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ORIGINAL RESEARCH article

Front. Neurosci.
Sec. Translational Neuroscience
Volume 18 - 2024 | doi: 10.3389/fnins.2024.1460157

Cognitive Assessment in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Multi-Site Clinical Assessment of ME/CFS (MCAM) Sub-study

Provisionally accepted
Gudrun Lange Gudrun Lange 1*Jin-Mann S. Lin Jin-Mann S. Lin 2Yang Chen Yang Chen 2Elizabeth A. Fall Elizabeth A. Fall 2Daniel L. Peterson Daniel L. Peterson 3Lucinda Bateman Lucinda Bateman 4Charles W. Lapp Charles W. Lapp 5Ríchard N. Podell Ríchard N. Podell 6Benjamin H. Natelson Benjamin H. Natelson 1Andreas M. Kogelnik Andreas M. Kogelnik 7Nancy Klimas Nancy Klimas 8Elizabeth Unger Elizabeth Unger 2
  • 1 Pain and Fatigue Study Center, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • 2 Centers for Disease Control and Prevention (CDC), Atlanta, United States
  • 3 Sierra Internal Medicine, Incline Village, Nevada, United States
  • 4 Bateman Horne Center, Salt Lake City, Utah, United States
  • 5 Hunter-Hopkins Center, Charlotte, North Carolina, United States
  • 6 Independent researcher, Summit, New Jersey, United States
  • 7 Independent researcher, Newark, California, United States
  • 8 Institute for Neuro-Immune Medicine, Nova Southeastern University, Davie, Florida, United States

The final, formatted version of the article will be published soon.

    Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) experience cognitive problems with attention, information processing speed, working memory, learning efficiency, and executive function. Commonly, patients report worsening of cognitive symptoms over time after physical and/or cognitive challenges. To determine, monitor, and manage longitudinal decrements in cognitive function after such exposures, it is important to be able to screen for cognitive dysfunction and changes over time in clinic and also remotely at home. The primary objectives of this paper were: 1) to determine whether a brief computerized cognitive screening battery will detect differences in cognitive function between ME/CFS and Healthy Controls (HC), 2) to monitor the impact of a full-day study visit on cognitive function over time, and 3) to evaluate the impact of exercise testing on cognitive dysfunction.: This cognitive sub-study was conducted between 2013 and 2019 across seven U.S. ME/CFS clinics as part of the Multi-Site Clinical Assessment of ME/CFS (MCAM) study. The analysis included 426 participants (261 ME/CFS and 165 HC), who completed cognitive assessments including a computerized CogState Brief Screening Battery (CBSB) administered across five timepoints (T0-T4) at the start of and following a full day in-clinic visit that included exercise testing for a subset of participants (182 ME/CFS and 160 HC). Exercise testing consisting of ramped cycle ergometry to volitional exhaustion. The primary outcomes are performance accuracy and latency (performance speed) on the computerized CBSB administered online in clinic (T0 and T1) and at home (T2-T4).Results: No difference was found in performance accuracy between ME/CFS and HCs whereas information processing speed was significantly slower for ME/CFS at most timepoints with Cohen's d effect sizes ranged 0.3-0.5 (p<0.01). The cognitive decline over time on all CBSB tasks was similar for patients with ME/CFS independent of whether exercise testing was included in the clinic visit.The challenges of a clinic visit (including cognitive testing) can lead to further cognitive deficits. A single short session of intense exercise does not further reduce speed of performance on any CBSB tasks.

    Keywords: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), computerized neurocognitive screening, Longitudinal assessment, speed and accuracy of performance, Executive Function, Physical Exertion

    Received: 05 Jul 2024; Accepted: 07 Oct 2024.

    Copyright: © 2024 Lange, Lin, Chen, Fall, Peterson, Bateman, Lapp, Podell, Natelson, Kogelnik, Klimas and Unger. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Gudrun Lange, Pain and Fatigue Study Center, Icahn School of Medicine at Mount Sinai, New York, 10029, New York, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.