 Neurological Effects of FM & CFS  Depression and Anxiety are common with FM and CFS. Some research support that these conditions come as a result of having FM and/or CFS. However there are abnormalities of the neurological system so it is possible that these conditions may stem from the abnormalities of the nervous system. Depression and anxiety can be caused by biological abnormalities causing chemical imbalances or may be caused by social or environmental factors which trigger maladaptive coping and problem solving skills resulting from increased stress due to increased amount of problems brought on by poor decision making. There may be some degree of these in some FM & CFS people or even in a subgroup of people with FM and CFS. Research is showing people with FM and CFS do have abnormalities of the nervous system which may contribute to the alpha waves (awake brain waves) in the delta sleep (deep sleep) which usually causes a poor quality of sleep. However some people can have this abnormality and be asymptomatic. They do not consider their sleep poor and sleep sound throughout the night. People with FM and CFS may also have higher levels of substance P which contribute to increase sense of pain. Researchers are also checking on the brain's psychological response and biological response to pain. Cortisol (stress hormone) may be higher in people with FM and CFS but may be biologically triggered as opposed to emotionally tiggered. These are just some of the abnormalities researchers are exploring. Therefore I will include sites that provide both the neurological and psychological information. Intraindividual variability in cognitive performance in persons with chronic fatigue syndrome. Artical provides research information on "brainfog" and cognitive functioning of people with CFS compared to healthy people. Neuropsychological Function in Patients With Chronic Fatigue Syndrome, Multiple Sclerosis, and Depression "Patients with chronic fatigue syndrome (CFS), multiple sclerosis (MS), and major depression were compared with controls and with each other on a neuropsychological battery that included standard neuropsychological tests and a computerized set of tasks that spanned the same areas of ability. A total of 101 participants were examined, including 29 participants with CFS, 24 with MS, 23 with major depressive disorder, and 25 healthy controls. There were significant differences among the groups in 3 out of 5 cognitive domains: memory, language, and spatial ability. Assessment of psychiatric symptoms indicated that all 3 patient groups had a higher prevalence of depression than the controls. A total measure of psychiatric symptomatology also differentiated the patients from the controls. After covarying the cognitive test scores by a measure of depression, the patient groups continued to differ from controls primarily in the area of memory. The findings support the view that the cognitive deficits found in CFS cannot be attributed solely to the presence of depressive symptomatology in the patients." Brain Fog A very good artical on what is brain fog which includes several physican's comments. An interesting comment explains the difference between brain fog & depression. According to Dr. Samuels: "The SPECT scan on the brain shows flow and function. If the temporal lobes are mismatched, you can be sure there will be trouble with memory, recall and concentration. If the frontal lobes are poorly lit, you will see depression." According to Dr. Jay Seastrunk, Psychiatrist: "Cognitive dysfunction is a right temporal lobe phenomena. Multiple mood swings, trouble sleeping are all temporal lobe abnormalities. Temporal lobe is responsible for understanding what we hear, retrieving and restoring our memories even though the patient may feel they have difficulty with their memory. The problem is actually the retrieval of this information. The card catalog is there but the Person With CIFDS" (or hypothyroidism) "can't find the right word. Not being able to find the word or you forget what you are going to do, or blocking, is a left temporal lobe phenomena." DEALING WITH BRAINFOG: MEMORY Good tips for dealing with the old grey matter that doesn't work the way it use to. It has tips on memory & if you have any ideas that has helped you, you can email them and they will post it on their site. Fibrofog Follies You don't have to just have FM or CFS to experience this. You just have to live on planet Earth. What is Brainfog and how significant is it? Good artical on brainfog. This sums it up in a nut shell. "Temporal lobe is responsible for understanding what we hear, retrieving and restoring our memories even though the patient may feel they have difficulty with their memory. The problem is actually the retrieval of this information." This is so true with apparently many autoimmune conditions. Prevalence of Neuropsychiatric Symptoms in Dementia and Mild Cognitive Impairment "Context