Impaired cognition in CFS is one of the most disabling and frustrating symptoms patients experience. Deficits in short-term memory, information processing and processing speed have been documented by several research groups. How closely does the medical literature reflect patients” experiences and how can cognitive testing help support self-reported measures?
On April 11, 2012, we hosted a two-hour webinar presentation that examined this topic in detail. Dr. Gudrun Lange and Dr. Suzanne Vernon reviewed published research findings, described the various imaging and other testing methods and offered some tips for coping. 530 people registered for the webinar and 310 attended, reinforcing the interest in this subject.
View the webinar recording on our YouTube channel at http://bit.ly/cognition-webinar.
View the presentation slides in PDF format. Link: http://www.cfids.org/webinar/cognition-slides.pdf (This large file may take a few moments to open)
You might also find these resources to be helpful supplements to the presentation. We”ve collected them here, based on more than 300 questions we received during and more than 100 received in advance of the webinar:
Overview: This review by Dr. Gudrun Lange covers the difficulties CFS patients have multi-tasking and strategies she offers to her clinical neuropsychology patients to cope and compensate with deficits. From the IACFS/ME Bulletin, “Multi-Tasking: A Challenge for Patients With CFS.”
Brain Imaging: fMRI 2.0: From top journal Nature, an overview of how functional MRI is becoming the “workhorse” of brain imaging. Link: http://www.nature.com/news/brain-imaging-fmri-2-0-1.10365
Matters of the Brain: This article by Dr. Floris de Lange (not related to Dr. Gudrun Lange) from the summer 2006 issue of the CFIDS Chronicle explores reports of gray matter reduction in two published studies. Link: http://www.cfids.org/pdf/matters-of-the-brain.pdf
The Role of Neuropsychology: This article from the fall 2004 issue of the CFIDS Chronicle is written by Dr. Leo Shea. He describes the benefits of a getting a proper neuropsych exam and its role in helping individuals document cognitive deficits for employment and disability purposes. Link: http://www.cfids.org/pdf/role-of-neuropsychology-cfs.pdf
Cognitive Rehabilitation: Strategies, Tasks, Theories & Games: This classic article by neuropsychologist Dr. Tarras Onischenko provides practical suggestions for ways that individuals can help improve cognition. Published in the August 1991 issue of the CFIDS Chronicle Physicians” Forum, the article is not available in digital format aside from a scan of a print copy from our archives. We apologize for the poor quality of the image. Click here to access the scanned version.
Orthostatic Challenge & Cognition in CFS: Dr. Marvin Medow and his team at the Center for Hypotension at New York Medical College have demonstrated that CFS patients” cognitive abilities diminish with postural challenge using an tilt table test. This research, described here (http://www.research1st.com/2011/11/28/medow/) was funded by the CFIDS Association. Dr. Medow will continue his studies under the Association”s Research Institute Without Walls, this time looking for interventions that improve symptoms and cognition during tilt. Read more here: http://bit.ly/2012-medow.
Evaluating Post-Exertional Malaise Systematically: Post-exertional malaise (PEM) or post-exertional relapse has been demonstrated as one of the cardinal features of CFS. During the webinar, many people asked about whether it makes cognition worse. Patient experience certainly suggests that it does, but there hasn”t been rigorous study of this — yet. Under the Association”s Research Institute Without Walls, Dr. Dane Cook of University of Wisconsin-Madison will study patients” cognition before and after an exercise challenge. He will also take blood samples and functional MRI (fMRI) images. Read more about Dr. Cook”s study at http://bit.ly/2012-cook.
Video: Wilhelmina Jenkins, former Association board member and a physicist before CFS hit, talks candidly about her struggle with CFS, especially cognitive impairment, in this YouTube video: http://bit.ly/wIn3OF
First-Person Account: Dr. Katrina Berne, another former Association director and a clinical psychologist who treats CFS and lives with it herself, describes the characteristic cognitive impairment in “I Can’t Brain Today; I’ve Got the Dumb” here on Resarch1st. The comments added by readers further enrich this popular article, one of the top 10 posted to Research1st in 2011.
Coping Tips: This classic Chronicle article offers 10 tips for coping with impaired cognition: http://bit.ly/wBhtAY
Pharmacotherapy for CFS: During the webinar, there were many questions about the value of certain medications to treat impaired cognition and other common symptoms. In this article from a special research issue of the CFIDS Chronicle published in early 2006, Loretta J. Spotila, Ph.D., reviews many medications used to treat CFS. Link:
Autonomic Dysfunction & CFS: Although not a main topic of this program, the link between orthostatic intolerance that people with CFS commonly experience was raised as a contributing factor to cognitive problems. This Research1st post provides a basic overview and links to numerous resources on the topic. Link: http://www.research1st.com/2011/06/19/the-outs-and-ins-of-oi/
Post-Exertional Relapse: The relapse of all/most symptoms following even modest physical or mental exertion, called post-exertional relapse or post-exertional malaise (PEM), is a cardinal feature of CFS. It”s hard to tease it apart from cognitive problems that seem to get worse with activity. This four-part series of articles written by Jennifer M. Spotila in 2010 for our monthly e-newsletter looks at PEM from many different angles. Link: http://www.cfids.org/cfidslink/2010/pem-series.asp
Disability Benefits: Several people inquired during the webinar about the process of applying for Social Security disability benefits. That was outside the scope of this program and was a topic of an August 2010 webinar presented by disability attorney Charles “Mac” Sasser. Link: http://www.youtube.com/watch?v=D6IV5t7sfq0&list=UUzrFQHNiCc_6AMpw_GpWZOA&index=15&feature=plcp
Stay In Touch With Us: Webinars are just one of the ways we keep folks up to date on topics of broad interest. Here are some other ways to stay in touch:
Research1st News (monthly enewsletter): free sign-up at http://bit.ly/R1st-signup
Programs like our webinar series and publications like Research1st and Research1st News are made possible through your support of the CFIDS Association of America. If you value these resources and want to make sure they continue, please consider making a tax-deductible gift today. Our is ready 24/7! Here”s the link: http://bit.ly/support-programs Thank you!