Cognitive dysfunction: Difference between revisions
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| date = 2014| pmid = | doi = 10.1080/21641846.2013.862993}}</ref><ref name="Kingdon2020">{{Cite journal|last=Kingdon|first=Caroline|author-link=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]] and patients refer to it as "fibro fog."<ref>{{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> | | date = 2014| pmid = | doi = 10.1080/21641846.2013.862993}}</ref><ref name="Kingdon2020">{{Cite journal|last=Kingdon|first=Caroline|author-link=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]] and patients refer to it as "fibro fog."<ref>{{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> | ||
Cognitive dysfunction in [[ME/CFS]] can take many different forms. Cognitive issues commonly observed in [[ME/CFS]] include [[attention deficit]], [[auditory sequencing problems]], [[brain fog]], [[concentration problems]], [[difficulty comprehending social cues]], [[dyscalculia]], [[dyslexia]], [[executive function problems]], [[linguistics reversals]], [[memory loss]], [[multi-tasking problems]], [[planning problems]], [[receptive language problems]], [[slowed thought]], [[spatial disorientation]], [[word-finding problems]],{{Citation needed}} cognitive overload, slow processing of information and poor working memory.<ref name=" | Cognitive dysfunction in [[ME/CFS]] can take many different forms. Cognitive issues commonly observed in [[ME/CFS]] include [[attention deficit]], [[auditory sequencing problems]], [[brain fog]], [[concentration problems]], [[difficulty comprehending social cues]], [[dyscalculia]], [[dyslexia]], [[executive function problems]], [[dyslexia|linguistics reversals]], [[memory loss]], [[multi-tasking problems]], [[planning problems]], [[receptive language problems]], [[slowed thought]], [[spatial disorientation]], [[word-finding problems]],{{Citation needed}} [[cognitive overload]], [[slow processing of information]] and [[poor working memory]].<ref name="ICC">{{citation| last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers| last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande| last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir| last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas| last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick| last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell| last7 = Staines | first7 = D | authorlink7 = Donald Staines| last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10= R | authorlink10= Rosamund Vallings | last11 = Bateman | first11= L | authorlink11= Lucinda Bateman | last12 = Bell | first12= DS | authorlink12= David Bell | last13 = Carlo-Stella | first13= N | authorlink13= Nicoletta Carlo-Stella | last14 = Chia | first14= J | authorlink14= John Chia | last15 = Darragh | first15= A | authorlink15= Austin Darragh | last16 = Gerken | first16= A | authorlink16= Anne Gerken | last17 = Jo | first17= D | authorlink17= Daehyun Jo | last18 = Lewis | first18= DP | authorlink18= Donald Lewis | last19 = Light | first19= AR | authorlink19= Alan Light | last20 = Light | first20= KC | authorlink20= Kathleen Light | last21 = Marshall-Gradisnik | first21= S | authorlink21= Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22= J | authorlink22= John McLaren-Howard | last23 = Mena | first23= I | authorlink23= Ismael Mena | ||
| last24 = Miwa | first24= K | authorlink24= Kunihisa Miwa| last25 = Murovska | first25= M | authorlink25= Modra Murovska| last26 = Stevens | first26= SR | authorlink26= Staci Stevens | |||
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=" | | 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">{{Cite journal|last=Nijhof|first=Linde N.|author-link=|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> | |||
==Prevalence== | ==Prevalence== | ||
==Symptom recognition== | ==Symptom recognition== | ||
===Mandatory ME/CFS symptom=== | |||
