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'''Cognitive dysfunction''' or '''cognitive impairment''' is a symptom in most diagnostic criteria for [[ME/CFS]]; some patients call it "[[brain fog]]".<ref name="Jason2014">{{Citation | last1 = Jason | first1 = Leonard A. | author-link1 = Leonard Jason | last2 = Sunnquist | first2 = Madison | author-link2 = Madison Sunnquist | last3 = Brown | first3 = Abigail | author-link3 = | last4 = Evans | first4 = Meredyth | author-link4 = Meredyth Evans | last5 = Vernon | first5 = Suzanne D. | author-link5 = Suzanne Vernon | last6 = Furst | first6 = Jacob D. | author-link6 = | last7 = Simonis | first7 = Valerie | author-link8 = | title = Examining case definition criteria for chronic fatigue syndrome and myalgic encephalomyelitis | journal = Fatigue: Biomedicine, Health & Behavior | volume = 2 | issue = 1 | page = 40-56 | date = 2014 | pmid = | doi = 10.1080/21641846.2013.862993}}</ref><ref name="Kingdon2020">{{Cite journal | last = Kingdon | first = Caroline | authorlink = Caroline Kingdon | last2 = Giotas | first2 = Dionysius | author-link2 = Dionysius Giotas | last3 = Nacul | first3 = Luis | author-link3 = Luis Nacul | last4 = Lacerda | first4 = Eliana | author-link4 = Eliana Lacerda | date = Sep 2020 | title = Health Care Responsibility and Compassion-Visiting the Housebound Patient Severely Affected by ME/CFS | url = https://www.mdpi.com/2227-9032/8/3/197 | journal = Healthcare|language=en|volume=8 | issue = 3 | pages = 197|doi=10.3390/healthcare8030197|pmc=PMC7551603|pmid=32635535|access-date=|quote=|via=}}</ref> It is also a common symptom of [[fibromyalgia]] which many patients call "fibro fog."<ref name="Katz2015">{{Cite journal | last = Kravitz|first = Howard M. | last2 = Katz | first2 = Robert S. | date = 2015-07-01 | title = Fibrofog and fibromyalgia: a narrative review and implications for clinical practice | url =https://doi.org/10.1007/s00296-014-3208-7 | journal = Rheumatology International|language=en|volume=35 | issue = 7 | pages = 1115–1125|doi=10.1007/s00296-014-3208-7|issn=1437-160X}}</ref> Forms of cognitive dysfunction commonly found in [[ME/CFS]] include [[attention deficit|reduced attention span]],<ref name="Constant2011" /><ref name="DeBecker2001">{{Cite journal | last = De Becker | first = Pascale | authorlink = Pascale De Becker | last2 = McGregor | first2 = Neil | author-link2 = Neil McGregor | last3 = De Meirleir | first3 = Kenny | author-link3 = Kenny De Meirleir | date = Dec 2001 | title = A definition‐based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome | url =https://onlinelibrary.wiley.com/doi/full/10.1046/j.1365-2796.2001.00890.x?sid=nlm%3Apubmed | journal = Journal of Internal Medicine|volume=250 | issue = 3 | pages = 234–240|doi=10.1046/j.1365-2796.2001.00890.x|quote=|via=}}</ref> [[brain fog|brain fog/cognitive fog]],<ref name="Jason2014" /><ref name="canadianconsensus-CCC" /> [[cognitive overload]],<ref name="canadianconsensus-CCC" /> [[concentration problems]],<ref name="ICC"/> [[confusion]],<ref name="ICC"/> [[dyscalculia|difficulties with calculations]],<ref name="canadianconsensus-CCC" /><ref name="DeBecker2001" /> [[dyslexia|dyslexia (or linguistic reversals) when fatigued]],<ref name="ICC"/><ref name="canadianconsensus-CCC" /> [[difficulty learning new information|difficulty absorbing information]],<ref name="ICC"/> difficulty sequencing words and numbers,<ref name="ICC"/> [[multi-tasking problems]],<ref name="Mizuno2015"/><ref name="ICC"/> [[planning problems]], [[poor working memory]],<ref name="canadianconsensus-CCC" /><ref name="ICC" /> [[reading or speaking difficulties]],<ref name="canadianconsensus-CCC" /> [[Memory problems#short-term_memory_problems|short-term memory problems]],<ref name="ICC"/><ref name="canadianconsensus-CCC" /> [[slowed thought]],<ref name="ICC"/><ref name="canadianconsensus-CCC" /> [[spatial disorientation]],<ref name="DeBecker2001" /> [[slow processing of information]]<ref name="ICC"/> and [[word-finding problems]].