Gaudino E A, Coyle P K, Krupp L B
Department of Neurology, State University of New York at Stony Brook, USA.
Arch Neurol. 1997 Nov;54(11):1372-6. doi: 10.1001/archneur.1997.00550230045015.
Patients with chronic fatigue syndrome (CFS) and post-Lyme syndrome (PLS) share many features, including symptoms of severe fatigue and cognitive difficulty.
To examine the neuropsychiatric differences in these disorders to enhance understanding of how mood, fatigue, and cognitive performance interrelate in chronic illness.
Twenty-five patients with CFS, 38 patients with PLS, and 56 healthy controls participated in the study. Patients with CFS met 1994 criteria for CFS and lacked histories suggestive of Lyme disease. Patients with PLS were seropositive for Lyme disease, had met the Centers for Disease Control and Prevention criteria, or had histories strongly suggestive of Lyme disease and were experiencing severe fatigue that continued 6 months or more following completion of antibiotic treatment for Lyme disease. All subjects completed self-report measures of somatic symptoms and mood disturbance and underwent neuropsychological testing. All patients also underwent a structured psychiatric interview.
Patients with CFS and PLS were similar in several somatic symptoms and in psychiatric profile. Patients with CFS reported more flulike symptoms than patients with PLS. Patients with PLS but not patients with CFS performed significantly worse than controls on tests of attention, verbal memory, verbal fluency, and motor speed. Patients with PLS without a premorbid history of psychiatric illness did relatively worse on cognitive tests than patients with PLS with premorbid psychiatric illness compared with healthy controls.
Despite symptom overlap, patients with PLS show greater cognitive deficits than patients with CFS compared with healthy controls. This is particularly apparent among patients with PLS who lack premorbid psychiatric illness.
慢性疲劳综合征（CFS）患者和莱姆病后综合征（PLS）患者有许多共同特征，包括严重疲劳和认知困难症状。
研究这些疾病中的神经精神差异，以增进对慢性病中情绪、疲劳和认知表现之间相互关系的理解。
25名CFS患者、38名PLS患者和56名健康对照者参与了该研究。CFS患者符合1994年CFS标准，且无提示莱姆病的病史。PLS患者莱姆病血清学呈阳性，符合疾病控制与预防中心标准，或有强烈提示莱姆病的病史，并且在完成莱姆病抗生素治疗后仍经历持续6个月或更长时间的严重疲劳。所有受试者均完成了躯体症状和情绪障碍的自我报告测量，并接受了神经心理学测试。所有患者还接受了结构化的精神科访谈。
CFS患者和PLS患者在几种躯体症状和精神状况方面相似。CFS患者报告的流感样症状比PLS患者更多。在注意力、言语记忆、言语流畅性和运动速度测试中，PLS患者（而非CFS患者）的表现明显比对照组差。与健康对照相比，无前驱精神疾病史的PLS患者在认知测试中的表现相对比有前驱精神疾病史的PLS患者更差。
尽管症状重叠，但与健康对照相比，PLS患者比CFS患者表现出更大的认知缺陷。这在无前驱精神疾病史的PLS患者中尤为明显。
