Neuropsychology and Psychology of MCS

Neurological symptoms are frequently reported by patients with multiple chemical sensitivities (MCS). Methods to compare the psychiatric, personality, and neuropsychological function of patients with MCS, chronic fatigue syndrome (CFS), and normal controls are described. Increased rates of Axis I psychiatric diagnoses are observed in the literature for MCS and CFS subjects relative to controls. Findings on the MMPI-2 and the Toronto Alexithymia Scale reveal prof iles consistent with the tendency to report somatic rather than emotional symptoms in response to stress. However, many of the reported somatic symptoms also coincide with those found in neurologic disorders. The overall neuropsychological prof ile for MCS subjects does not reflect cognitive impairment. Relative to normal controls, the only difference in neuropsychological performance observed is reduced recognition of nontarget designs on a visual memory task. More fruitful areas for future psychological research will include measurement of the interaction between behavioral response styles and attentional processes in cognition, as well as observations under controlled challenge conditions.

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Book Section: Essay and Review: A Clinician's Guide to Controversial Illnesses: Chronic Fatigue Syndrome, Fibromyalgia, and Multiple Chemical Sensitivities

The Journal of Psychiatry & Law ◽

10.1177/009318530102900408 ◽

2001 ◽

Vol 29 (4) ◽

pp. 527-531

Author(s):

R. Gregory Lande

Keyword(s):

Chronic Fatigue Syndrome ◽

Chronic Fatigue ◽

Multiple Chemical Sensitivities ◽

Fatigue Syndrome ◽

Multiple Chemical

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Using an interleukin-6 challenge to evaluate neuropsychological performance in chronic fatigue syndrome

Psychological Medicine ◽

10.1017/s0033291702006086 ◽

2002 ◽

Vol 32 (6) ◽

pp. 1075-1089 ◽

Cited By ~ 21

Author(s):

M. C. ARNOLD ◽

D. A. PAPANICOLAOU ◽

J. A. O'GRADY ◽

A. LOTSIKAS ◽

J. K. DALE ◽

...

Keyword(s):

Chronic Fatigue Syndrome ◽

Interleukin 6 ◽

Psychological Functioning ◽

Short Term Memory ◽

Somatic Symptoms ◽

Chronic Fatigue ◽

Cognitive Measures ◽

Attention And Executive Control ◽

Fatigue Syndrome ◽

Normal Controls

Background. Individuals with acute infections experience a range of symptoms including fatigue, malaise, muscle aches, and difficulties with concentration and memory that are usually self-limited. This cluster of symptoms is otherwise, similar to those that characterize chronic fatigue syndrome (CFS). The goal of the present study was to evaluate the cognitive and psychological functioning of CFS patients and normal controls (NCs) when they both were experiencing acute influenza-like symptoms. To induce influenza-like symptoms, we administered interleukin-6 (IL-6), a cytokine that temporarily activates the acute phase immunological and endocrine responses.Methods. Nineteen patients who met the 1994 International CFS Study Group Criteria and ten normal controls (NCs) completed routine clinical evaluations, neuropsychological tests of short-term memory, selective attention, and executive control, and self-ratings of somatic symptoms and psychological mood before, shortly following, and 1 day after IL-6 administration.Results. CFS patients consistently reported more somatic symptoms, even when both groups perceived that they were ill. Both groups somatic symptoms increased during the IL-6 challenge, but the CFS patients symptoms increased more rapidly than controls. In general, the CFS patients performed similarly to NCs on the cognitive measures before, during, and after the IL-6. In contrast to predictions, IL-6 provocation did not impair the cognitive performance of either CFS patients or NCs.Conclusions. The IL-6 provocation exacerbated the patients self-reported symptoms but did not reveal notable cognitive impairments between patients and controls during cytokine-induced acute influenza-like symptoms.

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A Controlled Comparison of Multiple Chemical Sensitivities and Chronic Fatigue Syndrome

Psychosomatic Medicine ◽

10.1097/00006842-199601000-00007 ◽

1996 ◽

Vol 58 (1) ◽

pp. 38-49 ◽

Cited By ~ 109

Author(s):

Nancy Fiedler ◽

Howard M. Kipen ◽

John DeLuca ◽

Kathie Kelly-McNeil ◽

Benjamin Natelson

Keyword(s):

Chronic Fatigue Syndrome ◽

Chronic Fatigue ◽

Multiple Chemical Sensitivities ◽

Fatigue Syndrome ◽

Multiple Chemical

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Comparison of patients with chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivities

Archives of Internal Medicine ◽

10.1001/archinte.154.18.2049 ◽

1994 ◽

Vol 154 (18) ◽

pp. 2049-2053 ◽

Cited By ~ 62

Author(s):

D. Buchwald

Keyword(s):

Chronic Fatigue Syndrome ◽

Chronic Fatigue ◽

Multiple Chemical Sensitivities ◽

Fatigue Syndrome ◽

Multiple Chemical

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Working memory deficits associated with chronic fatigue syndrome

Journal of the International Neuropsychological Society ◽

10.1017/s1355617701733024 ◽

2001 ◽

Vol 7 (3) ◽

pp. 285-293 ◽

Cited By ~ 33

Author(s):

BONNIE M. DOBBS ◽

ALLEN R. DOBBS ◽

IVAN KISS

Keyword(s):