<ref name="ICC">{{citation | last1 = Carruthers | first1 = BM | author-link1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | author-link2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | author-link3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | author-link4 = Nancy Klimas | last5 = Broderick | first5 = G | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = T | author-link6 = Terry Mitchell | last7 = Staines | first7 = D | author-link8 = Donald Staines | last8 = Powles | first8 = ACP | author-link8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | author-link10 = Rosamund Vallings | last11 = Bateman | first11 = L | author-link11 = Lucinda Bateman | last12 = Bell | first12 = DS | author-link12 = David Bell | last13 = Carlo-Stella | first13 = N | author-link13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | author-link14 = John Chia | last15 = Darragh | first15 = A | author-link15 = Austin Darragh | last16 = Gerken | first16 = A | author-link16 = Anne Gerken | last17 = Jo | first17 = D | author-link17 = Daehyun Jo | last18 = Lewis | first18 = DP | author-link18 = Donald Lewis | last19 = Light | first19 = AR | author-link19 = Alan Light | last20 = Light | first20 = KC | author-link20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | author-link21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | author-link22 = John McLaren-Howard | last23 = Mena | first23 = I | author-link23 = Ismael Mena | last24 = Miwa | first24 = K | author-link24 = Kunihisa Miwa | last25 = Murovska | first25 = M | author-link25= Modra Murovska | last26 = Stevens | first26 = SR | author-link26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf}}</ref> A 2016 study found that IQ scores of adolescents with CFS tested lower than the IQ scores of healthy peers with an equivalent school level. Currently it is not known whether lower IQ outcomes are due to concentration problems, a lowered processing speed or the illness itself.<ref name="Nijhof2016" /> ==Prevalence== Cognitive dysfunction is extremely common in ME/CFS, and is a symptom used for diagnosis in most case definitions including the current [[CDC_Myalgic_Encephalomyelitis/Chronic_Fatigue_Syndrome_2017_diagnostic_criteria|CDC diagnostic criteria for ME/CFS]]. Cognitive dysfunction is also a symptom that commonly occurs during [[post-exertional malaise]], which is the hallmark symptom of ME/CFS, and can result from [[orthostatic intolerance]], which is another very common ME/CFS symptom.<ref name="canadianconsensus-CCC" /><ref name="dysautonomia"/> {{See also|Post-exertional malaise}} ==Symptom recognition== Cognitive dysfunction is a particularly common symptom of ME/CFS, but is also a symptom of many other illnesses. ===Mandatory ME/CFS symptom=== Cognitive dysfunction is a mandatory diagnostic symptom for ME/CFS with the [[Canadian Consensus Criteria]] (CCC).<ref name="canadianconsensus-CCC">{{Cite journal | last1 = Carruthers | first1 = Bruce M. | author-link1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | author-link2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | author-link3 = Kenny De Meirleir | last4 = Peterson | first4 = Daniel L. | author-link4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | author-link5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | author-link6 = Martin Lerner | last7 = Bested | first7 = Alison C. | author-link8 = Alison Bested | last8 =Flor-Henry | first8 = Pierre | author-link8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | author-link9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | author-link10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | author-link11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | author-link12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref> ===Optional ME/CFS symptom=== '''Impaired memory or ability to concentrate''' is a core symptom in the current [[CDC_Myalgic_Encephalomyelitis/Chronic_Fatigue_Syndrome_2017_diagnostic_criteria|CDC ME/CFS diagnostic criteria]] diagnostic criteria, and is required when [[orthostatic intolerance]] is not present.<ref name="CDC-IOM-SEIDcriteria">{{Cite web | url = https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/iom-2015-diagnostic-criteria.html | title = IOM 2015 Diagnostic Criteria {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | website = [[Centers for Disease Control and Prevention]] | date = Jan 27, 2021|access-date = 2021-02-25}}</ref> Cognitive dysfunction is part of the possible diagnostic symptoms in the [[International Consensus Criteria]] (ICC) for [[myalgic encephalomyelitis]] (ME).<ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | author-link1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | author-link2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | author-link3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | author-link4 = Nancy Klimas | last5 = Broderick | first5 = G | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = T | author-link6 = Terry Mitchell | last7 = Staines | first7 = D | author-link8 = Donald Staines | last8 = Powles | first8 = ACP | author-link8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | author-link10 = Rosamund Vallings | last11 = Bateman | first11 = L | author-link11 = Lucinda Bateman | last12 = Bell | first12 = DS | author-link12 = David Bell | last13 = Carlo-Stella | first13 = N | author-link13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | author-link14 = John Chia | last15 = Darragh | first15 = A | author-link15 = Austin Darragh | last16 = Gerken | first16 = A | author-link16 = Anne Gerken | last17 = Jo | first17 = D | author-link17 = Daehyun Jo | last18 = Lewis | first18 = DP | author-link18 = Donald Lewis | last19 = Light | first19 = AR | author-link19 = Alan Light | last20 = Light | first20 = KC | author-link20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | author-link21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | author-link22 = John McLaren-Howard | last23 = Mena | first23 = I | author-link23 = Ismael Mena | last24 = Miwa | first24 = K | author-link24 = Kunihisa Miwa | last25 = Murovska | first25 = M | author-link25= Modra Murovska | last26 = Stevens | first26 = SR | author-link26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012| isbn = 978-0-9739335-3-6| url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref> ===Other causes=== == Diagnosis == * [http://www.dysautonomiainternational.org/blog/wordpress/cognitive-dysfunction-and-brain-fog-in-pots/ Cognitive Dysfunction and “Brain Fog” in POTS]<ref name="dysautonomia">{{Cite web | url = http://www.dysautonomiainternational.org/blog/wordpress/cognitive-dysfunction-and-brain-fog-in-pots/ | title = Cognitive Dysfunction and “Brain Fog” in POTS {{!}} The Dysautonomia Dispatch | last = Arnold | first = Amy | date = Feb 3, 2016 | website = Dysautonomia International|language=en-US| archive-url = | archive-date = |url-status = | access-date=2018-08-28}}</ref> ==Possible causes== ===Neurological changes in ME/CFS === [[File:MECFS-neuroeffects-brain.jpg|alt=Sketch of a brain with words inside saying intracranial hypertension, impaired cerebral blood flow, hyperventilation/hypocapnia, and adrenergic hyperactivity.