Skip to main content
×
Home
    • Aa
    • Aa

The neural correlates of fatigue: an exploratory imaginal fatigue provocation study in chronic fatigue syndrome

  • X. Caseras (a1) (a2), D. Mataix-Cols (a2) (a3), K. A. Rimes (a2), V. Giampietro (a4), M. Brammer (a4), F. Zelaya (a4), T. Chalder (a2) and E. Godfrey (a3)...
Abstract
Background

Fatigue is the central symptom in chronic fatigue syndrome (CFS) and yet very little is known about its neural correlates. The aim of this study was to explore the functional brain response, using functional magnetic resonance imaging (fMRI), to the imaginal experience of fatigue in CFS patients and controls.

Method

We compared the blood oxygen level dependent (BOLD) responses of 12 CFS patients and 11 healthy controls to a novel fatigue provocation procedure designed to mimic real-life situations. A non-fatiguing anxiety-provoking condition was also included to control for the non-specific effects of negative affect.

Results

During the provocation of fatigue, CFS patients reported feelings of both fatigue and anxiety and, compared to controls, they showed increased activation in the occipito-parietal cortex, posterior cingulate gyrus and parahippocampal gyrus, and decreased activation in dorsolateral and dorsomedial prefrontal cortices. The reverse pattern of findings was observed during the anxiety-provoking scenarios.

Conclusions

The results may suggest that, in CFS patients, the provocation of fatigue is associated with exaggerated emotional responses that patients may have difficulty suppressing. These findings are discussed in relation to the cognitive-behavioural model of CFS.