Cognitive dysfunction is a mandatory diagnostic symptom for ME/CFS with the [[Canadian Consensus Criteria]] (CCC).<ref name="canadianconsensus-CCC">{{Citation | Cognitive dysfunction is a mandatory diagnostic symptom for ME/CFS with the [[Canadian Consensus Criteria]] (CCC).<ref name="canadianconsensus-CCC">{{Citation | ||
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}}</ref> | }}</ref> | ||
===Optional ME/CFS symptom=== | |||
Cognitive dysfunction is an optional symptom in [[Systemic Exertion Intolerance Disease]] (SEID) diagnostic criteria<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]]|date=Jan 27, 2021|access-date =2021-02-25}}</ref> and the [[International Consensus Criteria]] (ICC) for [[myalgic encephalomyelitis]] (ME).<ref name="ICC2011primer">{{citation | Cognitive dysfunction is an optional symptom in [[Systemic Exertion Intolerance Disease]] (SEID) diagnostic criteria<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]]|date=Jan 27, 2021|access-date =2021-02-25}}</ref> and the [[International Consensus Criteria]] (ICC) for [[myalgic encephalomyelitis]] (ME).<ref name="ICC2011primer">{{citation | ||
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}}</ref> | }}</ref> | ||
===Other causes=== | |||
Cognitive dysfunction is also is one of the most common [[Long COVID]] symptoms<ref name="WHO-longcovid-criteria">{{citation|title =A clinical case definition of post COVID-19 condition by a Delphi consensus | Cognitive dysfunction is also is one of the most common [[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]] | |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 | |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 | |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> | |url =https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1}}</ref> | ||
== Diagnosis == | == Diagnosis == | ||
* [http://www.dysautonomiainternational.org/blog/wordpress/cognitive-dysfunction-and-brain-fog-in-pots/ Cognitive Dysfunction and “Brain Fog” in POTS]<ref>{{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> | * [http://www.dysautonomiainternational.org/blog/wordpress/cognitive-dysfunction-and-brain-fog-in-pots/ Cognitive Dysfunction and “Brain Fog” in POTS]<ref>{{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== | ==Possible causes== | ||
[[Mady Hornig]] has found evidence in the [[cerebrospinal fluid]] (CSF) of ME/CFS patients that may explain their cognitive dysfunction.<ref name="Hornig, 2016">{{ | [[Mady Hornig]] has 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 | authorlink1 = Mady Hornig | | last1 = Hornig | first1 = M | authorlink1 = Mady Hornig | ||
| last2 = Gottschalk | first2 = G | authorlink2 = Gunnar Gottschalk | | last2 = Gottschalk | first2 = G | authorlink2 = Gunnar Gottschalk | ||
| Line 120: | Line 95: | ||
| doi = 10.1038/mp.2015.29}}</ref> | | doi = 10.1038/mp.2015.29}}</ref> | ||
===Other causes=== | |||
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: | 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") | * [[Cancer]] or cancer treatment ("chemo brain") | ||
| Line 129: | Line 105: | ||
* [[Pregnancy]] | * [[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> | * [[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> | ||
=== Exercise and cognitive dysfunction === | |||
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" /> | |||
{{See also|Exercise}} | |||
==Potential treatments== | ==Potential treatments== | ||
Drugs, supplements and other treatments that have been suggested for improving brain fog: | Drugs, supplements and other treatments that have been suggested for improving brain fog: | ||
*[[Acetyl-L-carnitine]]<ref name=" | *[[Carnitine|Acetyl-L-carnitine]]<ref name="Collatz2014" /> | ||
*[[Arabinoxylan]] (ineffective)<ref name=" | *[[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|author-link=|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 complex]] | ||
*[[B vitamin]] | *[[B vitamin]] | ||
*[[Clonidine hydrochloride]] (ineffective)<ref name=" | *[[Clonidine hydrochloride]] (ineffective)<ref name="Collatz2014" /> | ||
*[[Dexamphetamine]] | *[[Dexamphetamine]] | ||
*[[Dynamic Neural Retraining System]] | *[[Dynamic Neural Retraining System]] | ||