Mild cognitive impairment (MCI) may be a precursor to dementia, at least in some cases. Dementia and MCI are associated with neuropsychiatric symptoms in clinical samples. Only 2 population-based studies exist of the prevalence of these symptoms in dementia, and none exist for MCI. Objective To estimate the prevalence of neuropsychiatric symptoms in dementia and MCI in a population-based study. Design Cross-sectional study derived from the Cardiovascular Health Study, a longitudinal cohort study. Setting and Participants A total of 3608 participants were cognitively evaluated using data collected longitudinally over 10 years and additional data collected in 1999-2000 in 4 US counties. Dementia and MCI were classified using clinical criteria and adjudicated by committee review by expert neurologists and psychiatrists. A total of 824 individuals completed the Neuropsychiatric Inventory (NPI); 362 were classified as having dementia, 320 as having MCI; and 142 did not meet criteria for MCI or dementia. Main Outcome Measure Prevalence of neuropsychiatric symptoms, based on ratings on the NPI in the previous month and from the onset of cognitive symptoms. Results Of the 682 individuals with dementia or MCI, 43% of MCI participants (n = 138) exhibited neuropsychiatric symptoms in the previous month (29% rated as clinically significant) with depression (20%), apathy (15%), and irritability (15%) being most common. Among the dementia participants, 75% (n = 270) had exhibited a neuropsychiatric symptom in the past month (62% were clinically significant); 55% (n = 199) reported 2 or more and 44% (n = 159) 3 or more disturbances in the past month. In participants with dementia, the most frequent disturbances were apathy (36%), depression (32%), and agitation/aggression (30%). Eighty percent of dementia participants (n = 233) and 50% of MCI participants (n = 139) exhibited at least 1 NPI symptom from the onset of cognitive symptoms. There were no differences in prevalence of neuropsychiatric symptoms between participants with Alzheimer-type dementia and those with other dementias, with the exception of aberrant motor behavior, which was more frequent in Alzheimer-type dementia (5.4% vs 1%; P = .02). Conclusions Neuropsychiatric symptoms occur in the majority of persons with dementia over the course of the disease. These are the first population-based estimates for neuropsychiatric symptoms in MCI, indicating a high prevalence associated with this condition as well. These symptoms have serious adverse consequences and should be inquired about and treated as necessary. Study of neuropsychiatric symptoms in the context of dementia may improve our understanding of brain-behavior relationships." National Institute of Neurological Disorders and Stroke A very large site which includes a large list of neurological diseases with links to general overview of each disease and links to other sites and research studies. Neuroanatomy and Neuropathology on the Internet A very large site which contains a bunch of information on the neurological system and many neurological disorders including sleep disorders. It even has information on neurological tests such as sleep studies. NDRF National Dysautonomia Research Foundation Site gives extensive information on the Autonomic Nervous System and abnormalities that may be common in CFIDS and related syndromes. Neurally Mediated / Neurocardiogenic Syncope and Orthostatic Intolerance are two abnormalities which seem to be common in CFIDS. American Autonomic Society Site gives scientific research information on autonomic disorders and other good information. Surgical Treatment of Chiari I Malformation: Indications and Approaches This condition creates FM & CFS symptoms due to a smaller than normal opening of the base of the skull which leads to a tight fit for the spinal cord. Surgery involves making the opening a little larger to relieve the pressure. Definition of the Adult Chiari Malformation: A Brief Historical Overview This link gives some background about this condition. Search Clinical Content on Medscape NEUROPEPTIDE LINKED TO DECREASED COGNITIVE FUNCTION AFTER EARLY-LIFE STRESS "Corticotropin-releasing hormone (CRH) appears have a role in the mechanisms associated with cognitive impairment that develops after stress in early life, according to the results of experiments in an animal model." Unfortunately I lost this artical, however this abstract sheds light on how stress can effect the immune system. "Stress Protein Expression in Primary and Immortalized Cultures of Human Thyroid Cells: A Model System for the Study of Stress Proteins in the Pathogenesis of Autoimmune Thyroid Disease Youde SJ, Mower J, Moore DP, Parkes AB Cell Stress & Chaperones 3(2):89-93, 1998 Jun Stress has, for many years, been linked to the onset of autoimmune disease and, in particular, autoimmune thyroid disease (AITD). Whilst the exact mechanism of this association is