affect labeled words.
  
  
  RESULTS
  Adolescent CFS patients were less able to engage the left amygdala and left midposterior insula (mpINS) in response to conflict than the healthy comparison group. An association between accuracy interference and conflict-related reactivity in the amygdala was observed in CFS patients. A relationship between response time interference and conflict-related reactivity in the mpINS was also reported. Neural responses in the amygdala and mpINS were specific to fatigue severity.
  
  
  CONCLUSIONS
  These data demonstrate that adolescent CFS patients displayed deficits in emotional conflict processing. Our results suggest abnormalities in affective and cognitive functioning of the salience network, which might underlie the pathophysiology of adolescent CFS.
authors.affiliation: a Department of Pediatrics , Akershus University Hospital , Nordbyhagen , Norway.|b Department of Psychology , University of Oslo , Oslo , Norway.
authors.forename: Laura Anne
authors.initials: LA
authors.lastname: Wortinger
authors.affiliation: b Department of Psychology , University of Oslo , Oslo , Norway.
authors.forename: Tor
authors.initials: T
authors.lastname: Endestad
authors.affiliation: c Cognitive Developmental Research Unit, Department of Psychology , University of Oslo , Oslo , Norway.
authors.forename: Annika Maria D
authors.initials: AM
authors.lastname: Melinder
authors.affiliation: b Department of Psychology , University of Oslo , Oslo , Norway.|d Research Department , Innlandet Hospital Trust , Lillehammer , Norway.
authors.forename: Merete Glenne
authors.initials: MG
authors.lastname: Øie
authors.affiliation: e Department of Pediatrics , Oslo University Hospital , Oslo , Norway.|f Department of Pediatrics , Innlandet Hospital Trust , Lillehammer , Norway.
authors.forename: Dag
authors.initials: D
authors.lastname: Sulheim
authors.affiliation: g Department of Anesthesiology and Critical Care , Oslo University Hospital , Oslo , Norway.
authors.forename: Even
authors.initials: E
authors.lastname: Fagermoen
authors.affiliation: a Department of Pediatrics , Akershus University Hospital , Nordbyhagen , Norway.
authors.forename: Vegard Bruun
authors.initials: VB
authors.lastname: Wyller
mesh_terms: D000293:Adolescent; D000679:Amygdala / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002540:Cerebral Cortex / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002648:Child; D003071:Cognition / Q000502:physiology; D004644:Emotions / Q000502:physiology*; D015673:Fatigue Syndrome, Chronic / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010865:Pilot Projects
keywords: Adolescents; Chronic fatigue syndrome; Cognitive control; Conflict; Emotion; Functional MRI