*[[Fludrocortisone]] (ineffective)<ref name="Collatz2014" /> | |||
*[[Fludrocortisone]] (ineffective)<ref name=" | |||
*[[Histamine]] | *[[Histamine]] | ||
*[[Hydrocortisone]] (most trials show some positive effective)<ref name=" | *[[Hydrocortisone]] (most trials show some positive effective)<ref name="Collatz2014" /> | ||
*[[Methylene blue]] | *[[Methylene blue]] | ||
*[[Methylphenidate]] and the experimental treatment [[KPAX002]]<ref>{{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> | *[[Methylphenidate]] 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]] (ineffective)<ref name=" | *[[Modafinil]] (ineffective)<ref name="Collatz2014" /> | ||
*[[Moclobemide]]<ref name=" | *[[Moclobemide]]<ref name="Collatz2014" /> | ||
*[[Neurolinguistic programming]] | *[[Neurolinguistic programming]] | ||
*[[Nimodipine]] | *[[Nimodipine]] | ||
*[[Phenelzine]] (ineffective in ME/CFS)<ref name=" | *[[Phenelzine]] (ineffective in ME/CFS)<ref name="Collatz2014" /> | ||
*[[Rintatolimod]] (Ampligen) | *[[Rintatolimod]] (Ampligen) | ||
*[[Stellate ganglion block]] in [[dysautonomia]] linked to [[long COVID]] | *[[Stellate ganglion block]] in [[dysautonomia]] linked to [[long COVID]] | ||
*[[Valganciclovir]] (ineffective)<ref name=" | *[[Valganciclovir]] (ineffective)<ref name="Collatz2014" /> | ||
*[[Yoga]] | *[[Yoga]] | ||
Drugs, supplements or interventions that may cause cognitive problems: | Drugs, supplements or interventions that may cause cognitive problems: | ||
*[[Diphenhydramine]] | *[[Diphenhydramine]] | ||
*[[Exercise]]<ref name=" | *[[Exercise]]<ref name="ICC" /><ref name="canadianconsensus-CCC" /><ref name="Collatz2014" /> | ||
*[[Graded exercise therapy]] (GET) / Graded Activity Therapy<ref name=" | *[[Graded exercise therapy]] (GET) / Graded Activity Therapy<ref name="ICC" /><ref name="canadianconsensus-CCC" /><ref name="Collatz2014" /> | ||
*Certain [[Analgesic|Pain killers]] | *Certain [[Analgesic|Pain killers]] | ||
==Notable studies== | |||
*2001, Neuropsychological functioning in chronic fatigue syndrome: a review - ([[pubmed:11167310|Abstract]])<ref>{{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> | |||
*2006, Cognitive dysfunction relates to subjective report of mental fatigue in patients with chronic fatigue syndrome<ref name="Capuron, 2006">{{Citation | |||
| last1 = Capuron | first1 = Lucile | authorlink1 = | |||
| last2 = Welberg | first2 = Leonie | authorlink2 = | |||
| last3 = Heim | first3 = Christine | authorlink3 = | |||
| last4 = Wagner | first4 = Dieter | authorlink4 = | |||
| last5 = Solomon | first5 = Laura | authorlink5 = | |||
| last6 = Papanicolaou | first6 = Dimitris A | authorlink6 = | |||
| last7 = Craddock | first7 = R Cameron | authorlink7 = | |||
| last8 = Miller | first8 = Andrew H | authorlink8 = | |||
| last9 = Reeves | first9 = William C | authorlink9 = 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>{{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]) | |||
*2016, Cognitive Dysfunction in Chronic Fatigue Syndrome: a Review of Recent Evidence<ref name="Cvejic2016">{{Cite journal|last=Cvejic|first=Erin|author-link=|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" /> - [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=":12">{{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|author-link=Marcie Zinn|date=2016|website=www.sciforschenonline.org|archive-url=|archive-date=|url-status=|access-date=2018-08-28|last2=Zinn|first2=Mark A.|last3=Jason|first3=Leonard|author-link3=Leonard Jason|issn=2469-6714|publisher=SciForschen|doi=10.16966/2469-6714.110}}</ref> - ([https://sciforschenonline.org/journals/clinical-research/CLROA-2-110.php Full text]) | |||
<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=":12" /></blockquote> | |||
[[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=":12" />]] | |||
==Notable studies== | |||
*2001, Neuropsychological functioning in chronic fatigue syndrome: a review - ([[pubmed:11167310|Abstract]])<ref>{{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> | |||