unknown, it is clear that episodes of stress can induce profound changes in the immune system. More specifically, recent studies from several laboratories have shown an association between the expression of stress proteins and, particularly, the Hsp70 family with AITD. Our own studies describe a thyroid-specific Hsp70 which shares antigenicity with the key thyroid autoantigen, thyroid peroxidase. Further studies on the molecular basis for this observation are, however, hampered by the lack of a suitably validated thyroid cell model. In this paper we compare the response of primary cultures of human thyrocytes to hyperthermia with the response seen in the immortalized human thyroid cell line HTori3. Both cell types responded in a broadly similar manner, synthesizing proteins from two of the major stress protein families, Hsp70 and Hsp90. In the primary human thyrocyte cultures the 70 kDa proteins showed a 7.5-fold increase and the 90 kDa proteins a 2.7-fold increase with hyperthermia whilst in the HTori3 cells the increases in response to hyperthermia were 10- and 6.5-fold, respectively. We also show a dose-dependent stress response in HTori3 cells cultured in the presence of arsenite ions. We conclude that the response of this highly differentiated and stable thyroid cell line to stress is similar to that seen in primary cultures of human thyroid cells and that these immortalized cells will afford a convenient and effective model for the further study of the role of stress in the pathology of AITD." I can tell you I developed Hashimoto's Thyroiditis after an unusually stressful period of a few years. Substance P: A New Era, a New Role by C. Lindsay DeVane, Pharm.D. "Abstract Substance P has been extensively studied and is considered the prototypic neuropeptide of the more than 50 known neuroactive molecules. The understanding of substance P has evolved beyond the original concept as the pain transmitter of the dorsal horn. Animal and genetic research, recent developments of nonpeptide substance P antagonists, and important changes in the understanding of neurotransmission have each contributed to the current understanding of substance P. After 7 decades, the physiologic role of substance P is known as a modulator of nociception, involved in signaling the intensity of noxious or aversive stimuli. Genetic studies in mice and development of substance P antagonists provide more recent results that support the redefinition of the central role of substance P. Evidence suggests that this neuropeptide is an integral part of central nervous system pathways involved in psychologic stress." Fibromyalgia A New Perspective Patricia shares what she has learned about a link between FM and attention deficit disorder. The cognitive problems that people with FM, CFS, hypothyroidism share are apparently similar to what people with attention deficit disorders experience. These symptoms all apparently do improve with CNS stimulants. Adult ADD/ADHD Attention-Deficit/Hyperactivity Disorder in Adults Diagnositic criteria. Is this a possible problem? You have to meet at least 11 of the 20 criterias. "A sense of underachievement Difficulty getting organized Chronic procrastination or trouble getting started Many projects going simultaneously; trouble with follow-through Tendency to say what comes to mind without necessarily considering the timing or appropriateness of the remark A frequent search for high stimulation An intolerance of boredom Easy distractibility, trouble focusing attention, tendency to tune out or drift away Often creative, intuitive, highly intelligent Trouble in going through established channels, following "proper" procedure. Impatient; low tolerance for frustration Impulsive, either verbally or in actions Tendency to worry needlessly, endlessly Sense of impending doom or insecurity Mood swings, mood liability Restlessness Tendency toward addictive behavior Chronic problems with self-esteem Inaccurate self-observation Family history of ADD or other disorders of impulse control or mood."   My 2 cents worth What I am thinking is that somehow the messages processing from one nerve cell to the next is slowed down to a significant degree that it poises slowing of processing information resulting in easily distracted and memory is hard to create. Also what is stored in memory is hard to retrieve. It's like having a junky file system so information can't be located. The brain apparently emits brain signals (alpha waves as seen in ADHD & apparently FM & CFS) creates static in the brain contributing to an increase in distractibility and lack of concentration. It's great effort to focus. With stimulants it apparently decreases the static (alpha waves) which lead to decrease distraction, improved information processing and consequently improved memory recall. The CNS problems may also contribute to the the increased substance P resulting in increased pain perception (the pain receptors don't shut off when they normally would). This may also contribute to the other CNS related problems (depression, anxiety, weakness, etc.)  