Cognitive remediation training improves performance in patients with chronic fatigue syndrome.
McBride, Richard L, Horsfield, Sarah, Sandler, Carolina X et al. · Psychiatry research · 2017 · DOI
Quick Summary
This study tested whether computer-based brain training exercises could help ME/CFS patients with concentration and memory problems. Thirty-six patients received standard cognitive-behavioral therapy plus exercise therapy, and thirty-six received the same treatment plus online cognitive training. The group that added brain training showed greater improvements in both their self-reported memory and concentration, and also performed better on objective memory and thinking tests.
Why It Matters
Cognitive dysfunction is one of the most disabling and under-treated symptoms in ME/CFS. If validated in larger randomized trials, cognitive training could offer patients a non-pharmacological, accessible home-based tool to improve concentration and memory—potentially enabling greater functional recovery and quality of life.
Observed Findings
Cognitive exercise therapy plus CBT/GET resulted in significantly greater self-reported improvements in neurocognitive symptoms compared to CBT/GET alone.
Objective testing revealed significant improvements in executive function, processing speed, and working memory in the CET group.
Improvement in subjective symptoms was predicted by assignment to the CET group and lower baseline mood disturbance.
The intervention was delivered online in a home-based format over 12 weeks with 11 clinic visits.
Both arms completed standardized measures of symptom severity and functional status at baseline and post-intervention.
Inferred Conclusions
Computer-based cognitive remediation training may be an effective adjunctive intervention for neurocognitive symptoms in ME/CFS patients.
Home-based cognitive training can produce both subjectively-reported and objectively-measured improvements in thinking processes.
Cognitive training warrants investigation in larger-scale randomized controlled trials to establish efficacy and determine optimal patient selection.
Remaining Questions
Do cognitive training benefits persist 6 months, 1 year, or longer after treatment ends, or do they fade over time?
What This Study Does Not Prove
This case-control study does not establish causation or test whether cognitive training is universally effective; selection bias and lack of randomization limit generalizability. The study cannot determine whether improvements were due to the cognitive training itself, natural recovery, increased attention from providers, or expectancy effects. Whether benefits persist beyond the 12-week treatment period remains unknown.
Tags
Symptom:Cognitive DysfunctionFatigue
Method Flag:PEM Not DefinedWeak Case DefinitionSmall Sample