*2006, Cognitive dysfunction relates to subjective report of mental fatigue in patients with chronic fatigue syndrome<ref name="Capuron, 2006">{{Citation | |||
| last1 = Capuron | first1 = Lucile | authorlink1 = | |||
| last2 = Welberg | first2 = Leonie | authorlink2 = | |||
| last3 = Heim | first3 = Christine | authorlink3 = | |||
| last4 = Wagner | first4 = Dieter | authorlink4 = | |||
| last5 = Solomon | first5 = Laura | authorlink5 = | |||
| last6 = Papanicolaou | first6 = Dimitris A | authorlink6 = | |||
| last7 = Craddock | first7 = R Cameron | authorlink7 = | |||
| last8 = Miller | first8 = Andrew H | authorlink8 = | |||
| last9 = Reeves | first9 = William C | authorlink9 = 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>{{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]) | |||
*2016, Cognitive Dysfunction in Chronic Fatigue Syndrome: a Review of Recent Evidence<ref name="Cvejic2016">{{Cite journal|last=Cvejic|first=Erin|author-link=|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" /> - [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=":12">{{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=www.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]) | |||
<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=":12" /></blockquote> | |||
[[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=":12" />]] | |||
==Learn more== | ==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] | *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] | *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] | *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]<ref name=" | * 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]<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> | ||
:[[Brian Vastag]] was able to prove with [[qEEG]] and cognitive tests 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.<ref name=" | :[[Brian Vastag]] was able to prove with [[qEEG]] and cognitive tests 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.<ref name="MEActionDisability" /> | ||
==See also== | ==See also== | ||
*[[Fibromyalgia]] | |||
*[[Long COVID]] | |||
*[[Aphasia]] | *[[Aphasia]] | ||
*[[Dyscalculia]] | *[[Dyscalculia]] | ||
| Line 180: | Line 209: | ||
==References== | ==References== | ||
{{Reflist}} | {{Reflist}} | ||
[[Category:Signs and symptoms]] | [[Category:Signs and symptoms]] | ||
[[Category:Cognitive signs and symptoms]] | [[Category:Cognitive signs and symptoms]] | ||
[[Category:Long COVID signs and symptoms]] | [[Category:Long COVID signs and symptoms]] | ||
Revision as of 22:19, January 22, 2022
Cognitive dysfunction is a required symptom in most diagnostic criteria for ME/CFS; some patients call it "brain fog".[1][2] It is also a common symptom of fibromyalgia and patients refer to it as "fibro fog."[3]
Cognitive dysfunction in ME/CFS can take many different forms. Cognitive issues commonly observed in ME/CFS include attention deficit, auditory sequencing problems, brain fog, concentration problems, difficulty comprehending social cues, dyscalculia, dyslexia, executive function problems, linguistics reversals, memory loss, multi-tasking problems, planning problems, receptive language problems, slowed thought, spatial disorientation, word-finding problems,[citation needed] cognitive overload, slow processing of information and poor working memory.[4] 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.[5]
Prevalence[edit | edit source]
Symptom recognition[edit | edit source]
Mandatory ME/CFS symptom[edit | edit source]
Cognitive dysfunction is a mandatory diagnostic symptom for ME/CFS with the Canadian Consensus Criteria (CCC).[6]
Optional ME/CFS symptom[edit | edit source]
Cognitive dysfunction is an optional symptom in Systemic Exertion Intolerance Disease (SEID) diagnostic criteria[7] and the International Consensus Criteria (ICC) for myalgic encephalomyelitis (ME).[8]
Other causes[edit | edit source]
Cognitive dysfunction is also is one of the most common Long COVID symptoms[9]
Diagnosis[edit | edit source]
Possible causes[edit | edit source]
