Clinical Rheumatology

, Volume 32, Issue 10, pp 1475–1485 | Cite as

Cognitive performance is of clinical importance, but is unrelated to pain severity in women with chronic fatigue syndrome

  • Kelly Ickmans
  • Mira Meeus
  • Daphne Kos
  • Peter Clarys
  • Geert Meersdom
  • Luc Lambrecht
  • Nathalie Pattyn
  • Jo Nijs
Original Article


In various chronic pain populations, decreased cognitive performance is known to be related to pain severity. Yet, this relationship has not been investigated in patients with chronic fatigue syndrome (CFS). This study investigated the relationship between cognitive performance and (1) pain severity, (2) level of fatigue, and (3) self-reported symptoms and health status in women with CFS. Examining the latter relationships is important for clinical practice, since people with CFS are often suspected to exaggerate their symptoms. A sample of 29 female CFS patients and 17 healthy controls aged 18 to 45 years filled out three questionnaires (Medical Outcomes Study 36-Item Short-Form Health Survey, Checklist Individual Strength (CIS), and CFS Symptom List) and performed three performance-based cognitive tests (psychomotor vigilance task, Stroop task, and operation span task), respectively. In both groups, pain severity was not associated with cognitive performance. In CFS patients, the level of fatigue measured with the CFS Symptom List, but not with the CIS, was significantly correlated with sustained attention. Self-reported mental health was negatively correlated with all investigated cognitive domains in the CFS group. These results provide evidence for the clinical importance of objectively measured cognitive problems in female CFS patients. Furthermore, a state-like measure (CFS Symptom List) appears to be superior over a trait-like measure (CIS) in representing cognitive fatigue in people with CFS. Finally, the lack of a significant relationship between cognitive performance and self-reported pain severity suggests that pain in CFS might be unique.


Chronic fatigue syndrome Cognitive performance Fatigue Health status Pain 



The authors would like to thank Tinne Boey, Martine Sweldens, and Wouter Rosseels for their aid in the data input. Kelly Ickmans is a research fellow of ME Research UK, a national charity funding biomedical research into myalgic encephalomyelitis/chronic fatigue syndrome. This work was partly supported by ixX Pharma, Belgium.




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Copyright information

© Clinical Rheumatology 2013

Authors and Affiliations

  • Kelly Ickmans
    • 1
    • 2
    • 3
  • Mira Meeus
    • 2
    • 4
  • Daphne Kos
    • 2
  • Peter Clarys
    • 5
  • Geert Meersdom
    • 6
  • Luc Lambrecht
    • 7
  • Nathalie Pattyn
    • 8
  • Jo Nijs
    • 1
    • 3
  1. 1.Pain in Motion Research Group (PIM), Department of Human Physiology, Faculty of Physical Education and PhysiotherapyVrije Universiteit BrusselBrusselsBelgium
  2. 2.Pain in Motion Research Group (PIM), Division of Musculoskeletal Physiotherapy, Department of Health Care SciencesArtesis University College AntwerpAntwerpBelgium
  3. 3.Pain in Motion Research Group (PIM), Department of Physical Medicine and PhysiotherapyUniversity Hospital BrusselsBrusselsBelgium
  4. 4.Rehabilitation Sciences and PhysiotherapyGhent UniversityGhentBelgium
  5. 5.Department of Human Biometry and Biomechanics, Faculty of Physical Education and PhysiotherapyVrije Universiteit BrusselBrusselsBelgium
  6. 6.vzw CVS ContactgroepBrugesBelgium
  7. 7.Private Practice for Internal MedicineGhent/AalstBelgium
  8. 8.VIPER Research UnitRoyal Military AcademyBrusselsBelgium

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