The whole brain atlas Want to see what the the healthy brain looks like? You can also check out what some sick brains look like. (physically sick not psychologically sick) The Digital Anatomist Project You can check out more visual graphics of the brain & neurological system as well as other body parts. Neurosurgical Focus Topic Section: Chiari I Malformation Links to information on this condition which involves a narrowing at the base of the skull where the spinal cord comes through. There was a lot of controversy over the surgery to correct this and also about this condition being a cause of FM. Now researchers are investigating this condition in relation to FM and appears to becoming more accepted in mainstream medicine. Official AAN Practice Statements Links to medical and research articals. Neurology Search the Journal of the American Academy of Neurology for articals of interest. Metrolina Neurological Associates Site has links to other neurological research and academic sites under their science and medicine link. Perpetuating Factors: What they are and how they effect us. Artical lists what may trigger "flares" and what may cause FM & CFS to develop in people who are predisposed. I included it here because many of these can be addressed by lifestyle changes which is our choice. It may be difficult but can be done. Personal Guidelines For Managing Chronic Illness Good artical on effective coping techniques. "Uncertainty: From the unpredictability of everyday life to not knowing whether one will improve, having a long-term illness means living with uncertainty. Accepting Responsibility: Even though we may not have control over the illness, there is much we can do to improve our quality of life if we accept responsibility for taking care of ourselves. Accepting Limits: Pacing or living within the limits imposed by the illness is a key strategy for gaining some control over symptoms and living a more predictable life. Flexibility: Circumstances change constantly. A flexible approach makes coping more effective. Creating Meaning: It is possible to lead a meaningful life in spite of the illness and its challenges." Kings College in London WHO Guide to Mental Health in Primary Care outline of CHRONIC FATIGUE AND CHRONIC FATIGUE SYNDROME - F48.0 (Known internationally as Neurasthenia, may be referred to as ME). They view it as primarily a mental health problem. A different view. However from a master's level mental health counselor's (for 7 years) with some medical background, I firmly believe all medical conditions (physical, psychological, emotional) effects all aspects of the individual. All conditions are in the mind as well as the body, spiritual and soul. (holestic approach) CFIDS/Fibromyalgia Self Help Ten Keys to Coping and Recovery. FMS Coping Tips 1 - 30 List of tips from reducing stress, improving stress, improving diet and other good ideals to use to help decrease symptoms. FMS Coping Tips 31 - 60 More good tips. FMS Coping Tips 61 - 73 More tips including ideas with migraines. FMS Coping Tips From Fibromyalgia Network More coping tips. Seasonal Depression Strikes Again Seasonal Effective Disorder occurs as the days become shorter and is more common in the northern hemispheres (or southern hemispheres) as the days get shorter. It's less of a problem as you get closer to the equator. Symptoms of Seasonal Affective Disorder (SAD) include: Depressed mood Fatigue and lack of energy Sleeping much more than usual, increased need for sleep, or difficulty awakening in the morning Increased appetite, often including carbohydrate craving Weight gain Reduced work productivity Having an office with no windows can also trigger this. Some people need the sunlight to keep their bodies "happy". HealthyPlace.Com A very large site which includes information & support for a wide range of mental illness. South Carolina Department of Mental Health Search information on Mental Illness National Institute of Mental Health Site includes research being done related to mental illness as well as information on mental illnesses. Gateway to Neurology at Massachusetts General Hospital If you live in the Boston area it looks like they have an excellent outpatient cognitive behavior program which may be helpful with the cognitive and emotional problems often associated with FM & CFS. Go under Partners Neurology (What services do we provide?) then click on Cognitive Behavioral Neurology. New Neuroscience Center Offers Region's Only Comprehensive Evaluation A joint venture between Sioux Valley and Neurology Associates where patients can have a comprehensive evaluation of their condition in a single clinic setting. Physician's Clinic list of various specialists in Sious Falls SD 4Therapy.com You can search for a therapist if you feel you need one. Treatment