Mady Hornig has found evidence in the cerebrospinal fluid (CSF) of ME/CFS patients that may explain their cognitive dysfunction.[11]
Other causes[edit | edit source]
Cognitive dysfunction can be caused or made worse by other health conditions, most of which should be ruled out or identified during diagnostic process for ME/CFS:
- Cancer or cancer treatment ("chemo brain")
- Depression
- Fibromyalgia
- Lupus
- Menopause
- Multiple sclerosis
- Pregnancy
- Sleep dysfunction or sleep disorders[12]
Exercise and cognitive dysfunction[edit | edit source]
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.[4]
Potential treatments[edit | edit source]
Drugs, supplements and other treatments that have been suggested for improving brain fog:
- Acetyl-L-carnitine[13]
- Arabinoxylan (ineffective)[13]
- B vitamin complex
- B vitamin
- Clonidine hydrochloride (ineffective)[13]
- Dexamphetamine
- Dynamic Neural Retraining System
- Fludrocortisone (ineffective)[13]
- Histamine
- Hydrocortisone (most trials show some positive effective)[13]
- Methylene blue
- Methylphenidate and the experimental treatment KPAX002[14]
- Modafinil (ineffective)[13]
- Moclobemide[13]
- Neurolinguistic programming
- Nimodipine
- Phenelzine (ineffective in ME/CFS)[13]
- Rintatolimod (Ampligen)
- Stellate ganglion block in dysautonomia linked to long COVID
- Valganciclovir (ineffective)[13]
- Yoga
Drugs, supplements or interventions that may cause cognitive problems:
- Diphenhydramine
- Exercise[4][6][13]
- Graded exercise therapy (GET) / Graded Activity Therapy[4][6][13]
- Certain Pain killers
Notable studies[edit | edit source]
- 2001, Neuropsychological functioning in chronic fatigue syndrome: a review - (Abstract)[15]
- 2006, Cognitive dysfunction relates to subjective report of mental fatigue in patients with chronic fatigue syndrome[16] - (Full text)
- 2015, Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome[17] - (Full Text)
- 2016, Cognitive Dysfunction in Chronic Fatigue Syndrome: a Review of Recent Evidence[18] - (Abstract)
- 2016, The impact of chronic fatigue syndrome on cognitive functioning in adolescents[5] - (Full text)
- 2016, qEEG / LORETA in Assessment of Neurocognitive Impairment in a Patient with Chronic Fatigue Syndrome: A Case Report[19] - (Full text)
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.[19]
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).[19]
Notable studies[edit | edit source]
- 2001, Neuropsychological functioning in chronic fatigue syndrome: a review - (Abstract)[20]
- 2006, Cognitive dysfunction relates to subjective report of mental fatigue in patients with chronic fatigue syndrome[16] - (Full text)
- 2015, Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome[21] - (Full Text)
- 2016, Cognitive Dysfunction in Chronic Fatigue Syndrome: a Review of Recent Evidence[18] - (Abstract)
- 2016, The impact of chronic fatigue syndrome on cognitive functioning in adolescents[5] - (Full text)
- 2016, qEEG / LORETA in Assessment of Neurocognitive Impairment in a Patient with Chronic Fatigue Syndrome: A Case Report[19] - (Full text)
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.[19]
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).[19]
Learn more[edit | edit source]
- 2015, Dr. Gudrun Lange Reviews Neuropsychological Testing for CFS and FM
- 2016, Case Study: "Brain Fog" in CFS can be seen in qEEG/Loreta
- 2018, Study Identifies the Types of Cognitive Dysfunction That Are Most Prevalent in Fibromyalgia
- Jun 4, 2018, Victory For ME Disability Claim – U.S. Court Upholds Plaintiff's Lawsuit After Being Denied Disability[22]
- Brian Vastag was able to prove with qEEG and cognitive tests he had "significant problems with visual perception and analysis, scanning speed, attention, visual motor coordination, motor and mental speed, memory, and verbal fluency" winning his long term disability (LTD) claim.[22]
See also[edit | edit source]
- Fibromyalgia
- Long COVID
- Aphasia
- Dyscalculia
- Dysphasia
- Memory problems
- Word-finding problems
- Myalgic encephalomyelitis (M.E.)
