COGNITIVE-FUNCTIONING AND MAGNETIC-RESONANCE-IMAGING IN CHRONIC FATIGUE

Background. This study examines whether cognitive dysfunction in chron ic fatigue may be accounted for by depression and anxiety or is due to brain pathology evident on magnetic resonance imaging (MRI). Method. Twenty-six subjects with chronic fatigue, with and without coexisting depression, and 18 age-matched normal controls were recruited from pri mary care following a presumed viral illness six months previously. Co mparison was made with 13 psychiatric controls with depressive illness on standardised cognitive tests. MRI determined the presence of cereb ral white-matter lesions. Results. No substantial differences in perfo rmance were shown between subjects with chronic fatigue, most of wham met the criteria for chronic fatigue syndrome, and controls. Subjectiv e cognitive dysfunction increased with psychapathology. White-matter l esions were found in a minority from all groups. Improvement in fatigu e and depression coincided with improved performance on cognitive meas ures. Conclusions. Subjective complaints of cognitive impairment are a prominent feature of chronic fatigue, but objective cognitive and MRI abnormalities are not. Such complaints probably reflect psychopatholo gy rather than a post-viral process.