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Information processing efficiency in Chronic Fatigue Syndrome (CFS) & multiple sclerosis

  [ 69 votes ]   [ Discuss This Article ] • March 3, 1993

OBJECTIVE--To compare the cognitive performance of subjects
with chronic fatigue syndrome (CFS), multiple sclerosis (MS),
and healthy controls. All subjects were matched for age,
education, and verbal intelligence, as previous
neuropsychological studies of CFS had not used appropriate
control groups.

DESIGN--Case-control design. All subjects were
given a neuropsychological battery and the test scores were
compared among the groups.

SETTING--Subjects with CFS and
subjects with MS were recruited from private and institutional
practice and from the community. Healthy subjects were
recruited from the community.

PARTICIPANTS--Twelve subjects (all female) with CFS
participated in the study. Chronic fatigue syndrome was
diagnosed in these patients in accordance with the
requirements outlined by the Centers for Disease Control as
modified subsequently to not exclude patients with concurrent
depression and/or anxiety. All subjects with CFS were referred
for a neuropsychological examination to assess persistent
cognitive complaints. Eleven subjects (10 female, one male)
with the diagnosis of clinically stable MS were chosen from
clinics and the community because of complaints of mild to
moderate cognitive impairment. The subjects with MS and 11
healthy volunteers (10 female, one male) were matched to the
group with CFS by age, education, and estimated verbal
intelligence (based on the Vocabulary subtest of the Wechsler
Adult Intelligence Scale-Revised). The subjects with MS had a
mean Kurtzke Expanded Disability Status Scale score of 4.95
(SD, 1.95; range, 2.0 to 7.5). As a result of the matching
procedure, there were no differences among the three groups in
age (F[2,31] = 0.32), education (F[2,31] = 0.80), and verbal
intelligence (F[2,31] = 0.31).


MAIN OUTCOME MEASURES--These measures included the Beck Depression
Inventory (BDI), the Paced Auditory Serial Addition Test
(PASAT), Digit Span Test, and the Similarities Test of Verbal
Abstract Reasoning.

RESULTS--The mean number of correctly
identified responses collapsed across the four PASAT trials
was significantly different across groups (F[2,31] = 4.03; P <
.05). While the CFS and MS groups did not differ from each
other, subjects with CFS (SEM, 124.2 +/- 6.4) and subjects
with MS (SEM, 112.9 +/- 10.9) scored significantly below
controls (SEM, 146.4 +/- 6.4) (Fisher's Protected Least
Significant Difference test; P < .05). There were significant
differences among the three groups on mean Digit Span Test
performance (F[2,31] = 5.5; P < .01). While the CFS and MS
group did not differ significantly from each other, only the
CFS group was significantly lower than control (Fisher's
Protected Least Significant Difference test; P < .05). Mean
performance on the Similarities test did not differ among the
three groups (F = 0.58). In addition, there were significant
differences among the three groups in mean BDI scores (F[2,31]
= 7.6; P < .01). The CFS and MS groups did not differ
significantly from each other, and both groups showed a
statistically significantly elevated mean BDI score relative
to the control group (Fisher's Protected Least Significant
Difference test; P < .05). No significant correlations were
found between BDI scores and PASAT total scores (CFS, r =
-.21; MS, r = .13; control, r = .27), or between BDI and Digit
Span Test (CFS, r = -.32; MS, r = -.40; control, r = -.19).
Results of the PASAT and Digit Span Test were significantly
correlated in the CFS group (r = .71; P < .01), but not in the
MS (r = .06) or control groups (r = .49).

CONCLUSIONS--These results indicate that subjects with CFS and subjects with MS show significant impairment on a test of complex concentration when compared with appropriate controls. The data suggest that subjects with CFS and subjects with MS have difficulty on
tasks that require the simultaneous processing of complex
cognitive information.

DeLuca J, Johnson SK, Natelson BH

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