|thumb|Key neurological pathomechanisms in ME/CFS.<br>'''Source:''' Wirth, K.J., Scheibenbogen, C. & Paul, F. [https://doi.org/10.1186/s12967-021-03143-3 An attempt to explain the neurological symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.] J Transl Med 19, 471 (2021). https://doi.org/10.1186/s12967-021-03143-3]] Causes of neurological symptoms in ME/CFS include: *hyperventilation/hypnocapnia (reduced carbon dioxide levels in the blood) *[[intracranial hypertension]] (increased pressure within the skull and around brain) * reduced blood flow to the brain * [[Neuroinflammation|brain inflammation]] may also be a factor<ref name="Wirth2021b" /> Wirth, Scheibenbogen and Paul (2021) state these "can explain cognitive impairment, [[brain fog]], [[headache]], psychomotor slowing, [[ataxia]] and loss of coordination of movements, [[Sensory overload|hypersensitivity]], [[sleep dysfunction|sleep disturbances]] and [[dysautonomia]]."<ref name="Wirth2021b" /> ===Cerebrospinal fluid changes === [[Mady Hornig]] and colleagues have found evidence in the [[cerebrospinal fluid]] (CSF) of ME/CFS patients that may explain their cognitive dysfunction.<ref name="Hornig, 2016">{{Cite journal | last1 = Hornig | first1 = M | author-link1 = Mady Hornig | last2 = Gottschalk | first2 = G | author-link2 = Gunnar Gottschalk | last3 = Peterson | first3 = D | author-link3 = Daniel Peterson | last4 = Knox | first4 = KK | author-link4 = | last5 =Schultz | first5 = AF | author-link5 = | last6 = Eddy | first6 = ML | author-link6 = | last7 = Che | first7 = X | author-link7 = | last8 =Lipkin | first8 = WI | author-link8 = Ian Lipkin | title = Cytokine network analysis of cerebrospinal fluid in myalgic encephalomyelitis/chronic fatigue syndrome. | journal = Molecular Psychiatry | volume = 21 | issue = 2 | page = 261-9 | date = 2016 | doi = 10.1038/mp.2015.29}}</ref> ===Brain changes === [[File:CLROA-2-110-F1.gif|850px|thumb|center| Figure 1: Results of LORETA current source density in a case with CFS showing widespread decreased current density for delta at 2 Hz and beta (12- 15 Hz) demonstrating a global reduction in brain functioning (blue). The higher frequencies (beta) have been shown to be a function of delta frequencies. In other words, local oscillations are under constant influence of global brain dynamics (Buzsaki, 2006).<ref name="Zinn2016" />]] Zinn et al. (2016) studied brain functioning in chronic fatigue syndrome and concluded: <blockquote>Our case study confirmed the pattern of dysregulation in the cortex reviewed in the introduction. Furthermore, since both periods of phase shift/lock durations were found to be significantly shorter, that might contribute to an increased rate of phase reset, also seen in our data. Phase reset deregulation--phase locking periods being too brief and phase reset happening too often—appear to be consistent with the associated lower rate of information processing and reaction times found in the ME and CFS literature. These deregulated states represent the brain during nonoptimal functioning, rendering it inefficient for most types of information processing functioning, whether it is executive functioning, [[Memory problems|memory]], perceptual reasoning or information processing speed. When phase lock is significantly less than normal, as in this data set, the ability of the brain to sustain commitment of resources to mediate different functions is severely compromised. Phase shift duration in this data is also hypoactive, meaning that significantly less neurons are being recruited to perform a function than normal. The results here indicate slowed verbal comprehension, executive functions, perceptual reasoning, processing speed and memory, the sum total of which is known as [[cognitive impairment]].