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Increase in prefrontal cortical volume following cognitive behavioral therapy in patients with chronic fatigue syndrome – Source: Brain, June 28, 2008

  [ 12 votes ]   [ 1 Comment ]
By Floris P de Lange, PhD, et al. • www.ProHealth.com • July 18, 2008


[Note: human and primate studies have indicated that the lateral prefrontal cortex is “critically involved in broad aspects of executive behavioral control.” Specifically, in selective attention, behavioral planning, and selecting an intended action.]

Chronic fatigue syndrome (CFS) is a disabling disorder, characterized by persistent or relapsing fatigue.

Recent studies have detected a decrease in cortical grey matter volume in patients with CFS, but it is unclear whether this cerebral atrophy constitutes a cause or a consequence of the disease.

Cognitive behavioral therapy (CBT) is an effective behavioral intervention for CFS, which combines a rehabilitative approach of a graded increase in physical activity with a psychological approach that addresses thoughts and beliefs about CFS which may impair recovery.

Here, we test the hypothesis that cerebral atrophy may be a reversible state that can ameliorate with successful CBT. We have quantified cerebral structural changes in 22 CFS patients that underwent CBT and 22 healthy control participants.

  • At baseline, CFS patients had significantly lower grey matter volume than healthy control participants.
  • CBT intervention led to a significant improvement in health status, physical activity and cognitive performance.
  • Crucially, CFS patients showed a significant increase in grey matter volume, localized in the lateral prefrontal cortex.
  • This change in cerebral volume was related to improvements in cognitive speed in the CFS patients.

Our findings indicate that the cerebral atrophy associated with CFS is partially reversed after effective CBT.

  • This result provides an example of macroscopic cortical plasticity in the adult human brain,
  • Demonstrating a surprisingly dynamic relation between behavioral state and cerebral anatomy.
  • Furthermore, our results reveal a possible neurobiological substrate of psychotherapeutic treatment.

Source: Brain, June 28, 2008. PMID: 18587150, by de Lange FP, Koers A, Kalkman JS, Bleijenberg G, Hagoort P, van de Meer JWM, Toni I. Donders Centre for Cognitive Neuroimaging and Nijmegen Institute for Cognition and Information, Radboud University Nijmegen; Expert Center Chronic Fatigue and Department of General Internal Medicine, Radboud University Nijmegen Medical Center, Netherlands. [E-mail: florisdelange@gmail.com]





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questions re: study design
Posted by: outofstep
Jul 19, 2008
Why were the controls healthy? Why didn't they use a control group with CFS and no CBT to see if the same changes occurred over time without CBT? It would be great if CBT could reverse CFS brain abnormalities but if this study is flawed and this is not the case, yet this study is taken seriously (especially by insurance companies) then people with CFS could be forced into CBT for no reason. Hopefully someone will try to replicate this in a better-controlled study before it is embraced by the medical/insurance community.
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