慢性疲劳综合征患者的认知表现受损较为常见，与共病性抑郁无关，但与自主神经功能障碍相关。
Impairments in cognitive performance in chronic fatigue syndrome are common, not related to co-morbid depression but do associate with autonomic dysfunction.
机构信息
School of Psychology, Newcastle University, Newcastle, United Kingdom, and Northumbria Healthcare NHS Foundation Trust, Newcastle, United Kingdom.
Institute of Neuroscience, Newcastle University, The Henry Wellcome Building, Framlington Place, Newcastle upon Tyne, United Kingdom.
出版信息
PLoS One. 2019 Feb 5;14(2):e0210394. doi: 10.1371/journal.pone.0210394. eCollection 2019.
OBJECTIVES
To explore cognitive performance in chronic fatigue syndrome (CFS) examining two cohorts. To establish findings associated with CFS and those related to co-morbid depression or autonomic dysfunction.
METHODS
Identification and recruitment of participants was identical in both phases, all CFS patients fulfilled Fukuda criteria. In Phase 1 (n = 48) we explored cognitive function in a heterogeneous cohort of CFS patients, investigating links with depressive symptoms (HADS). In phase 2 (n = 51 CFS & n = 20 controls) participants with co-morbid major depression were excluded (SCID). Furthermore, we investigated relationships between cognitive performance and heart rate variability (HRV).
RESULTS
Cognitive performance in unselected CFS patients is in average range on most measures. However, 0-23% of the CFS sample fell below the 5th percentile. Negative correlations occurred between depressive symptoms (HAD-S) with Digit-Symbol-Coding (r = -.507, p = .006) and TMT-A (r = -.382, p = .049). In CFS without depression, impairments of cognitive performance remained with significant differences in indices of psychomotor speed (TMT-A: p = 0.027; digit-symbol substitution: p = 0.004; digit-symbol copy: p = 0.007; scanning: p = .034) Stroop test suggested differences due to processing speed rather than inhibition. Both cohorts confirmed relationships between cognitive performance and HRV (digit-symbol copy (r = .330, p = .018), digit-symbol substitution (r = .313, p = .025), colour-naming trials Stroop task (r = .279, p = .050).
CONCLUSION
Cognitive difficulties in CFS may not be as broad as suggested and may be restricted to slowing in basic processing speed. While depressive symptoms can be associated with impairments, co-morbidity with major depression is not itself responsible for reductions in cognitive performance. Impaired autonomic control of heart-rate associates with reductions in basic processing speed.
目的
通过两个队列研究来探讨慢性疲劳综合征（CFS）患者的认知表现。确定与 CFS 相关的发现，以及与合并的抑郁或自主神经功能障碍相关的发现。
方法
两个阶段的参与者都是通过相同的方式被识别和招募的，所有的 CFS 患者都符合 Fukuda 标准。在第 1 阶段（n=48），我们研究了异质队列的 CFS 患者的认知功能，并探讨了与抑郁症状（HADS）的关联。在第 2 阶段（n=51 CFS 和 n=20 对照组）排除了合并的重度抑郁症患者（SCID）。此外，我们还研究了认知表现与心率变异性（HRV）之间的关系。
结果
在未经选择的 CFS 患者中，大多数认知功能测试的结果都处于平均水平。然而，CFS 样本中仍有 0-23%的患者的得分低于第 5 个百分位数。抑郁症状（HAD-S）与数字符号编码（r = -.507，p =.006）和 TMT-A（r = -.382，p =.049）之间存在负相关。在没有抑郁的 CFS 患者中，认知表现仍存在显著差异，包括心理运动速度指数（TMT-A：p = 0.027；数字符号替代：p = 0.004；数字符号复制：p = 0.007；扫描：p =.034）；Stroop 测试表明差异是由于处理速度而不是抑制。两个队列都证实了认知表现与 HRV 之间的关系（数字符号复制（r =.330，p =.018），数字符号替代（r =.313，p =.025），颜色命名试验 Stroop 任务（r =.279，p =.050）。
结论
CFS 患者的认知困难可能没有那么广泛，可能仅限于基本处理速度的减慢。虽然抑郁症状可能与认知障碍有关，但合并的重度抑郁症本身并不是导致认知表现下降的原因。心率自主神经控制受损与基本处理速度的降低有关。
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