Working Memory ◽

Chronic Fatigue Syndrome ◽

Storage Capacity ◽

Digit Span ◽

Memory Task ◽

Memory Deficits ◽

Chronic Fatigue ◽

Central Executive ◽

Attention Task ◽

Fatigue Syndrome

Cognitive impairments are among the most frequently reported and least investigated components of the chronic fatigue syndrome (CFS). As part of a multifaceted study of the CFS, the present study investigated the cognitive functioning of chronic fatigue patients. The performance of 20 CFS patients was compared to that of controls (N = 20) on 4 tests of working memory (WM). Digit Span Forward was used to assess the storage capacity of WM. Multiple aspects of central executive functioning were assessed using several standard measures: Digit Span Backward, and Trails A and Trails B. More recently developed measures of WM were used to assess control of processing under temporal demands (working memory task) and resistance to interference (a sustained attention task). Deficits were restricted to more demanding tasks, requiring resistance to interference and efficient switching between processing routines. The overall results clearly implicate deficits in the control aspects of central executive function in CFS. (JINS, 2001, 7, 285–293.)

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A randomized, double-blind, placebo-controlled pilot study of a probiotic in emotional symptoms of chronic fatigue syndrome

Gut Pathogens ◽

10.1186/1757-4749-1-6 ◽

2009 ◽

Vol 1 (1) ◽

pp. 6 ◽

Cited By ~ 274

Author(s):

A Venket Rao ◽

Alison C Bested ◽

Tracey M Beaulne ◽

Martin A Katzman ◽

Christina Iorio ◽

...

Keyword(s):

Pilot Study ◽

Chronic Fatigue Syndrome ◽

Chronic Fatigue ◽

Emotional Symptoms ◽

Double Blind ◽

Double Blind Placebo ◽

Fatigue Syndrome

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Human Herpesviruses in Chronic Fatigue Syndrome

Clinical and Diagnostic Laboratory Immunology ◽

10.1128/cdli.6.2.216-223.1999 ◽

1999 ◽

Vol 6 (2) ◽

pp. 216-223 ◽

Cited By ~ 49

Author(s):

Howard L. Wallace ◽

Benjamin Natelson ◽

William Gause ◽

John Hay

Keyword(s):

Chronic Fatigue Syndrome ◽

Mononuclear Cells ◽

Chronic Fatigue ◽

Double Blind Study ◽

Double Blind ◽

Peripheral Blood Mononuclear ◽

Fatigue Syndrome ◽

Axis I ◽

And Control ◽

Human Herpesviruses

ABSTRACT We have conducted a double-blind study to assess the possible involvement of the human herpesviruses (HHVs) HHV6, HHV7, Epstein-Barr virus (EBV), and cytomegalovirus in chronic fatigue syndrome (CFS) patients compared to age-, race-, and gender-matched controls. The CFS patient population was composed of rigorously screened civilian and Persian Gulf War veterans meeting the Centers for Disease Control and Prevention’s CFS case definition criteria. Healthy control civilian and veteran populations had no evidence of CFS or any other exclusionary medical or psychiatric condition. Patient peripheral blood mononuclear cells were analyzed by PCR for the presence of these HHVs. Using two-tailed Fisher’s exact test analyses, we were unable to ascertain any statistically significant differences between the CFS patient and control populations in terms of the detection of one or more of these viruses. This observation was upheld when the CFS populations were further stratified with regard to the presence or absence of major axis I psychopathology and patient self-reported gradual versus acute onset of disease. In tandem, we performed serological analyses of serum anti-EBV and anti-HHV6 antibody titers and found no significant differences between the CFS and control patients.

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Explanatory and Pragmatic Perspectives Regarding Idiopathic Physical Symptoms and Related Syndromes

CNS Spectrums ◽

10.1017/s1092852900014395 ◽

2006 ◽

Vol 11 (3) ◽

pp. 225-232 ◽

Cited By ~ 12

Author(s):

Charles C. Engel

Keyword(s):

Real Life ◽

Internal Validity ◽

Chronic Fatigue ◽

Physical Symptoms ◽

Case Definition ◽

Somatization Disorder ◽

Multiple Chemical Sensitivities ◽

Fatigue Syndrome ◽

Study Results ◽

Clinical Pragmatism

ABSTRACTIn recent years, research-methods literature mainly addressing controlled clinical trials has arisen regarding explanatory and pragmatic treatment trials. Explanatory trials tend to examine causal mechanisms and questions of efficacy and value internal validity (creating optimal study conditions) over generalizability (using study results to understand treatment effects in real-life patient populations). In contrast, pragmatictrials value “external relevance” (generalizability) of study results over “internal elegance” so that clinicians and health policymakers can better understand how treatments might impact their patients and policies.This review draws inspiration from these contrasting explanatory and pragmatic perspectives and develops them for clinical and research pertaining to idiopathic physical symptoms and related syndromes (eg, somatization disorder, chronic fatigue syndrome, multiple chemical sensitivities, irritable bowel syndrome). Explanatory and pragmatic perspectives are used to examine these idiopathies with regard to causation, case definition, labels, and treatment. It is concluded that idiopathic symptom syndromes are fundamentally pragmatic clinical and research challenges. For epidemiologic and methodologic reasons, the complex explanations for these syndromes remain largely elusive. Even so, scientific and clinical pragmatism offers the opportunity to reduce disagreement between competing medical disciplines and between clinicians and affected patients with regard to irreconcilable etiologic questions and to remain evidence-based in the care of patients.

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