Cognitive dysfunction and mental fatigue in childhood chronic fatigue syndrome--a 6-month follow-up

[Dolphin]

http://linkinghub.elsevier.com/retrieve/pii/S0387-7604(10)00361-X

Cognitive dysfunction and mental fatigue in childhood chronic fatigue syndrome--a 6-month follow-up study.

Brain Dev. 2011 Nov;33(10):832-41. doi: 10.1016/j.braindev.2010.12.009. Epub 2011 May 6.

Kawatani J1, Mizuno K, Shiraishi S, Takao M, Joudoi T, Fukuda S, Watanabe Y, Tomoda A.

Author information

Abstract

OBJECTIVES:

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.

Copyright © 2011 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

PMID: 21530119 [PubMed - indexed for MEDLINE]

 

[Dolphin]

Six of 19 patients (31.6%) were treated with antidepressant agents during the 6 month follow-up period: four received only SSRI, one received both sulpiride and SSRI, one received both midodrine hydrochloride and SSRI. Five patients received only midodrine hydrochloride. Four patients received other medication such as hypnotic agents and four received no medication.

so hard to know what helped.

Also, there was no no-treatment group so some or all of the change could be due to passage of time (particularly important with young people).

 

[Dolphin]

The abstract doesn't mention there was no significant improvement in fatigue:

In the CCFS group, two-way ANOVA for repeated measures revealed no main effect for timing of data collection of the fatigue score (F(1, 42) = 0.72,P= 0.407). Likewise, physical fatigue (P= 0.854), mental fatigue (P= 0.275), and total fatigue scores (P= 0.407) showed no significant changes between baseline and follow up (Table 2).

They used the Chalder Fatigue Scale (14-item)
Baseline: 24.1 (+/- 8.4)
Follow-up: 22.7 (+/- 8.4).

 

[daisybell]

Plus, there's no way of filtering out the positive effects of repetition on the assessment task...