Cognitive functioning & magnetic resonance imaging in chronic fatigue

BACKGROUND. This study examines whether cognitive dysfunction in
chronic fatigue may be accounted for by depression and anxiety
or is due to brain pathology evident on magnetic resonance
imaging (MRI).

METHOD. Twenty-six subjects with chronic
fatigue, with and without coexisting depression, and 18
age-matched normal controls were recruited from primary care
following a presumed viral illness six months previously.
Comparison was made with 13 psychiatric controls with
depressive illness on standardised cognitive tests. MRI
determined the presence of cerebral white-matter lesions.

RESULTS. No substantial differences in performance were shown
between subjects with chronic fatigue, most of whom met the
criteria for chronic fatigue syndrome, and controls.
Subjective cognitive dysfunction increased with
psychopathology. White-matter lesions were found in a minority
from all groups. Improvement in fatigue and depression
coincided with improved performance on cognitive measures.

CONCLUSIONS. Subjective complaints of cognitive impairment are
a prominent feature of chronic fatigue, but objective
cognitive and MRI abnormalities are not. Such complaints
probably reflect psychopathology rather than a post-viral

Cope H, Pernet A, Kendall B, David A

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