Cognitive dysfunction

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Cognitive dysfunction is a constant struggle for most ME/CFS patients and they often describe it as "brain fog."[1] It is also a symptom of fibromyalgia and patients refer to it as "fibro fog."[2]

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.[3]

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.[4]

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.[3]

Prevalence[edit | edit source]

Symptom recognition[edit | edit source]


Cognitive dysfunction is a mandatory symptom to diagnose ME/CFS with the Canadian Consensus Criteria (CCC).[5].


Cognitive dysfunction is an optional symptom in Systemic Exertion Intolerance Disease (SEID) criteria[6] and the International Consensus Criteria (ICC) which diagnoses myalgic encephalomyelitis (ME).[7]

Diagnosis[edit | edit source]

Notable studies[edit | edit source]

  • 2001, Neuropsychological functioning in chronic fatigue syndrome: a review - (Abstract)[11]
  • 2006, Cognitive dysfunction relates to subjective report of mental fatigue in patients with chronic fatigue syndrome[12] - (Full text)
  • 2015, Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome[13] - (Full Text)
  • 2016, Cognitive Dysfunction in Chronic Fatigue Syndrome: a Review of Recent Evidence[14] - (Abstract)
  • 2016, The impact of chronic fatigue syndrome on cognitive functioning in adolescents[4] - (Full text)
  • 2016, qEEG / LORETA in Assessment of Neurocognitive Impairment in a Patient with Chronic Fatigue Syndrome: A Case Report[15] - (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.[15]

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).[15]

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.[16]

Potential treatments[edit | edit source]

Learn more[edit | edit source]

According to the Marshall Pathogenesis, cognitive dysfunction is caused by microbes. More severe forms of cognitive dysfunction are seen in diseases such as Alzheimer's, diseases for which there is strong evidence of a bacterial etiology. Often associated with chronic fatigue syndrome,1) cognitive dysfunction is also seen in patients with multiple sclerosis,2)depression,3)fibromyalgia,4) and dozens of others diseases.[20]

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.[21]

See also[edit | edit source]

References[edit | edit source]

  1. Dellwo, Adrienne (Jun 29, 2018). "Living with a Foggy Brain from Fibromyalgia or ME/CFS". Verywell Health. Retrieved Aug 10, 2018. 
  2. Dellwo, Adrienne (Feb 28, 2018). "What Is Fibro Fog and ME/CFS Brain Fog?". Verywell Health. Retrieved Aug 10, 2018. 
  3. 3.03.1 Carruthers, Bruce M.; van de Sande, Marjorie I.; De Meirleir, Kenny L.; Klimas, Nancy G.; Broderick, Gordon; Mitchell, Terry; Staines, Donald; Powles, A. C. Peter; Speight, Nigel; Vallings, Rosamund; Bateman, Lucinda; Baumgarten-Austrheim, Barbara; Bell, David; Carlo-Stella, Nicoletta; Chia, John; Darragh, Austin; Jo, Daehyun; Lewis, Donald; Light, Alan; Marshall-Gradisnik, Sonya; Mena, Ismael; Mikovits, Judy; Miwa, Kunihisa; Murovska, Modra; Pall, Martin; Stevens, Staci (Aug 22, 2011). "Myalgic encephalomyelitis: International Consensus Criteria". Journal of Internal Medicine. 270 (4): 327–338. doi:10.1111/j.1365-2796.2011.02428.x. ISSN 0954-6820. PMC 3427890Freely accessible. PMID 21777306. 
  4. 4.04.1 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 (Feb 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 4724362Freely accessible. PMID 26334394. 
  5. "Canadian Consensus Criteria - MEpedia". Retrieved Aug 10, 2018. 
  6. "Systemic Exertion Intolerance Disease - MEpedia". Retrieved Aug 10, 2018. 
  7. "International Consensus Criteria - MEpedia". Retrieved Aug 10, 2018. 
  8. "Mild cognitive impairment - Diagnosis and treatment - Mayo Clinic". Retrieved Aug 28, 2018. 
  9. "Cognitive Function Test". Retrieved Aug 28, 2018. 
  10. Arnold, Amy (Feb 3, 2016). "Cognitive Dysfunction and "Brain Fog" in POTS | The Dysautonomia Dispatch". Retrieved Aug 28, 2018. 
  11. 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. 
  12. 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 
  13. Mizuno, Kei; Tanaka, Masaaki; Tanabe, Hiroki C.; Joudoi, Takako; Kawatani, Junko; Shigihara, Yoshihito; Tomoda, Akemi; Miike, Teruhisa; Imai-Matsumura, Kyoko (Sep 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. 
  14. 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. 
  15., Zinn ML, DePaul University, Center for Community Research, Chicago, IL, Tel/ Fax: (773) 325-4923; E-mail:; Zinn, Mark A.; Jason, Leonard (2016). "qEEG / LORETA in Assessment of Neurocognitive Impairment in a Patient with Chronic Fatigue Syndrome: A Case Report". SciForschen. doi:10.16966/2469-6714.110. ISSN 2469-6714. Retrieved Aug 28, 2018. 
  16. "Scientists find clues into cognitive dysfunction in chronic fatigue syndrome". ScienceDaily. Mar 31, 2015. Retrieved Aug 10, 2018. 
  17. "Dr. Gudrun Lange Reviews Neuropsychological Testing for CFS and FM". Nov 20, 2015. Retrieved Aug 10, 2018. 
  18. M, Beth (Feb 7, 2016). "Case Study: "Brain Fog" in CFS can be seen in qEEG/Loreta - #MEAction". #MEAction. Retrieved Aug 28, 2018. 
  19. Pena, Amy (Mar 21, 2018). "Fibromyalgia Study Identifies Main Types of Patients' Cognitive Dysfunction". Fibromyalgia News Today. Retrieved Aug 28, 2018. 
  20. 20.020.1 "Cognitive dysfunction (brain fog) (MPKB)". Retrieved Aug 28, 2018. 
  21. 21.021.1 Tillman, Adriane (Jun 4, 2018). "Victory for ME Disability Claim - U.S. Court Upholds Plaintiff's Lawsuit After Being Denied Disability". #MEAction. Retrieved Feb 2, 2019. 

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From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history.