Copyright
Corresponding author
*Address for correspondence: Dr X. Caseras, PO 69, Section of Cognitive Neuropsychiatry, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK. (Email: xavier.caseras@iop.kcl.ac.uk)
References
Hide All
Angst J, Dobler-Mikola A (1985). The Zurich Study. V. Anxiety and phobia in young adults. European Archives of Psychiatry and Neurological Sciences 235, 171178.
Beauregard M, Paquette V, Levesque J (2006). Dysfunction in the neural circuitry of emotional self-regulation in major depressive disorder. Neuroreport 17, 843846.
Brammer M, Bullmore ET, Simmons A, Williams SCR, Grasby PM, Howard RJ, Woodruff PWR, Rabe-Hesketh S (1997). Generic brain activation mapping in functional magnetic resonance imaging: a nonparametric approach. Magnetic Resonance Imaging 15, 763770.
Bullmore ET, Brammer M, Rabe-Hesketh S, Curtis V, Morris R, Williams SCR, Sharma T, McGuire PK (1999 a). Methods for the diagnosis and treatment of stimulus correlated motion in generic brain activation studies using fMRI. Human Brain Mapping 7, 3848.
Bullmore ET, Long C, Suckling J, Fadili J, Calvert GA, Zelaya F, Carpenter TA, Brammer MJ (2001). Coloured noise and computational inference in neurophysiological (fMRI) time series analysis: resampling methods in time and wavelet domains. Human Brain Mapping 12, 6178.
Bullmore ET, Suckling J, Overmeyer S, Rabe-Hesketh S, Taylor E, Brammer MJ (1999 b). Global, voxel and cluster tests, by theory and permutation, for a difference between two groups of structural MR images of the brain. IEEE Transactions on Medical Imaging 18, 3242.
Caseras X, Mataix-Cols D, Giampietro V, Rimes KA, Brammer M, Zelaya F, Chalder T, Godfrey EL (2006). Probing the working memory system in chronic fatigue syndrome: a functional magnetic resonance imaging study using the n-back task. Psychosomatic Medicine 68, 947955.
Chalder T, Berelowitz G, Pawlikowska T, Watts L, Wessely S, Wright D, Walalce EP (1993). Development of a fatigue scale. Journal of Psychosomatic Research 37, 147153.
Chalder T, Cleare A, Wessely S (2000). The management of stress and anxiety in chronic fatigue syndrome. In The Management of Stress and Anxiety in Medical Disorders (ed. Mostofsky D. I. and Barlow D. H.), pp. 160179. Alleyn and Bacon: Boston.
Cook DA, O'Connor PJ, Lange G, Steffener J (2007). Functional neuroimaging correlates of mental fatigue induced by cognition among chronic fatigue syndrome patients and controls. NeuroImage 36, 108122.
Creswell C, Chalder T (2001). Defensive coping styles in chronic fatigue syndrome. Journal of Psychosomatic Research 51, 607610.
Critchley HD (2004). The human cortex responds to an interoceptive challenge. Proceedings of the National Academy of Sciences USA 101, 63336334.
Deale A, Chalder T, Wessely S (1998). Illness beliefs and outcome in chronic fatigue syndrome: is change in causal attribution necessary for clinical improvement? Journal of Psychosomatic Research 45, 7783.
Fischler B, Cluydts R, De Gucht V, Kaufman L, DeMeirleir K (1997). Generalised anxiety disorder in chronic fatigue syndrome. Acta Psychiatrica Scandinavica 95, 405413.
Friman O, Borga M, Lundberg P, Knutsson H (2003). Adaptive analysis of fMRI data. NeuroImage 19, 837845.
Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A (1994). The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Annals of Internal Medicine 121, 953959.
Garret AS, Maddock RJ (2006). Separating subjective emotion from the perception of emotion-inducing stimuli: an fMRI study. NeuroImage 33, 263274.
Georgiades E, Behan WMH, Kilduff LP, Hadjicharalambous M, Mackie EE, Wilson J, Ward SA, Pitsiladis YP (2003). Chronic fatigue syndrome: new evidence for a central fatigue disorder. Clinical Science 105, 213218.
Godfrey E, Chalder T, Ridsdale L, Seed P, Ogden J (2007). Investigating the ‘active ingredients’ of cognitive behaviour therapy and counselling for patients with chronic fatigue in primary care; developing a new process measure to assess treatment fidelity and predict outcome. British Journal of Clinical Psychology 46, 253272.
Heim C, Wagner D, Maloney E, Papanicolaou DA, Solomon L, Jones JF, Unger ER, Reeves WC (2006). Early adverse experience and risk for chronic fatigue syndrome: results from a population-based study. Archives of General Psychiatry 63, 12581266.
Kato K, Sullivan PF, Evengard B, Pedersen NL (2006). Premorbid predictors of chronic fatigue. Archives of General Psychiatry 63, 12671272.
Kent-Braun JA, Sharma KR, Weiner MW, Massie B, Miller RG (1993). Central basis of muscle fatigue in chronic fatigue syndrome. Neurology 43, 125131.
Lange G, Steffener J, Cook DB, Bly BM, Christodoulou C, Liu WC, Deluca J, Natelson BH (2005). Objective evidence of cognitive complaints in chronic fatigue syndrome: a BOLD fMRI study of verbal working memory. NeuroImage 26, 513524.
Mataix-Cols D, Cowley AJ, Hankins M, Schneider A, Bachofen M, Kenwright M, Gega L, Cameron R, Marks IM (2005). Reliability and validity of the Work and Social Adjustment Scale in phobic disorders. Comprehensive Psychiatry 46, 223228.
Mataix-Cols D, Wooderson S, Lawrence N, Brammer MJ, Speckens A, Phillips ML (2004). Distinct neural correlates of washing, checking, and hoarding symptom dimensions in obsessive-compulsive disorder. Archives of General Psychiatry 6, 564576.
Mundt JC, Marks IM, Greist JH, Shear K (2002). Work and Social Adjustment Scale: a simple accurate measure of impairment in functioning. British Journal of Psychiatry 180, 461464.
Nielsen FA, Balslev D, Hansen LK (2005). Mining the posterior cingulate: segregation between memory and pain components. NeuroImage 27, 520532.
Ochsner KN, Bunge SA, Gross JJ, Gabrieli JD (2002). Rethinking feelings: an fMRI study of the cognitive regulation of emotion. Journal of Cognitive Neuroscience 14, 12151229.
Phan KL, Fitzgerald DA, Nathan PJ, Moore GJ, Uhde TW, Tancer ME (2005). Neural substrates for voluntary suppression of negative affect: a functional magnetic resonance imaging study. Biological Psychiatry 57, 210219.
Phan KL, Wager T, Taylor SF, Liberzon I (2002). Functional neuroanatomy of emotion: a meta-analysis of emotion activation studies in PET and fMRI. NeuroImage 16, 331348.
Phillips ML, Drevets WC, Rauch SL, Lane R (2003). Neurobiology of emotion perception. I: Implications for major psychiatric disorders. Biological Psychiatry 54, 515528.
Pourtois G, Schwartz S, Seghier ML, Lazeyras F, Vuilleumier P (2006). Neural systems for orienting attention to the location of threat signals: an event-related fMRI study. NeuroImage 31, 920933.
Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Barker R, Dunbar GC (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59 (Suppl. 20), 2233.
Silver A, Haeney M, Vijayadurai P, Wilks D, Pattrick M, Main CJ (2002). The role of fear of physical movement and activity in chronic fatigue syndrome. Journal of Psychosomatic Research 52, 485493.
Smith AP, Stephan KE, Rugg MD, Dolan RJ (2006). Task and content modulate amygdale-hippocampal connectivity in emotional retrieval. Neuron 49, 631638.
St Clair Gibson A, Baden DA, Lambert MI, Lambert EV, Harley YX, Hampson D, Russell VA, Noakes TD (2003). The conscious perception of the sensation of fatigue. Sports Medicine 33, 167176.
Talairach J, Tournoux P (1988). Co-planar Stereotactic Atlas of the Human Brain. Thieme: Stuttgart.
van der Werf SP, Prins JB, Vercoulen JHMM, van der Meer JWM, Bleijenberg G (2000). Identifying physical activity patterns in chronic fatigue syndrome using actigraphic assessment. Journal of Psychosomatic Research 49, 373379.
Ware JE, Sherbourne C (1992). The MOS 36-item short form health survey (SF-36). Medical Care 30, 473483.
Whiteside A, Hansen S, Chaudhuri A (2004). Exercise lowers pain threshold in chronic fatigue syndrome. Pain 109, 497499.
Whiting P, Bagna AM, Sowden AJ, Cornell JE, Mulrow CD, Ramírez G (2001). Interventions for the treatment and management of chronic fatigue syndrome. Journal of the American Medical Association 286, 13601368.
Zigmond AS, Snaith RP (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 67, 361370.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 8
Total number of PDF views: 53 *
Loading metrics...

Abstract views

Total abstract views: 198 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 22nd October 2017. This data will be updated every 24 hours.