Programs for PTSD & Dissociative Disorders Some people with FM & CFS may also suffer from these conditions. These conditions do not cause FM & CFS nor do people with FM & CFS have these conditions more than the general population but since a friend shared these sites I decided to share them here. National Depressive and Manic-Depressive Association Some general information on depression & manic depression as well as support Alternative Health Links Includes a list of other links to a bunch of sites related to alternative health care. The Center Program for Post Traumatic Stress Disorder and dissociative identity disorder, conditions caused by severe psychological &/or physical abuse. The center helps patients handle flashbacks and identify triggers and what to do about them. BioMedNet Report: Left-Right asymmetry found in emotion Investigator: Antonio Damasio "Theories that dubbed math- and art-types as left- and right-brainers have long grown out of fashion in academia, but new research suggests a surprising role for brain asymmetry in emotion." BioMedNet Report: Brain scan analysis gets objective Investigator: Richard Frackowiak "A new technique for analyzing the results of brain scans provides a bridge between the brain morphology and individual gene activity. "This is the first opportunity to link brain development and function with the actions of a specific gene," said Richard Frackowiak, dean of the Institute of Neurology in London. The technique will allow accurate measurement of neurological disease progression and the effects of drug therapy." BioMedNet Report: Collins predicts bright future for neurology Investigator: Francis Collins "Genomics will transform neurology, said the leader of the human genome project today. Francis Collins, director of the National Human Genome Research Institute (NHGRI) in Bethesda, Maryland, discussed the current and future state of genomic neurology." BioMedNet Report: Tantalizing hint of a new migraine gene Investigator: Michel Ferrari "The majority of migraines are multifactorial, involving a complex interaction between genes and other unidentified factors - such as hormones or the environment - triggering dilation of the blood vessels within the skull and around the brain, particularly in the meninges. Clues to which genes may be responsible are coming from studies of families with rare inherited forms of the disease. Each gene predisposes sufferers to the triggering effects of certain foods, wine, stress, or lack of sleep." BioMedNet Report: A vitamin a day may keep stroke away Investigator: James Toole Tuesday Jun 19th, 2001 by Melissa Mertl "Prevention for stroke "is so simple," said James Toole, head of stroke research at the Wake Forest University School of Medicine. Vitamins like B12, B6, and folic acid may go a long way to protect at-risk persons from developing blocked arteries. Toole, president of the World Federation of Neurology, is coordinating a large international clinical trial to test the hypothesis." BioMedNet Report: Astronomical research dismissed as moonshine "The pull of the moon is too strong for neurologists to resist. Conflicting evidence was presented today on the moon's role in triggering neurological disorders." Investigators: Giorgio Zanchin and Sally Zachariah BioMedNet Report: Eyes provide a window on memory Investigator: Christopher Kennard "Spatial working memory - vital to everyday tasks - remains a largely elusive process. Now a study in Parkinson's disease patients provides the first demonstration that eye movements can provide a window on the processes involved." Can Prayer Heal? Research is proving prayer does have a positive influence on our health. CITY LIVING CAN DRIVE YOU CRAZY "If you feel city living is making you crazy, you're not alone. A new study from the Netherlands suggests you're more at risk for a psychotic illness if you live in a city than if you live in a rural area." When I saw this it reminded me of a segment I saw on TV in the mid 1960's as a young child about an experiment with mice. One cage had the "normal" amount of mice in the cage while the other cage was greatly over populated. The first cage all the mice related and behaved as "normal" mice. They ate, played & slept. They had no aggression towards each other but related as "normal" mice. The over populated mice were different. The researchers over time noticed the mice were aggressive towards one another, mice were killing mice, some mice were hovering in corners isolating themselves from others, some were sexually attracted to mice of the same sex rather than matting with opposite sex mice, some mice displayed anxiety & depressive symptoms. The program did not share any conclusions except the researchers were amazed and puzzled by the mice behavior. I guess in my first abstract reasoning I thought "That's what's wrong with society today!". Close to 30 years later researchers are supporting this theory.   |