Memory Loss and M.E./CFS/CFIDS


Index
Memory Loss
Research on Memory Loss
IQ Isn't Everything!
Few of the more Interesting Findings
Unscrambling Your Thought Process
How to Improve Your Memory
Cognitive Problems with CFS

Memory Loss

Taken from the MEssenger dated April 1992 by Tina Harvey, Editor

In its most complete form, memory implies a capacity to recall events and experiences that belong to a person's past life. Somehow by a process, not fully understood, our lifetime is recorded in our brain. It is also crucical for survival.

Our pattern of existence depends upon memory. What we smell, see, hear, touch and taste becomes a memory in our brain. Our brain interprets the world around us using past perceptual activity thus ensuring survival by optimizing success and avoiding failure. Memory is often a reconstruction of events and forgetting can occur minutes after learning something new. hese imperfections must be balanced with losses that can occur because of fatigue, depression, aging, stress, head injury, illness, alcohol, drug abuse, etc. When an individual experiences these losses or changes, the consequences can be alarming.

Research with computerized assessment of memory and dementia has indicated that memory loss in M.E. patients was far greater and more specific than initially assumed. It is the loss of memory, and the intellectual ineffeciency that follows, that is the most difficult for M.E. patients to accept. Patients complain that decisions that were once easily made, now have becaome an insurmountable chore and can be a source of prcrastination. Thoughts get lost in mid-sentence and blank spots replace missing words. There are feelings of mental fogginess and mental lethargy.

Even when the physical symptoms of M.E. are in remission, this memory and concentration loss persists and is often invisible to friends and physicians. It produces disappointment, frustration and depression. To some it can be more devastating than a doctor's busy receptionist.

Because of this cognitive dysfunction that most patients experience during the course of their illness, I have decided to devote a large part of this issue to memory loss. Part II of the Second Annual Los Angles CFIDS conference on Current Theory, Treatment and Patient Advocacy in memory impairments will be presented.  Drs. Bastien and Sandman both present evidence for the involvement of the left temporal lobe in memory disorder.

To quote Dr.Curt Sandman"The cognitive problems of CFIDS are unique, difficult to diagnose, and a challenge for rehabilitation". In this issue and the next, Dr. Tarras G. Onischenko presents different strategies, tasks, theories and games - a cognitive rehabilitation - for patients with ME/CFIDS/CFS. I will be putting these up later.

As promised , the finding of hormonal deficiencies found in ME patients, summarized in a Backgrounder report, are presented here.

HORMONAL DEFICIENCES FOUND IN CFS



My Emotions with CFS Section delves into the emotions surrounding chronic fatigue - emotions which all of you have experienced in whole or in part. However, because of the length of the major points introduced in this issue, I have not been able to include a section on Alternative/Complementary Medicine. I plan on continuing it in future issues.

SEE EMOTIONS WITH CFS


Research on Memory Loss

Second Annual Los Angeles CFIDS Conference - Research on Memory Loss

Current Theory, Threatment and Patient Advocacy - Part II Held on May 18-19, this conference was coordinated and sponsored in part by Jay. A. Goldstein, M.D. This issue will address the frequent complaints of poor memory and difficulty concentrating, and then provide a few suggestions on how to overcome these problems. Reproduced from Fibromyalgia Network (October 1991)


Index
IQ isn't Everything!
Few of the more Interesting Findings
Unscrambling Your Thought Process

IQ Isn't Everything!

Some say that the memory impairment in CFIDS patients is non-existent. It's just a smoke screen for depression, anxiety or whatever problems ails them. But there were at least two presenteres at the Los Angeles conference who chose to ignore this claim.

Psychologist Shelia Batien, Ph.D, of Bereley, CA said that she would like to dispute the recent Canadian study that attempted to show no impairment in CFS patients' IQ. "I think it depends on what you're looking for". Then she explained that the IQ test consists of a battery of individual exams designed to measure several different areas of brain function, such as verbal and visual recall, spacial perception and other performance skills. While patients may excel in some areas, they blunder in others. When the individual tests are plotted on a graph, Bastien says it looks "saw toothed", with the average value (the IQ score) being within the normal range.

All of the 85 CFIDS patients in Dr. Bastien's study met the CDC criterai for this conditon. The clinical and laboratory data for this group will soon be published in The Annuals of Clinical Medicine due to the collaborative efforst of well-known researchers Daniel Peterson, M.D., Paul Chaney, M.D., Anthony Komaroff, M.D., and others. 71% were women, 77% were college educated and 57% were professionals or had held high level management positions.

Few of the more interesting findings:

* Verbal recall was poor
* Visual discrimination was below normal, which means that patients didn't scan efficiently. "They would be looking at something and not really see it".
* Spacial perception reasoning was not what it should be. This means that the individuals may be troubled by the simple task of putting together blocks into a form-board square when blind-folded.
* Dyscalia was a problem. "Over 50% of the patients couldn't subtract $7.18 from $15.00" remarked Baetein.

* Patients gave a poor performance on the Draw-A-Person test in which patients are asked a person. "Some of these drawings look like they were done by a three or four year old. There was a gross immaturity or drawing, lack of details, omition of body parts, large or flat heads, scribbled fingers and sometimes no clothing."


According to Bastien, veral memory is mediated by the left temporal lobe while visual memory is more likely to be facilitated by the right temporal lobe. Based on this knowledge of brain function, she concludes that the left temporal lobe is more significantly impaired than the right side. This happens to coincide with two other brain imaging studies (BEAM and SPECT) mentioned in the April 91 issue. (The BEAM test results showed no difference between FM and CFIDS patients).

