Cognitive Dysfunction

 Cognitive Dysfunction

Scientists Find Clues Into Cognitive Dysfunction in Chronic Fatigue Syndrome

Immune Markers in Cerebrospinal Fluid Provide Insights Into the Basis for Symptoms Like “Brain Fog”

March 31, 2015—Scientists at Columbia University’s Mailman School of Public Health have identified a unique pattern of immune molecules in the cerebrospinal fluid of people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) that provides insights into the basis for cognitive dysfunction—frequently described by patients as “brain fog”—as well as new hope for improvements in diagnosis and treatment.

In the study published in Molecular Psychiatry, Mady Hornig, MD, and colleagues used immunoassay testing methods to measure levels of 51 immune biomarkers called cytokines in the cerebrospinal fluid of 32 people with ME/CFS for an average of seven years, 40 with multiple sclerosis, and 19 non-diseased controls. The researchers found that levels of most cytokines, including the inflammatory immune molecule interleukin 1, were depressed in individuals with ME/CFS compared with the other two groups, matching what was seen in a blood study in patients who had the disease for more than three years. One cytokine—eotaxin—was elevated in the ME/CFS and MS groups, but not in the control group.

“We now know that the same changes to the immune system that we recently reported in the blood of people with ME/CFS with long-standing disease are also present in the central nervous system,” says Dr. Hornig, professor of Epidemiology and director of translational research at the Center for Infection and Immunity at the Mailman School. “These immune differences may contribute to symptoms in both the peripheral parts of the body and the brain, from muscle weakness to brain fog.”

Implications for Diagnosis and Treatment

“Diagnosis of ME/CFS is now based on clinical criteria. Our findings offer the hope of objective diagnostic tests for disease as well as the potential for therapies that correct the imbalance in cytokine levels seen in people with ME/CFS at different stages of their disease,” adds W. Ian Lipkin, MD, John Snow Professor of Epidemiology and director of the Center for Infection and Immunity.

There is precedent for use of human monoclonal antibodies that regulate the immune response in a wide range of disorders from rheumatoid arthritis to multiple sclerosis. However, the researchers note, additional work will be needed to assess the safety and efficacy of this approach.

10 Replies

  • Lipkin is a big hitter NIH fund this research change the landscape.

  • Watched a You Tube video from Solve ME/CFS Initiative keeping the momentum of the IOM report that renamed as SEID.

    The briefing featured three speakers:

    Morgan Fairchild, Actress, Activist and Former Patient

    Dr. Ellen Wright Clayton, Chair of the IOM Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

    Carol Head, Solve ME/CFS Initiative President/CEO

  • So heartening to see positive research, thank you for posting Ian.

  • The IOM report had a part open door on the cover, allowing myself some cautious optimism this will open the door further.

  • I have been trawling some of your posts and could weep with gratitude. There is a saying that

    things appear when you need them most.


  • And I didn't even whisper Abracadabra.

  • It's magic that you can join us nedd

    If I can do some good then I can feel good about that :-)

  • Sample my brain fog please.

  • It can be measured SophiaG

  • Paediatric department at Oslo University Hospital, Norway.

    Participants: 120 adolescents with chronic fatigue (average age 15.4 years; range 12-18) and 39 Healthy Controls (average age 15.2 years; range 12-18).

    Methods: The adolescents completed a neurocognitive test battery measuring processing speed, working memory, cognitive inhibition, cognitive flexibility, verbal learning and verbal memory, and questionnaires addressing demographic data, depression symptoms, anxiety traits, fatigue and sleep problems. Parents completed the Behaviour Rating Inventory of Executive Function (BRIEF), which measures the everyday executive functions of children.

    Results: Adolescents with chronic fatigue had impaired cognitive function compared to Healthy Controls regarding processing speed (mean difference 3.3, 95% CI 1.1 to 5.5, p=0.003), working memory (-2.4, -3.7 to -1.1, p<0.001), cognitive inhibition response time (6.2, 0.8 to 11.7, p=0.025) and verbal learning (-1.7, -3.2 to -0.3, p=0.022). The BRIEF results indicated that everyday executive functions were significantly worse in the chronic fatigue group compared to the HC (11.2, 8.2 to 14.3, p<0.001). Group differences remained largely unaffected when adjusted for symptoms of depression, anxiety traits and sleep problems.

    Conclusions: Adolescents with chronic fatigue had impaired cognitive function of clinical relevance, measured by objective cognitive tests, in comparison to Healthy Controls. Working memory and processing speed may represent core difficulties.