Australia’s University of NSW’s Psychiatry Department tested a graded activity program on 25 patients with chronic fatigue syndrome.
Before the study, patients could complete around 4 hours of ‘moderate intensity exercise’ a week (self-reported). It was not measured or recorded at the end of the program but the study found small improvements in cognitive performance, with some caveats.
The Australian study ‘Neurocognitive improvements after best-practice intervention for chronic fatigue syndrome: Preliminary evidence of divergence between objective indices and subjective perceptions’ (UNSW May 16) was published in the April 2016 edition of Comprehensive Psychiatry.
It looked at subjective and objective measures on 25 patients with chronic fatigue syndrome (1994 Fukuda criteria) who completed a 12-week program (28 patients began, only 25 completed). Nine patients were also on antidepressants. There was no comparison group. The study did not include severely ill patients and says it may be substantially different for patients with more severe functional impairment.
The study describes an ‘intervention’, which is a program already in place and used by the authors: “the aim of this program is to assist patients with re-conditioning, both physically and cognitively, toward normal everyday functioning”.
The paper says neurocognitive difficulties “are strongly linked to occupational and social impairment.”
“Best-practice” intervention, in this case, refers to cognitive-behavioral/graded exercise therapies:
“…cognitive-behavioral therapy (CBT) and graded exercise therapy (GET) have consistently produced moderate improvements in levels of reported fatigue as well as cognitive and social functioning in controlled trials.”
“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.”
The study used an electrocardiogram to measure heart rate. Breathing rate, and accuracy and speed at mental tasks were also captured.
“It may be argued that the observed performance improvements may simply be due to the use of a repeated measures design, with previous exposure, familiarity, and reduced anxiety to neurocognitive tasks eliciting quicker responses during follow-up assessment.”
The University of NSW has come under fire for proposing to roll out a training program for medical professionals, teaching them about using CBT/GET on chronic fatigue syndrome patients. #MEAction produced a form letter to send to UNSW and the Mason Foundation.
This study was funded by the Mason Foundation and supported by the National Health and Medical Health Council (NHMRC). Lloyd, one of the authors of this study, has been the recipient of $1.6m in fellowship money from the NHMRC. He is also one of the authors of the 2002 Australian guidelines for chronic fatigue syndrome.