"The Draw A Person test", says Bastien, "is valid for it's organic indicators or right parietal lobe dysfunction". And the lack of motor skills required to place blocks into foam board square when blind-folded may hint at a problem in the left temporal lobe.

Summarizing her studies, Dr. Bastien said, " The pattern of impairment is consistent across the study group, although the levels may vary. It's not the pattern seen in Alzheimer's disease, head injury, PMS, lupis, anxiety, personality disorder of situational stress....The most affected areas are the left temporal, right parietal and left frontal lobes of the brain".

Another study by psycholigist Cur Sandman, Ph.D, of The University of California at Irvine says "On conventional standardized testing of IQ, CFIDS patients may do as well as normal controls". However, Sandman has developed a series of tests that are more sensitive to memory disorders in general. They can identify problems that may not be picked up on the IQ score alone.

"CFIDS patients do well to retreive everything that they store in their brain", says Sandman, "but they just don't seem to get it all". In other words, they encounter difficulties in making memories and interference or distractions can further compound this problem. "Many CFIDS patients can't recall 3 letters after 10 seconds of interference!" And when it comes to measuring how much information a person can store before they get confused, "CFIDS patients suffer terribly as the amount of information that they have to remember increases".

"If there is something wrong with the memory,", Sandman reasoned, "there should be something wrong with the brain". Sandman has evaluated the computerized EEG results from 12 CFIDS patients using loud sounds as stimuli. This test is designed to objectively measure short term memory function and decision making. Although the study sample was small, the EEGs were different from normal controls and Sandman hypothesized that both the temporal lobe and hippocampus (part of the limbic system) are involved in this disorder.

UNSCRAMBLING YOUR THOUGHT PROCESS

Drs Bastien and Sandman have both discussed the memory problems faced by CFIDS patients in a laboratory environment.  But, how can these impairments relate to daily activities?

Pychologist Linda Iger, Ph.D., of Anaheim Hills, CA, says that patients may get lost or confused when they go to large shopping malls.  "This happens because they are barraged with too much visual information, both in the background and foreground". The same problem may crop up when a person attempts to read a page from a book. All those words jump out of the page at you and it's easy to loose track of where you are at."

"To improve your ability to remember what you are reading, it is best to focus on what is being read," said Iger. Then she held up a post card with a 2" wide by 1/4" tall slit cut out of the center and suggested that patients use such a device to help highlight the section of words currently being read.

Building upon Dr.Iger's example for reading, patients should make a conscious effort to filter out the crowd of faces, the bright lights and other distractions typically encountered in public places such as shopping malls.
As silly as it may sound, those funky looking, then-slit visors that were popular in the 60's may come in handy for the FM/CFIDS impaired.

In order to record in your memory important items - free of surrounding static - Sandman says, "You have to do something to amplify the input to get your attention to register better". This seems like sound advice, given that most patients are bothered by fatigue that staying alert is a major task for them. Yet, how does a person go about amplifying the information that they need?
SEE HOW TO IMPROVE YOUR MEMORY BELOW


How to Improve Your Memory

In order to record in your memory important items - free of surrounding static - Sandman says, "You have to do something to amplify the input to get your attention to register better". This seems like sound advice, given that most patients are bothered by fatigue that staying alert is a major task for them. Yet, how does a person go about amplifying the information they need?
To answer this question, Sandman used the analogy of rats in a maze.
"Throw a cat into the maze of rats and they'll find the way out much faster"!
This form of jogging the mental processes can work, but may become exhausting after repeated use. However, the concept of amplifying the stimuli (which is what the cat does) is certainly valid.
The hippocampus portion of the brain is known to be involved in Alzheimer's and it is speculated to be involved in CFIDS. "The hippocampus is very vulnerable to disease", comments Sandman. In additon, "it's responsive to the environment and highly sensitive to experience".  For example, if you can associate a new acquaintance's name or face with someone that you already know, you will be more likely to remember them.

Associating new input with old experiences isn't the only way you can improve your memory. According to Dr. Iger, you can also make things tand out by associating them with color, size, shape or proximity.  If you have trouble remembering where you parked your car at the super market, make a mental note that it's on the left or right hand side of the store entrance, or that it's near a pole, a tree or other object in the parking lot.

It is also important to trim down tasks, comments Iger. By doing so, you can improve your capacity to remember. For example, break down a street number, such as 1740 into 17 and 40. And if you just happen to be 40 years old, this latter number can be linked with something already learned to increase your liklihood of remebering it.

Restructuring the way in which you store information can require a lot of effort on your part. And, it can be as frustrating as a six year old in first grade learning how to read for the first time. So, while you're training your brain to see things in a different light, take full advantage of writing information down and posting notes for yourself (Post-it pads are great for this). You'll eventually get the hang of it.

If you are still searching for tips on how to improve your memory, Drs.Sandman and Iger just published articles on this subject in the August 91 issue of Physician's Forum - put out by the CFIDS Association. The cost of this issue is only $6.00 in the US and can be ordered from the Association at: P.O.220398, Charlotte, NC 28222.


What types of cognitive dysfunction are associated with CFS?

CFS patients commonly report one or more symptoms of cognitive dysfunction, including confusion, difficulty in concentrating, impaired thinking, and forgetfulness. Patients often regard these symptoms among the most debilitating features of CFS. This information was taken from the CFS Home Page.


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