I don't have this study. I don't know what kind of "neurocognitive training" was involved or how they did the graded-activity (not exercise apparently). This appears to be an evolved CBT/GET study. I personally don't have a problem with the right kinds of CBT/activity management programs helping out.
My interest is in this.....
The people in the study apparently improved their neurocognitive functioning but didn't feel they had. My guess is that either
My interest is in this.....
Moderate improvements from 'best practice' therapy are promising, but to date reported efficacy is based entirely on subjective measures.This is problematic, given the well-documented divergence between subjective perceptions and actual neurocognitive performance, including in this patient group.
These improvements were accompanied by improvements in symptom ratings (p's≤0.01). However, subjective ratings of neurocognitive difficulties, and CFS-related symptoms were not linked to objective performance improvements.
The people in the study apparently improved their neurocognitive functioning but didn't feel they had. My guess is that either
- the improvements were too subtle to notice.Note that they said moderate improvements..Note also that the problem of subjective not matching objective improvement is common; it's not just in ME/CFS.
- Ditto with the symptom improvement; it was there - but it just wasn't substantial enough for the patient to feel that much better.
- the effort remained the same; i.e. the patients did better but they still had to work hard and were fatigued by the tests....and that is what why they did not feel they improved that much (???)
Compr Psychiatry. 2016 Apr;66:166-75. doi: 10.1016/j.comppsych.2016.02.002. Epub 2016 Feb 9.Neurocognitive improvements after best-practice intervention for chronic fatigue syndrome: Preliminary evidence of divergence between objective indices and subjective perceptions.
Cvejic E1, Lloyd AR2, Vollmer-Conna U3.
BACKGROUND:
Neurocognitive difficulties are commonly reported by patients suffering from chronic fatigue syndrome (CFS). Moderate improvements from 'best practice' therapy are promising, but to date reported efficacy is based entirely on subjective measures. This is problematic, given the well-documented divergence between subjective perceptions and actual neurocognitive performance, including in this patient group.
MATERIAL AND METHODS:
Subjective and objective measures of neurocognitive performance were obtained from 25 patients with well-characterized CFS before and after the completion of a 12-week graded-activity program incorporating a cognitive training component. Additionally, self-reported symptoms, cardiac autonomic activity (a relevant biomarker of stress responsivity), and their relation to neurocognitive improvements were examined.
RESULTS:
Substantive post-intervention improvements in subjective (p=0.006) and objective (including faster responses speeds and greater accuracy, p's<0.001) neurocognitive performance were documented. Participants also demonstrated reduced autonomic reactivity to the cognitive challenge at follow-up (p's≤0.01). These improvements were accompanied by improvements in symptom ratings (p's≤0.01). However, subjective ratings of neurocognitive difficulties, and CFS-related symptoms were not linked to objective performance improvements.
CONCLUSIONS:
These initial data provide the first evidence of objective neurocognitive performance improvements accompanied by a significant reduction in responsiveness in stress-related neural pathways consequent to cognitive-behavioral/graded exercise therapy programs. These findings provide support for the effectiveness of such programs in remediating clinical status. These promising findings warrant further investigation, including replication in a larger sample utilizing more controlled study designs.
Last edited: