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J Neurol Neurosurg Psychiatry. 1996 May; 60(5): 495–503.
PMCID: PMC486360

Memory, attention, and executive function in chronic fatigue syndrome.


OBJECTIVES--To examine cognitive function in chronic fatigue syndrome. METHODS--Twenty patients with chronic fatigue syndrome recruited from primary care and 20 matched normal controls were given CANTAB computerised tests of visuospatial memory, attention, and executive function, and verbal tests of letter and category fluency and word association learning. RESULTS: Patients with chronic fatigue syndrome were impaired, predominantly in the domain of memory but their pattern of performance was unlike that of patients with amnesic syndrome or dementia. They were normal on tests of spatial pattern recognition memory, simultaneous and delayed matching to sample, and pattern-location association learning. They were impaired on tests of spatial span, spatial working memory, and a selective reminding condition of the pattern-location association learning test. An executive test of planning was normal. In an attentional test, eight subjects with chronic fatigue syndrome were unable to learn a response set; the remainder exhibited no impairment in the executive set shifting phase of the test. Patients with chronic fatigue syndrome were also impaired on verbal tests of unrelated word association learning and letter fluency. CONCLUSION--Patients with chronic fatigue syndrome have reduced attentional capacity resulting in impaired performance on effortful tasks requiring planned or self ordered generation of responses from memory.

