Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
Department of Medical Psychology, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands.
BMC Infect Dis. 2020 Jun 5;20(1):397. doi: 10.1186/s12879-020-05118-z.
Primary aim of this study was to compare cognitive performance of patients with chronic Q fever or Q fever fatigue syndrome (QFS) to matched controls from the general population, while taking performance validity into account. Second, we investigated whether objective cognitive performance was related to subjective cognitive complaints or psychological wellbeing.
Cognitive functioning was assessed with a neuropsychological test battery measuring the domains of processing speed, episodic memory, working memory and executive functioning. Tests for performance validity and premorbid intelligence were also included. Validated questionnaires were administered to assess self-reported fatigue, depressive symptoms and cognitive complaints.
In total, 30 patients with chronic Q fever, 32 with QFS and 35 controls were included. A high percentage of chronic Q fever patients showed poor performance validity (38%) compared to controls (14%, p = 0.066). After exclusion of participants showing poor performance validity, no significant differences between patients and controls were found in the cognitive domains. QFS patients reported a high level of cognitive complaints compared to controls (41.2 vs 30.4, p = 0.023). Cognitive complaints were not significantly related to cognitive performance in any of the domains for this patient group.
The high level of self-reported cognitive complaints in QFS patients does not indicate cognitive impairment. A large proportion of the chronic Q fever patients showed suboptimal mental effort during neuropsychological assessment. More research into the underlying explanations is needed. Our findings stress the importance of assessing cognitive functioning by neuropsychological examination including performance validity, rather than only measuring subjective cognitive complaints.
本研究的主要目的是比较慢性 Q 热或 Q 热疲劳综合征（QFS）患者与普通人群匹配对照者的认知表现，同时考虑到表现的有效性。其次，我们研究了客观认知表现是否与主观认知抱怨或心理幸福感有关。
使用神经心理学测试套件评估认知功能，该测试套件测量处理速度、情景记忆、工作记忆和执行功能领域。还包括用于测试表现有效性和先前智力的测试。使用经过验证的问卷来评估自我报告的疲劳、抑郁症状和认知抱怨。
总共纳入了 30 名慢性 Q 热患者、32 名 QFS 患者和 35 名对照者。与对照组（14%，p=0.066）相比，慢性 Q 热患者表现出较差表现有效性的比例较高（38%）。排除表现出较差表现有效性的参与者后，患者和对照组在认知领域没有发现显著差异。QFS 患者报告的认知抱怨水平明显高于对照组（41.2 对 30.4，p=0.023）。对于该患者组，认知抱怨与任何认知领域的认知表现均无显著相关性。
QFS 患者报告的高水平自我认知抱怨并不表明认知障碍。很大一部分慢性 Q 热患者在神经心理学评估中表现出不佳的心理努力。需要进一步研究潜在的解释。我们的研究结果强调了通过神经心理学检查评估认知功能的重要性，包括表现有效性，而不仅仅是测量主观认知抱怨。