- Long COVID
References[edit | edit source]
- ↑ Jason, Leonard A.; Sunnquist, Madison; Brown, Abigail; Evans, Meredyth; Vernon, Suzanne D.; Furst, Jacob D.; Simonis, Valerie (2014), "Examining case definition criteria for chronic fatigue syndrome and myalgic encephalomyelitis", Fatigue: Biomedicine, Health & Behavior, 2 (1): 40-56, doi:10.1080/21641846.2013.862993
- ↑ Kingdon, Caroline; Giotas, Dionysius; Nacul, Luis; Lacerda, Eliana (September 2020). "Health Care Responsibility and Compassion-Visiting the Housebound Patient Severely Affected by ME/CFS". Healthcare. 8 (3): 197. doi:10.3390/healthcare8030197. PMC 7551603. PMID 32635535.
- ↑ Kravitz, Howard M.; Katz, Robert S. (July 1, 2015). "Fibrofog and fibromyalgia: a narrative review and implications for clinical practice". Rheumatology International. 35 (7): 1115–1125. doi:10.1007/s00296-014-3208-7. ISSN 1437-160X.
- ↑ 4.0 4.1 4.2 4.3 Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6
- ↑ 5.0 5.1 5.2 Nijhof, Linde N.; Nijhof, Sanne L.; Bleijenberg, Gijs; Stellato, Rebecca K.; Kimpen, Jan L. L.; Pol, Hilleke E. Hulshoff; van de Putte, Elise M.; E (February 2016). "The impact of chronic fatigue syndrome on cognitive functioning in adolescents". European Journal of Pediatrics. 175 (2): 245–252. doi:10.1007/s00431-015-2626-1. ISSN 0340-6199. PMC 4724362. PMID 26334394.
- ↑ 6.0 6.1 6.2 Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip; Powles, A C Peter; Sherkey, Jeffrey A.; van de Sande, Marjorie I. (2003), "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols" (PDF), Journal of Chronic Fatigue Syndrome, 11 (2): 7-115, doi:10.1300/J092v11n01_02
- ↑ "IOM 2015 Diagnostic Criteria | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome". Centers for Disease Control. January 27, 2021. Retrieved February 25, 2021.
- ↑ Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6
- ↑ Soriano, Joan B.; Allan, Maya; Alsokhn, Carine; Alwan, Nisreen A.; Askie, Lisa; Davis, Hannah E.; Diaz, Janet V.; Dua, Tarun; de Groote, Wouter; Jakob, Robert; Lado, Marta; Marshall, John; Murthy, Srin; Preller, Jacobus; Relan, Pryanka; Schiess, Nicoline; Seahwag, Archana (October 6, 2021), A clinical case definition of post COVID-19 condition by a Delphi consensus, World Health Organization (WHO) clinical case definition working group on post COVID-19 condition, World Health Organization
- ↑ Arnold, Amy (February 3, 2016). "Cognitive Dysfunction and "Brain Fog" in POTS | The Dysautonomia Dispatch". Dysautonomia International. Retrieved August 28, 2018.
- ↑ Hornig, M; Gottschalk, G; Peterson, D; Knox, KK; Schultz, AF; Eddy, ML; Che, X; Lipkin, WI (2016). "Cytokine network analysis of cerebrospinal fluid in myalgic encephalomyelitis/chronic fatigue syndrome". Molecular Psychiatry. 21 (2): 261-9. doi:10.1038/mp.2015.29.