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  • Altay HT, Toner BB, Brooker H, Abbey SE, Salit IE, Garfinkel PE. The neuropsychological dimensions of postinfectious neuromyasthenia (chronic fatigue syndrome): a preliminary report. Int J Psychiatry Med. 1990;20(2):141–149. [PubMed]
  • Grafman J, Schwartz V, Dale JK, Scheffers M, Houser C, Straus SE. Analysis of neuropsychological functioning in patients with chronic fatigue syndrome. J Neurol Neurosurg Psychiatry. 1993 Jun;56(6):684–689. [PMC free article] [PubMed]
  • Ray C, Phillips L, Weir WR. Quality of attention in chronic fatigue syndrome: subjective reports of everyday attention and cognitive difficulty, and performance on tasks of focused attention. Br J Clin Psychol. 1993 Sep;32(Pt 3):357–364. [PubMed]
  • Krupp LB, Sliwinski M, Masur DM, Friedberg F, Coyle PK. Cognitive functioning and depression in patients with chronic fatigue syndrome and multiple sclerosis. Arch Neurol. 1994 Jul;51(7):705–710. [PubMed]
  • Schmaling KB, DiClementi JD, Cullum CM, Jones JF. Cognitive functioning in chronic fatigue syndrome and depression: a preliminary comparison. Psychosom Med. 1994 Sep-Oct;56(5):383–388. [PubMed]
  • Riccio M, Thompson C, Wilson B, Morgan DJ, Lant AF. Neuropsychological and psychiatric abnormalities in myalgic encephalomyelitis: a preliminary report. Br J Clin Psychol. 1992 Feb;31(Pt 1):111–120. [PubMed]
  • DeLuca J, Johnson SK, Natelson BH. Information processing efficiency in chronic fatigue syndrome and multiple sclerosis. Arch Neurol. 1993 Mar;50(3):301–304. [PubMed]
  • DeLuca J, Johnson SK, Beldowicz D, Natelson BH. Neuropsychological impairments in chronic fatigue syndrome, multiple sclerosis, and depression. J Neurol Neurosurg Psychiatry. 1995 Jan;58(1):38–43. [PMC free article] [PubMed]
  • Smith AP, Behan PO, Bell W, Millar K, Bakheit M. Behavioural problems associated with the chronic fatigue syndrome. Br J Psychol. 1993 Aug;84(Pt 3):411–423. [PubMed]
  • McDonald E, Cope H, David A. Cognitive impairment in patients with chronic fatigue: a preliminary study. J Neurol Neurosurg Psychiatry. 1993 Jul;56(7):812–815. [PMC free article] [PubMed]
  • Sandman CA, Barron JL, Nackoul K, Goldstein J, Fidler F. Memory deficits associated with chronic fatigue immune dysfunction syndrome. Biol Psychiatry. 33(8-9):618–623. [PubMed]
  • Prasher D, Smith A, Findley L. Sensory and cognitive event-related potentials in myalgic encephalomyelitis. J Neurol Neurosurg Psychiatry. 1990 Mar;53(3):247–253. [PMC free article] [PubMed]
  • Scheffers MK, Johnson R, Jr, Grafman J, Dale JK, Straus SE. Attention and short-term memory in chronic fatigue syndrome patients: an event-related potential analysis. Neurology. 1992 Sep;42(9):1667–1675. [PubMed]
  • Sahakian BJ, Owen AM. Computerized assessment in neuropsychiatry using CANTAB: discussion paper. J R Soc Med. 1992 Jul;85(7):399–402. [PubMed]
  • Gaffney G, Sellers S, Flavell V, Squier M, Johnson A. Case-control study of intrapartum care, cerebral palsy, and perinatal death. BMJ. 1994 Mar 19;308(6931):743–750. [PMC free article] [PubMed]
  • Chalder T, Berelowitz G, Pawlikowska T, Watts L, Wessely S, Wright D, Wallace EP. Development of a fatigue scale. J Psychosom Res. 1993;37(2):147–153. [PubMed]
  • Lewis G, Pelosi AJ, Araya R, Dunn G. Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychol Med. 1992 May;22(2):465–486. [PubMed]
  • Sharpe MC, Archard LC, Banatvala JE, Borysiewicz LK, Clare AW, David A, Edwards RH, Hawton KE, Lambert HP, Lane RJ, et al. A report--chronic fatigue syndrome: guidelines for research. J R Soc Med. 1991 Feb;84(2):118–121. [PubMed]
  • Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. [PubMed]
  • Milner B. Interhemispheric differences in the localization of psychological processes in man. Br Med Bull. 1971 Sep;27(3):272–277. [PubMed]
  • Shallice T. Specific impairments of planning. Philos Trans R Soc Lond B Biol Sci. 1982 Jun 25;298(1089):199–209. [PubMed]
  • Owen AM, Downes JJ, Sahakian BJ, Polkey CE, Robbins TW. Planning and spatial working memory following frontal lobe lesions in man. Neuropsychologia. 1990;28(10):1021–1034. [PubMed]
  • Joyce EM, Robbins TW. Frontal lobe function in Korsakoff and non-Korsakoff alcoholics: planning and spatial working memory. Neuropsychologia. 1991;29(8):709–723. [PubMed]
  • Owen AM, James M, Leigh PN, Summers BA, Marsden CD, Quinn NP, Lange KW, Robbins TW. Fronto-striatal cognitive deficits at different stages of Parkinson's disease. Brain. 1992 Dec;115(Pt 6):1727–1751. [PubMed]
  • Robbins TW, James M, Lange KW, Owen AM, Quinn NP, Marsden CD. Cognitive performance in multiple system atrophy. Brain. 1992 Feb;115(Pt 1):271–291. [PubMed]
  • Robbins TW, James M, Owen AM, Lange KW, Lees AJ, Leigh PN, Marsden CD, Quinn NP, Summers BA. Cognitive deficits in progressive supranuclear palsy, Parkinson's disease, and multiple system atrophy in tests sensitive to frontal lobe dysfunction. J Neurol Neurosurg Psychiatry. 1994 Jan;57(1):79–88. [PMC free article] [PubMed]
  • Robbins TW, James M, Owen AM, Sahakian BJ, McInnes L, Rabbitt P. Cambridge Neuropsychological Test Automated Battery (CANTAB): a factor analytic study of a large sample of normal elderly volunteers. Dementia. 1994 Sep-Oct;5(5):266–281. [PubMed]
  • Joyce EM, Robbins TW. Memory deficits in Korsakoff and non-Korsakoff alcoholics following alcohol withdrawal and the relationship to length of abstinence. Alcohol Alcohol Suppl. 1993;2:501–505. [PubMed]
  • Sahakian BJ, Morris RG, Evenden JL, Heald A, Levy R, Philpot M, Robbins TW. A comparative study of visuospatial memory and learning in Alzheimer-type dementia and Parkinson's disease. Brain. 1988 Jun;111(Pt 3):695–718. [PubMed]
  • Owen AM, Sahakian BJ, Semple J, Polkey CE, Robbins TW. Visuo-spatial short-term recognition memory and learning after temporal lobe excisions, frontal lobe excisions or amygdalo-hippocampectomy in man. Neuropsychologia. 1995 Jan;33(1):1–24. [PubMed]
  • Cohen RM, Weingartner H, Smallberg SA, Pickar D, Murphy DL. Effort and cognition in depression. Arch Gen Psychiatry. 1982 May;39(5):593–597. [PubMed]
  • Roy-Byrne PP, Weingartner H, Bierer LM, Thompson K, Post RM. Effortful and automatic cognitive processes in depression. Arch Gen Psychiatry. 1986 Mar;43(3):265–267. [PubMed]
  • O'Brien JT, Sahakian BJ, Checkley SA. Cognitive impairments in patients with seasonal affective disorder. Br J Psychiatry. 1993 Sep;163:338–343. [PubMed]

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