Brain fog

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Brain fog manifests as impaired working memory and concentration accompanied by difficulty processing complex information.[1]

It is a type of cognitive impairment experienced by ME/CFS patients. Fibromyalgia patients often refer to it as "fibro fog".[2]

Causes[edit | edit source]

Brain fog is a common symptom of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, but can also be caused - or linked to - other illnesses:

  • during chemotherapy, the mild cognitive impairment is often called "chemo brain" or "chemo fog"[3]
  • depression - concentration problems may be described as brain fog[4]
  • Ehlers-Danlos syndrome (EDS) patients may use the term brain fog to refer to the "inability to focus and maintain concentration" that is common in people with EDS, although ME/CFS is also common in people with EDS[5]
  • the endocrine disorder hypoparathyroidism, which also causes mood problems[6]
  • brain fog is common in people with fibromyalgia, and is often referred to as "fibro fog"[2]
  • gluten sensitivity[7] or celiac disease[8]
  • hepatitis C virus[9]
  • hypocalcemia - low levels of calcium in the blood, which also causes fatigue and many other symptoms[10]
  • brain fog may be described by people with Ehlers-Danlos syndrome (EDS) as the "inability to focus and maintain concentration" that common in people with EDS, although ME/CFS is also common in people with EDS[11]
  • Lyme disease patients may use the term brain fog to describe an impairment in thinking[12]
  • postural orthostatic tachycardia syndrome (POTS) or other forms of orthostatic intolerance cause brain fog, "impaired cognition" and many other symptoms occur when a person stands or moves to an upright position[13][14]
  • brain fog may be used to describe memory impairment resulting from concussion or traumatic brain injury[15]
  • sarcoidosis-associated brain fog, which also causes fatigue[16]
  • Sjögren's syndrome[17]

Presentation[edit | edit source]

Prevalence[edit | edit source]

  • Katrina Berne reports a prevalence of 75-100% for confusion and inability to think clearly.[18]

Symptom recognition[edit | edit source]

Notable studies[edit | edit source]

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, 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.[20]
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).[20]


Possible causes[edit | edit source]

Potential treatments[edit | edit source]

Learn more[edit | edit source]

According to the Marshall Pathogenesis, cognitive dysfunction is caused by microbes. More severe forms of cognitive dysfunction are seen in diseases such as Alzheimer's, diseases for which there is strong evidence of a bacterial etiology. Often associated with chronic fatigue syndrome,1) cognitive dysfunction is also seen in patients with multiple sclerosis,2)depression,3)fibromyalgia,4) and dozens of others diseases.[24]

See also[edit | edit source]

References[edit | edit source]