- ↑ "Reasons You May Have Brain Fog". WebMD. Retrieved January 22, 2022.
- ↑ 13.00 13.01 13.02 13.03 13.04 13.05 13.06 13.07 13.08 13.09 13.10 Collatz, Ansel; Johnston, Samantha C.; Staines, Donald R.; Marshall-Gradisnik, Sonya M. (June 2016). "A Systematic Review of Drug Therapies for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis". Clinical Therapeutics. 38 (6): 1263–1271.e9. doi:10.1016/j.clinthera.2016.04.038. ISSN 1879-114X. PMID 27229907.
- ↑ Valdizán Usón, José Ramón; Idiazábal Alecha, María Ángeles (June 1, 2008). "Diagnostic and treatment challenges of chronic fatigue syndrome: role of immediate-release methylphenidate". Expert Review of Neurotherapeutics. 8 (6): 917–927. doi:10.1586/14737175.8.6.917. ISSN 1473-7175.
- ↑ Michiels, V.; Cluydts, R. (2001). "Neuropsychological functioning in chronic fatigue syndrome: a review". Acta Psychiatrica Scandinavica. 103 (2): 84–93. ISSN 0001-690X. PMID 11167310.
- ↑ 16.0 16.1 Capuron, Lucile; Welberg, Leonie; Heim, Christine; Wagner, Dieter; Solomon, Laura; Papanicolaou, Dimitris A; Craddock, R Cameron; Miller, Andrew H; Reeves, William C (2006), "Cognitive Dysfunction Relates to Subjective Report of Mental Fatigue in Patients with Chronic Fatigue Syndrome", Neuropsychopharmacology, 31: 1777–1784, doi:10.1038/sj.npp.1301005
- ↑ Mizuno, Kei; Tanaka, Masaaki; Tanabe, Hiroki C.; Joudoi, Takako; Kawatani, Junko; Shigihara, Yoshihito; Tomoda, Akemi; Miike, Teruhisa; Imai-Matsumura, Kyoko (September 10, 2015). "Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome". NeuroImage : Clinical. 9: 355–368. doi:10.1016/j.nicl.2015.09.001. ISSN 2213-1582. PMID 26594619.
- ↑ 18.0 18.1 Cvejic, Erin; Birch, Rachael C.; Vollmer-Conna, Uté (May 2016). "Cognitive Dysfunction in Chronic Fatigue Syndrome: a Review of Recent Evidence". Current Rheumatology Reports. 18 (5): 24. doi:10.1007/s11926-016-0577-9. ISSN 1523-3774.
- ↑ 19.0 19.1 19.2 19.3 19.4 19.5 Zinn, ML; 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 August 28, 2018. Cite error: Invalid
<ref>tag; name ":12" defined multiple times with different content - ↑ Michiels, V.; Cluydts, R. (2001). "Neuropsychological functioning in chronic fatigue syndrome: a review". Acta Psychiatrica Scandinavica. 103 (2): 84–93. ISSN 0001-690X. PMID 11167310.
- ↑ Mizuno, Kei; Tanaka, Masaaki; Tanabe, Hiroki C.; Joudoi, Takako; Kawatani, Junko; Shigihara, Yoshihito; Tomoda, Akemi; Miike, Teruhisa; Imai-Matsumura, Kyoko (September 10, 2015). "Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome". NeuroImage : Clinical. 9: 355–368. doi:10.1016/j.nicl.2015.09.001. ISSN 2213-1582. PMID 26594619.
- ↑ 22.0 22.1 Tillman, Adriane (June 4, 2018). "Victory for ME Disability Claim - U.S. Court Upholds Plaintiff's Lawsuit After Being Denied Disability". #MEAction. Retrieved February 2, 2019.