<ref name="Zinn2016" /></blockquote> ===Drug and supplements === Drugs, supplements or treatment interventions that may cause cognitive problems in some ME/CFS patients: *[[Diphenhydramine]] (Benadryl) an [[antihistamine]] also used to aid sleep *Certain [[Analgesic|pain killers]], particularly [[opioid]]s, [[gabapentin]] (Neurontin), [[:Category:Tricyclic antidepressants|tricyclic antidepressants]] including [[amitriptyline]] (Elavil, Endep) and [[nortriptyline]] (Aventyl, Pamelor)<ref name="medicinecabinet">https://www.health.harvard.edu/mind-and-mood/stuck-in-a-brain-fog-look-in-your-medicine-cabinet</ref> * [[:Category:Sleep aids and hypnotics|sleep medications]]<ref name="medicinecabinet" /> ===Exercise and graded exercise therapy === A healthy person becomes more alert after [[exercise]], but people with ME/CFS find their cognitive difficulties increase, they become much slower at mental activities, and cognitive tasks seem to take extra effort.<ref name="ICC" /><ref name="canadianconsensus-CCC" /><ref name="Collatz2014" /> [[Graded exercise therapy]] (GET) / Graded Activity Therapy also has this effect in ME/CFS patients.<ref name="ICC" /><ref name="canadianconsensus-CCC" /><ref name="Collatz2014" /> {{See also|Exercise}} ===Other illnesses or health conditions === Cognitive dysfunction can be caused or made worse by other health conditions, most of which should be [[Differential diagnosis|ruled out or identified]] during diagnostic process for ME/CFS: * [[Cancer]] or cancer treatment ("chemo brain") * [[Depression]] * [[Fibromyalgia]] * [[Long COVID]] symptoms<ref name="WHO-longcovid-criteria">{{citation | title = A clinical case definition of post COVID-19 condition by a Delphi consensus | date =Oct 6, 2021 | publisher = [[World Health Organization]] | others = World Health Organization (WHO) clinical case definition working group on post COVID-19 condition | first1 = Joan B. | last1 = Soriano | first2 = Maya | last2 = Allan | first3 = Carine | last3 = Alsokhn | first4 = Nisreen A. | last4 = Alwan | author-link4 = Nisreen Alwan | first5 = Lisa | last5 = Askie | first6 = Hannah E. | last6 = Davis | author-link6 = Hannah Davis | first7 = Janet V. | last7 = Diaz | first8 = Tarun | last8 = Dua | first9 = Wouter | last9 = de Groote | first10 = Robert | last10 = Jakob | first11 = Marta | last11 = Lado | first12 = John | last12 = Marshall | first13 = Srin | last13 = Murthy | first14 = Jacobus | last14 = Preller | first15 = Pryanka | last15 = Relan | first16 = Nicoline | last16 = Schiess | first17 = Archana | last17 = Seahwag | ref = WHO reference number: WHO/2019-nCoV/Post_COVID-19_condition/Clinical_case_definition/2021.1 | url = https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1}}</ref> * [[Systemic lupus erythematosus|Lupus]] * [[Menopause]] * [[Multiple sclerosis]] * [[Pregnancy]] * [[Sleep dysfunction]] or [[:Category:Sleep disorders|sleep disorders]]<ref>{{Cite web | url = https://www.webmd.com/brain/ss/slideshow-brain-fog | title = Reasons You May Have Brain Fog | website = WebMD|language=en|access-date=2022-01-22}}</ref> ==Potential treatments== Drugs, supplements and other treatments that have been suggested for reducing cognitive impairment and/or improving brain fog include: *[[Carnitine|Acetyl-L-carnitine]]<ref name="Collatz2014" /> *[[Arabinoxylan]] (ineffective)<ref name="Collatz2014">{{Cite journal | title = A Systematic Review of Drug Therapies for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis | date = Jun 2016 | url = https://pubmed.ncbi.nlm.nih.gov/27229907/ | journal = Clinical Therapeutics|volume=38 | issue = 6 | pages = 1263–1271.e9 | last = Collatz|first = Ansel | authorlink = | last2 = Johnston | first2 = Samantha C. | author-link2 = | last3 = Staines | first3 = Donald R. | author-link3 = Donald Staines | last4 = Marshall-Gradisnik | first4 = Sonya M. | author-link4 = Sonya Marshall-Gradisnik|doi=10.1016/j.clinthera.2016.04.038|pmc=|pmid=27229907|access-date=|issn=1879-114X|quote=|via=}}</ref> *[[B vitamin complex]] *[[B vitamin]] *[[Clonidine hydrochloride]] (ineffective)<ref name="Collatz2014" /> *[[Dexamphetamine]] (weak evidence)<ref name="canadianconsensus-CCC"/> *[[Dynamic Neural Retraining System]] *[[Fludrocortisone]] (ineffective)<ref name="Collatz2014" /> *[[Histamine]] *[[Hydrocortisone]] (most trials show some positive effective)<ref name="Collatz2014" /> *Lying down or moving to a semi-reclined position for cognitive tasks<ref name="canadianconsensus-CCC"/> *[[Methylene blue]] *[[Methylphenidate]] (weak evidence)<ref name="canadianconsensus-CCC"/> and the experimental treatment [[KPAX002]]<ref name="Uson2008">{{Cite journal | title = Diagnostic and treatment challenges of chronic fatigue syndrome: role of immediate-release methylphenidate | date = 2008-06-01 | url = https://doi.org/10.1586/14737175.8.6.917 | journal = Expert Review of Neurotherapeutics|volume=8 | issue = 6 | pages = 917–927 | last = Valdizán Usón | first = José Ramón | last2 = Idiazábal Alecha | first2 = María Ángeles|doi=10.1586/14737175.8.6.917|issn=1473-7175}}</ref> *[[Modafinil]] for alertness<ref name="canadianconsensus-CCC"/> but Collatz et al. (2014) found it ineffective<ref name="Collatz2014" /> *[[Moclobemide]]<ref name="Collatz2014" /> *[[Neurolinguistic programming]] *[[Nimodipine]] for mental clarity, starting at 30mg, increase up to 60mg if tolerated (weak evidence)<ref name="canadianconsensus-CCC"/> *[[Phenelzine]] (ineffective in ME/CFS)<ref name="Collatz2014" /> *[[Rintatolimod]] (Ampligen) *[[Stellate ganglion block]] in [[dysautonomia]] in some [[long COVID]] patients *[[Valganciclovir]] (ineffective)<ref name="Collatz2014" /> *[[Yoga]] ==Notable studies== *2022, Systematic review and meta‐analysis of cognitive impairment in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)<ref name="Sebaiti2022">{{Cite journal | title = Systematic review and meta-analysis of cognitive impairment in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) | date = 2022-02-09 | url = https://www.nature.com/articles/s41598-021-04764-w | journal = Scientific Reports|volume=12 | issue = 1 | pages = 2157 | last = Aoun Sebaiti|first = Mehdi | authorlink = | last2 = Hainselin | first2 = Mathieu | author-link2 = | last3 = Gounden | first3 = Yannick | author-link3 = | last4 = Sirbu | first4 = Carmen Adella | author-link4 = | last5 = Sekulic | first5 = Slobodan | author-link5 = | last6 = Lorusso | first6 = Lorenzo | author-link6 = Lorenzo Lorusso | last7 = Nacul | first7 = Luis | author-link8 = Luis Nacul | last8 = Authier | first8 = François Jérôme | author-link8 = François Jérôme Authier|language=en|doi=10.1038/s41598-021-04764-w|pmc=PMC8828740|pmid=35140252|access-date=|issn=2045-2322|quote=|via=}}</ref> - [https://www.researchgate.net/journal/Scientific-Reports-2045-2322/publication/356471001_Neuropsychological_impairment_in_myalgic_encephalomyelitischronic_fatigue_syndrome_MECFS_Analysis_of_literature_and_proposal_for_patients'_evaluation/links/6204898e4a5456050db288da/Neuropsychological-impairment-in-myalgic-encephalomyelitis-chronic-fatigue-syndrome-ME-CFS-Analysis-of-literature-and-proposal-for-patients-evaluation.pdf (Full text)] *2016, Cognitive Dysfunction in Chronic Fatigue Syndrome: a Review of Recent Evidence<ref name="Cvejic2016">{{Cite journal | last = Cvejic|first = Erin | authorlink = | last2 = Birch | first2 = Rachael C. | author-link2 = | last3 = Vollmer-Conna | first3 = Uté | author-link3 = Uté Vollmer-Conna | date = May 2016 | title = Cognitive Dysfunction in Chronic Fatigue Syndrome: a Review of Recent Evidence | url =http://link.springer.com/10.1007/s11926-016-0577-9 | journal = Current Rheumatology Reports|language=en|volume=18 | issue = 5 | pages = 24|doi=10.1007/s11926-016-0577-9|issn=1523-3774|pmc=|pmid=|access-date=|quote=|via=}}</ref> - [https://www.ncbi.nlm.nih.gov/pubmed/27032787 (Abstract)] *2016, The impact of chronic fatigue syndrome on cognitive functioning in adolescents<ref name="Nijhof2016">{{Cite journal | last = Nijhof|first = Linde N. | authorlink = | last2 = Nijhof | first2 = Sanne L. | author-link2 = | last3 = Bleijenberg | first3 = Gijs | author-link3 = Gijs Bleijenberg | last4 = Stellato | first4 = Rebecca K. | author-link4 = | last5 = Kimpen | first5 = Jan L.L. | author-link5 = | last6 = Pol | first6 = Hilleke E. Hulshoff | author-link6 = | last7 = van de Putte | first7 = Elise M. | last8 = E | first8 = | date = Feb 2016 | title = The impact of chronic fatigue syndrome on cognitive functioning in adolescents |url =http://link.springer.com/10.1007/s00431-015-2626-1 | journal = European Journal of Pediatrics|language=en|volume=175 | issue = 2 | pages = 245–252|doi=10.1007/s00431-015-2626-1|issn=0340-6199|pmc=4724362|pmid=26334394|access-date=|quote=|via=}}</ref> - [https://link.springer.com/article/10.1007/s00431-015-2626-1 (Full text)] *2016, qEEG / LORETA in Assessment of Neurocognitive Impairment in a Patient with Chronic Fatigue Syndrome: A Case Report<ref name="Zinn2016">{{Cite web | url = https://www.sciforschenonline.org/journals/clinical-research/CLROA-2-110.php | title = qEEG / LORETA in Assessment of Neurocognitive Impairment in a Patient with Chronic Fatigue Syndrome: A Case Report | last = Zinn | first = ML | date = 2016 | website = sciforschenonline.org| archive-url = | archive-date = |url-status = | access-date=2018-08-28 | last2 = Zinn | first2 = Mark A. | last3 = Jason | first4 = | first3 = Leonard|issn=2469-6714| publisher = SciForschen|doi=10.16966/2469-6714.110}}</ref> - ([https://sciforschenonline.org/journals/clinical-research/CLROA-2-110.php Full text]) *2011, Cognitive deficits in patients with chronic fatigue syndrome compared to those with major depressive disorder and healthy controls<ref name="Constant2011">{{Cite journal | title = Cognitive deficits in patients with chronic fatigue syndrome compared to those with major depressive disorder and healthy controls | date = 2011-05-01 | url = https://www.sciencedirect.com/science/article/pii/S0303846710003884 | journal = Clinical Neurology and Neurosurgery|volume=113 | issue = 4 | pages = 295–302 | last = Constant | first = E.L. | last2 = Adam | first2 = S. | last3 = Gillain | first3 = B. | last4 = Lambert | first4 = M. | last5 = Masquelier | first5 = E. | last6 = Seron | first6 = X.|language=en|doi=10.1016/j.clineuro.2010.12.002|issn=0303-8467}}</ref> - [https://www.sciencedirect.com/science/article/abs/pii/S0303846710003884 (Full text)] *2006, Cognitive dysfunction relates to subjective report of mental fatigue in patients with chronic fatigue syndrome<ref name="Capuron, 2006">{{Cite journal | last1 = Capuron | first1 = Lucile| author-link1 = | last2 = Welberg | first2 = Leonie| author-link2 = | last3 = Heim | first3 = Christine | author-link3 = | last4 = Wagner | first4 = Dieter| author-link4 = | last5 =Solomon | first5 = Laura| author-link5 = | last6 = Papanicolaou | first6 = Dimitris A | author-link6 = | last7 = Craddock | first7 = R Cameron | author-link7 = | last8 =Miller | first8 = Andrew H | author-link8 = | last9 = Reeves | first9 = William C | author-link9 = William Reeves | title = Cognitive Dysfunction Relates to Subjective Report of Mental Fatigue in Patients with Chronic Fatigue Syndrome| journal = Neuropsychopharmacology | volume = 31 | issue = | page = 1777–1784 | date = 2006 | doi = 10.1038/sj.npp.1301005}}</ref> - [https://www.nature.com/articles/1301005 (Full text)] *2015, Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome<ref name="Mizuno2015">{{Cite journal | last = Mizuno|first = Kei | last2 = Tanaka | first2 = Masaaki | last3 = Tanabe | first3 = Hiroki C. | last4 = Joudoi | first4 = Takako | last5 = Kawatani | first5 = Junko | last6 = Shigihara | first6 = Yoshihito | last7 = Tomoda | first7 = Akemi | last8 = Miike | first8 = Teruhisa | last9 = Imai-Matsumura | first9 = Kyoko | date = 2015-09-10 | title = Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome | url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589845/ | journal = NeuroImage : Clinical|volume=9 | pages = 355–368|doi=10.1016/j.nicl.2015.09.001|issn=2213-1582|pmid=26594619|via=}}</ref> - ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589845/ Full Text]) *2001, Neuropsychological functioning in chronic fatigue syndrome: a review - ([[pubmed:11167310|Abstract]])<ref name="Michiels2001">{{Cite journal | last = Michiels | first = V. | last2 = Cluydts | first2 = R.| date = 2001 | title = Neuropsychological functioning in chronic fatigue syndrome: a review | url =https://www.ncbi.nlm.nih.gov/pubmed/11167310 | journal = Acta Psychiatrica Scandinavica|volume=103 | issue = 2 | pages = 84–93|issn=0001-690X|pmid=11167310|via=}}</ref> == Disability == In 2018 [[Brian Vastag]] was able to prove the severity of his chronic fatigue syndrome cognitive dysfunction with [[qEEG]] and cognitive tests, which proved he had "significant problems with [[Visual dysfunction|visual perception]] and analysis, scanning speed, attention, visual motor coordination, motor and mental speed, [[Memory problems|memory]], and [[Word-finding problems|verbal fluency]]" winning his long term disability (LTD) claim in the [[United States]].<ref name="MEActionDisability">{{Cite web | url = https://www.meaction.net/2018/06/04/victory-for-me-disability-claim-court-upholds-plaintiffs-lawsuit-after-being-denied-disability/ | title = Victory for ME Disability Claim - U.S. Court Upholds Plaintiff's Lawsuit After Being Denied Disability | last = Tillman | first = Adriane | authorlink = | date = 2018-06-04 | website = #MEAction|language=en-US| archive-url = | archive-date = |url-status = | access-date=2019-02-02}}</ref> ==See also== *[[Fibromyalgia]] *[[Long COVID]] *[[Aphasia]] *[[Dyscalculia]] *[[Dysphasia]] *[[Memory problems]] *[[Word-finding problems]] *[[Myalgic encephalomyelitis]] (M.E.) *[[Long COVID]] ==Learn more== *2015, [https://www.masscfids.org/resource-library/15-conference-reports/395-dr-gudrun-lange-reviews-neuropsychological-testing-for-cfs-and-fm Dr. Gudrun Lange Reviews Neuropsychological Testing for CFS and FM] *2016, [http://www.meaction.net/2016/02/07/case-study-brain-fog-in-cfs-can-be-seen-in-qeegloreta-analysis/ Case Study: "Brain Fog" in CFS can be seen in qEEG/Loreta] *2018, [https://fibromyalgianewstoday.com/2018/03/21/fibromyalgia-cognitive-dysfunction-study-identifies-main-types/ Study Identifies the Types of Cognitive Dysfunction That Are Most Prevalent in Fibromyalgia] * Jun 4, 2018, [https://www.meaction.net/2018/06/04/victory-for-me-disability-claim-court-upholds-plaintiffs-lawsuit-after-being-denied-disability/ Victory For ME Disability Claim – U.S. Court Upholds Plaintiff's Lawsuit After Being Denied Disability] ==References== {{Reflist}} [[Category:Signs and symptoms]] [[Category:Cognitive signs and symptoms]] [[Category:Long COVID signs and symptoms]]
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