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Investigating neural mechanisms of change of cognitive behavioural therapy for chronic fatigue syndrome: a randomized controlled trial.

van Der Schaaf ME, Schmits IC, Roerink M, Geurts DE, Toni I, Roelofs K, De Lange FP, Nater UM, van der Meer JW, Knoop H - BMC Psychiatry (2015)

Bottom Line: Cognitive behavioral therapy (CBT) has proven to be a successful intervention leading to a reduction in fatigue and disability.Based on previous neuroimaging findings, it has been suggested that central neural mechanisms may underlie CFS symptoms and play a role in the change brought on by CBT.This project creates an unique opportunity to enhance our understanding of CFS symptoms and its change by CBT in terms of neuroanatomical, neurofunctional, endocrinological and immunological mechanisms and can help to further improve future treatments strategies.

View Article: PubMed Central - PubMed

Affiliation: Radboud University Medical Center, Expert Centre for Chronic Fatigue, Nijmegen, The Netherlands. marieke.vanderschaaf@donders.ru.nl.

ABSTRACT

Background: Chronic fatigue syndrome (CFS) is characterized by profound and disabling fatigue with no known somatic explanation. Cognitive behavioral therapy (CBT) has proven to be a successful intervention leading to a reduction in fatigue and disability. Based on previous neuroimaging findings, it has been suggested that central neural mechanisms may underlie CFS symptoms and play a role in the change brought on by CBT. In this randomized controlled trial we aim to further investigate the neural mechanisms that underlie fatigue in CFS and their change by CBT.

Methods/design: We will conduct a randomized controlled trial in which we collect anatomical and functional magnetic resonance imaging (MRI) measures from female CFS patients before and after CBT (N = 60) or waiting list (N = 30) and compare these with measures from age and education matched healthy controls (N = 30). By including a large treatment group we will also be able to compare patients that benefit from CBT with those that do not. In addition, to further investigate the role of endocrine and immune biomarkers in CFS, we will determine cortisol and cytokine concentrations in blood, hair and/or saliva.

Discussion: This project creates an unique opportunity to enhance our understanding of CFS symptoms and its change by CBT in terms of neuroanatomical, neurofunctional, endocrinological and immunological mechanisms and can help to further improve future treatments strategies.

Trial registration: Dutch Trial Register #15852. Registered 9 December 2013 ( http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4311 ).

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Related in: MedlinePlus

Flowchart of fMRI session day. MVC = Maximal voluntaty contraction, MRI = Magnetic resonance imaging, fMRI = functional MRI
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Fig2: Flowchart of fMRI session day. MVC = Maximal voluntaty contraction, MRI = Magnetic resonance imaging, fMRI = functional MRI

Mentions: Participants will be invited to the Donders institute for brain cognition and behavior on two session days separated by approximately 6 months. Each session will include the following procedures: (1) hair and blood sampling. (2) practice of fMRI tasks, including the calibration of MVC for the two fMRI tasks. The practice session is done in a dummy scanner to ensure same body position during handgrip-calibration, practice and fMRI-scanning. (3) MRI scanning, including six scans and a 15 minute break: structural MRI, fMRI during task1, MRS, break, fMRI during task2, DTI and resting state. (4) Behavioral and neuropsychological testing. The order is kept the same across subjects and sessions. An overview of a session day is given in Fig. 2. Written informed consent is given on the first session day. Trait measures such as the adult reading test are only assessed on the first test day. POMS measurements are assessed before sampling, during the break and after behavioral testing. The total duration of each session will be about 5 hours. For CFS patients, questionnaires are assessed as part of the clinical routine of the ECCF prior to the session days. For healthy controls, questionnaires are assessed at home through an internet link, sent to the subjects by email.Fig. 2


Investigating neural mechanisms of change of cognitive behavioural therapy for chronic fatigue syndrome: a randomized controlled trial.

van Der Schaaf ME, Schmits IC, Roerink M, Geurts DE, Toni I, Roelofs K, De Lange FP, Nater UM, van der Meer JW, Knoop H - BMC Psychiatry (2015)

Flowchart of fMRI session day. MVC = Maximal voluntaty contraction, MRI = Magnetic resonance imaging, fMRI = functional MRI
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4489043&req=5

Fig2: Flowchart of fMRI session day. MVC = Maximal voluntaty contraction, MRI = Magnetic resonance imaging, fMRI = functional MRI
Mentions: Participants will be invited to the Donders institute for brain cognition and behavior on two session days separated by approximately 6 months. Each session will include the following procedures: (1) hair and blood sampling. (2) practice of fMRI tasks, including the calibration of MVC for the two fMRI tasks. The practice session is done in a dummy scanner to ensure same body position during handgrip-calibration, practice and fMRI-scanning. (3) MRI scanning, including six scans and a 15 minute break: structural MRI, fMRI during task1, MRS, break, fMRI during task2, DTI and resting state. (4) Behavioral and neuropsychological testing. The order is kept the same across subjects and sessions. An overview of a session day is given in Fig. 2. Written informed consent is given on the first session day. Trait measures such as the adult reading test are only assessed on the first test day. POMS measurements are assessed before sampling, during the break and after behavioral testing. The total duration of each session will be about 5 hours. For CFS patients, questionnaires are assessed as part of the clinical routine of the ECCF prior to the session days. For healthy controls, questionnaires are assessed at home through an internet link, sent to the subjects by email.Fig. 2

Bottom Line: Cognitive behavioral therapy (CBT) has proven to be a successful intervention leading to a reduction in fatigue and disability.Based on previous neuroimaging findings, it has been suggested that central neural mechanisms may underlie CFS symptoms and play a role in the change brought on by CBT.This project creates an unique opportunity to enhance our understanding of CFS symptoms and its change by CBT in terms of neuroanatomical, neurofunctional, endocrinological and immunological mechanisms and can help to further improve future treatments strategies.

View Article: PubMed Central - PubMed

Affiliation: Radboud University Medical Center, Expert Centre for Chronic Fatigue, Nijmegen, The Netherlands. marieke.vanderschaaf@donders.ru.nl.

ABSTRACT

Background: Chronic fatigue syndrome (CFS) is characterized by profound and disabling fatigue with no known somatic explanation. Cognitive behavioral therapy (CBT) has proven to be a successful intervention leading to a reduction in fatigue and disability. Based on previous neuroimaging findings, it has been suggested that central neural mechanisms may underlie CFS symptoms and play a role in the change brought on by CBT. In this randomized controlled trial we aim to further investigate the neural mechanisms that underlie fatigue in CFS and their change by CBT.

Methods/design: We will conduct a randomized controlled trial in which we collect anatomical and functional magnetic resonance imaging (MRI) measures from female CFS patients before and after CBT (N = 60) or waiting list (N = 30) and compare these with measures from age and education matched healthy controls (N = 30). By including a large treatment group we will also be able to compare patients that benefit from CBT with those that do not. In addition, to further investigate the role of endocrine and immune biomarkers in CFS, we will determine cortisol and cytokine concentrations in blood, hair and/or saliva.

Discussion: This project creates an unique opportunity to enhance our understanding of CFS symptoms and its change by CBT in terms of neuroanatomical, neurofunctional, endocrinological and immunological mechanisms and can help to further improve future treatments strategies.

Trial registration: Dutch Trial Register #15852. Registered 9 December 2013 ( http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4311 ).

Show MeSH
Related in: MedlinePlus