  1. 1.01.1 "Brain Fog in ME/CFS: What's Going On? - Solve ME/CFS Initiative". Solve ME/CFS Initiative. Retrieved Aug 10, 2018. 
  2. 2.02.1 Abril, Andy; Bruce, Barbara K. (Sep 24, 2019). Mayo Clinic Guide to Fibromyalgia: Strategies to Take Back Your Life. Simon and Schuster. p. 69. ISBN 978-1-893005-49-5. 
  3. McKay, Judith; Schacher, Tamera (May 2009). The Chemotherapy Survival Guide: Everything You Need to Know to Get Through Treatment. New Harbinger Publications. p. 163. ISBN 978-1-57224-621-8. 
  4. Alpert, Jack N. (Nov 27, 2018). The Neurologic Diagnosis: A Practical Bedside Approach. Springer. p. 50. ISBN 978-3-319-95951-1. 
  5. Overeem, Sebastiaan; Reading, Paul (Sep 24, 2018). Sleep Disorders in Neurology: A Practical Approach. John Wiley & Sons. p. 4. ISBN 978-1-118-77726-8. 
  6. Camacho, Pauline M. (Feb 22, 2019). Metabolic Bone Diseases: A Case-Based Approach. Springer. ISBN 978-3-030-03694-2. 
  7. Ukleja, Andrew (Feb 7, 2018). Nutritional Management of Gastrointestinal Disease, an Issue of Gastroenterology Clinics of North America. Elsevier Health Sciences. p. 141. ISBN 978-0-323-58155-4. 
  8. Levenson, James L.; Ferrando, Stephen J. (Oct 18, 2016). Clinical Manual of Psychopharmacology in the Medically. III (2nd ed.). American Psychiatric Pub. p. 142. ISBN 978-1-58562-501-7. 
  9. Miyamura, Tatsuo; Lemon, Stanley M.; Walker, Christopher M.; Wakita, Takaji (Oct 28, 2016). Hepatitis C Virus II: Infection and Disease. Springer. p. 168. ISBN 978-4-431-56101-9. 
  10. Papadakis, Maxine A.; McPhee, Stephen J.; Rabow, Michael W. (Sep 9, 2019). CURRENT Medical Diagnosis and Treatment 2020 (59 ed.). McGraw Hill Professional. pp. 915,1169. ISBN 978-1-260-45529-8. 
  11. Overeem, Sebastiaan; Reading, Paul (Sep 24, 2018). Sleep Disorders in Neurology: A Practical Approach. John Wiley & Sons. p. 4. ISBN 978-1-118-77726-8. 
  12. Georgiev, Vassil St (Jul 6, 2009). National Institute of Allergy and Infectious Diseases, NIH: Volume 2: Impact on Global Health. Springer Science & Business Media. ISBN 978-1-60327-297-1. 
  13. Evans, Randolph W. (Aug 2, 2016). Case Studies in Neurology, An Issue of Neurologic Clinics. Elsevier Health Sciences. p. 538. ISBN 978-0-323-45980-8. 
  14. DePace, Nicholas L.; Colombo, Joseph (Aug 1, 2019). Clinical Autonomic and Mitochondrial Disorders: Diagnosis, Prevention, and Treatment for Mind-Body Wellness. Springer. p. 515. ISBN 978-3-030-17016-5. 
  15. Louis, Elan D.; Mayer, Stephan A.; Rowland, Lewis P. (Aug 31, 2015). Merritt's Neurology. Lippincott Williams & Wilkins. ISBN 978-1-4963-2107-7. 
  16. Lisak, Robert P.; Truong, Daniel D.; Carroll, William M.; Bhidayasiri, Roongroj (Jun 13, 2016). International Neurology. John Wiley & Sons. p. 97. ISBN 978-1-118-77736-7. 
  17. Hochberg, Marc C.; Silman, Alan J.; Smolen, Josef S.; Weinblatt, Michael E.; Weisman, Michael H. (Jun 24, 2014). Rheumatology. Elsevier Health Sciences. p. 304. ISBN 978-0-7020-6303-9. 
  18. Berne, Katrina (Dec 1, 1995), Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS), 2nd ed., Hunter House, p. 59, ISBN 978-0897931915 
  19. Ross, A. J.; Medow, M. S.; Rowe, P. C.; Stewart, J. M. (2013), "What is brain fog? An evaluation of the symptom in postural tachycardia syndrome.", Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society, 23 (6): 305–311, doi:10.1007/s10286-013-0212-z 
  20. 20.020.120.2 dr.marcie.zinn@gmail.com, Zinn ML, DePaul University, Center for Community Research, Chicago, IL, Tel/ Fax: (773) 325-4923; E-mail:; Zinn, Mark A.; Jason, Leonard (2016). "qEEG / LORETA in Assessment of Neurocognitive Impairment in a Patient with Chronic Fatigue Syndrome: A Case Report". www.sciforschenonline.org. SciForschen. doi:10.16966/2469-6714.110. ISSN 2469-6714. Retrieved Aug 28, 2018. 
  21. Wu, Yu-Lin; Huang, Chun-Jen; Fang, Su-Chen; Ko, Ling-Hsin; Tsai, Pei-Shan (Jun 1, 2018). "Cognitive Impairment in Fibromyalgia: A Meta-Analysis of Case–Control Studies". insights.ovid.com. Retrieved Aug 28, 2018. 
  22. M, Beth (Feb 7, 2016). "Case Study: "Brain Fog" in CFS can be seen in qEEG/Loreta - #MEAction". #MEAction. Retrieved Aug 28, 2018. 
  23. Pena, Amy (Mar 21, 2018). "Fibromyalgia Study Identifies Main Types of Patients' Cognitive Dysfunction". Fibromyalgia News Today. Retrieved Aug 28, 2018. 
  24. 24.024.1 "Cognitive dysfunction (brain fog) (MPKB)". mpkb.org. Retrieved Aug 28, 2018. 

postural orthostatic tachycardia syndrome (POTS) - A form of orthostatic intolerance where the cardinal symptom is excessive tachycardia due to changing position (e.g. from lying down to sitting up).

cognition - Thought processes, including attention, reasoning, and memory.

tachycardia - An unusually rapid heart beat. Can be caused by exercise or illness. A symptom of postural orthostatic tachycardia syndrome (POTS). (Learn more: www.heart.org)

The information provided at this site is not intended to diagnose or treat any illness.
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history.