Cognitive performance is of clinical importance, but is unrelated to pain severity in women with chronic fatigue syndrome

Editor's Comment: This study suggests that cognitive dysfunction in ME/CFS originates in the central nervous system, rather than being caused by the distraction of pain.

By K. Ickmans et al.


In various chronic pain populations, decreased cognitive performance is known to be related to pain severity. Yet, this relationship has not been investigated in patients with chronic fatigue syndrome (CFS). This study investigated the relationship between cognitive performance and (1) pain severity, (2) level of fatigue, and (3) self-reported symptoms and health status in women with CFS. Examining the latter relationships is important for clinical practice, since people with CFS are often suspected to exaggerate their symptoms.

A sample of 29 female CFS patients and 17 healthy controls aged 18 to 45 years filled out three questionnaires (Medical Outcomes Study 36-Item Short-Form Health Survey, Checklist Individual Strength (CIS), and CFS Symptom List) and performed three performance-based cognitive tests (psychomotor vigilance task, Stroop task, and operation span task), respectively. In both groups, pain severity was not associated with cognitive performance. In CFS patients, the level of fatigue measured with the CFS Symptom List, but not with the CIS, was significantly correlated with sustained attention. Self-reported mental health was negatively correlated with all investigated cognitive domains in the CFS group.

These results provide evidence for the clinical importance of objectively measured cognitive problems in female CFS patients. Furthermore, a state-like measure (CFS Symptom List) appears to be superior over a trait-like measure (CIS) in representing cognitive fatigue in people with CFS. Finally, the lack of a significant relationship between cognitive performance and self-reported pain severity suggests that pain in CFS might be unique.

Source: Clin Rheumatol. 2013 Jun 5. [Epub ahead of print] Ickmans K, Meeus M, Kos D, Clarys P, Meersdom G, Lambrecht L, Pattyn N, Nijs J. Pain in Motion Research Group (PIM), Department of Human Physiology, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building L, Pleinlaan 2, 1050, Brussels, Belgium.

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One thought on “Cognitive performance is of clinical importance, but is unrelated to pain severity in women with chronic fatigue syndrome”

  1. drbeth2000 says:

    The study that you printed and gave five stars is fatally flawed. Usually people with CFS and Fibro were extremely high functioning before they got sick. Their cognitive functioning now may match the non CFS sample, but it was only 15 people. The only way to validate this study would be to take the test of cognitive ability before they got sick.

    Research proves yet again that there are lies, dammed lies and statistics which are clearly being manipulated here. Pro Health should publish articles that have at least some validity.
    This is a real disappointment.

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