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

Published online by Cambridge University Press:  30 April 2008

X. Caseras ,
D. Mataix-Cols ,
K. A. Rimes ,
V. Giampietro ,
M. Brammer ,
F. Zelaya ,
T. Chalder  and
E. Godfrey
X. Caseras*
Affiliation:
Unitat de Psicologia Mèdica, Institut de Neurociències, Universitat Autònoma de Barcelona, Catalonia, Spain Division of Psychological Medicine and Psychiatry, King's College London, Institute of Psychiatry, London, UK
D. Mataix-Cols
Affiliation:
Division of Psychological Medicine and Psychiatry, King's College London, Institute of Psychiatry, London, UK Department of Psychology, King's College London, Institute of Psychiatry, London, UK
K. A. Rimes
Affiliation:
Division of Psychological Medicine and Psychiatry, King's College London, Institute of Psychiatry, London, UK
V. Giampietro
Affiliation:
Centre for Neuroimaging Sciences, King's College London, Institute of Psychiatry, London, UK
M. Brammer
Affiliation:
Centre for Neuroimaging Sciences, King's College London, Institute of Psychiatry, London, UK
F. Zelaya
Affiliation:
Centre for Neuroimaging Sciences, King's College London, Institute of Psychiatry, London, UK
T. Chalder
Affiliation:
Division of Psychological Medicine and Psychiatry, King's College London, Institute of Psychiatry, London, UK
E. Godfrey
Affiliation:
Department of Psychology, King's College London, Institute of Psychiatry, London, UK
*
*Address for correspondence: Dr X. Caseras, PO 69, Section of Cognitive Neuropsychiatry, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK. (Email: [email protected])
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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.

Keywords

Anxietychronic fatigue syndromefatiguefMRI
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 7 , July 2008 , pp. 941 - 951
Copyright
Copyright © 2008 Cambridge University Press

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