The Conners Continuous Performance Test CPT3™: Is it a reliable marker to predict neurocognitive dysfunction in ME/CFS ? 2023, Fernandez-Quiros et al

The Conners Continuous Performance Test CPT3™: Is it a reliable marker to predict neurocognitive dysfunction in Myalgic encephalomyelitis/chronic fatigue syndrome?

Introduction: The main objective is to delimit the cognitive dysfunction associated with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in adult patients by applying the Continuous Performance Test (CPT3™). Additionally, provide empirical evidence on the usefulness of this computerized neuropsychological test to assess ME/CFS.

Method: The final sample (n = 225; 158 Patients/67 Healthy controls) were recruited in a Central Sensitization Syndromes (CSS) specialized unit in a tertiary hospital. All participants were administered this neuropsychological test.

Results: There were significant differences between ME/CFS and healthy controls in all the main measures of CPT3™. Mainly, patients had a worse indicator of inattentiveness, sustained attention, vigilance, impulsivity, slow reaction time, and more atypical T-scores, which is associated with a likelihood of having a disorder characterized by attention deficits, such as Attention Deficit Hyperactivity Disorder (ADHD). In addition, relevant correlations were obtained between the CPT3™ variables in the patient’s group. The most discriminative indicators of ME/CFS patients were Variability and Hit Reaction Time, both measures of response speed.

Conclusion: The CPT3™ is a helpful tool to discriminate neurocognitive impairments from attention and response speed in ME/CFS patients, and it could be used as a marker of ME/CFS severity for diagnosing or monitoring this disease.

https://www.frontiersin.org/article...ME/CFS) is,frequently related to acute stress.

 

It would have been better if we were told exactly what tasks PWME were 'worse' on rather than pre-interpreting them in psychological terms.

But maybe there is something here that might be of use.

I have a sneaking feeling that I would only take seriously the results of a test of cognitive function in PWME if the PWME did not know at the time that they were being tested for cognitive function. I would also like to be sure that patients had not been chosen to do the test because someone thought they had problems with certain sorts of cognitive function.

A tough ask, I realise.

 

Doable with the help of something like DecodeME, if you asked participants to log in to an online survey which required multiple Captchas and other fiendishly complicated verification processes. You’d need a very latency-sensitive back end to get trustworthy results, but it would be technically and ethically achievable.

 

trouble is you cannot do any research on people without asking them if it is alright to do it. So if the intention was to publish data on cognition you would have to ask the patients to fill in a consent form before doing the multiple Captchas! Of course that might do the job but if it did you would have to ask them first....

 

I loathe captchas on any logins even with good eye sight the images can be very poor quality and sometimes do not have the wanted item in any image.

 

Which would be a good cover story for using a novel, if very time-consuming, alternative to captchas.

I’ve been frustrated IRL by overly deontological interpretations of ethics which make it impossible to commission work from universities. Transparency and consent are all very well, but when they have obviously confounding consequences it’s perfectly reasonable to sidestep them without going full Milgram.

 

IRL = In real life

 

So perhaps what is needed is a consent form that is so complicated that it could act as a cognitive test.

(This was intended as a joke).

 

It seems that the test, the 3rd Conners Continuous Performance Test, CPT3™ mostly measures attention deficits and is used to diagnose ADHD. It's a computerized test that takes 14 minutes. Patients sit in front of a computer screen and have to press the spacebar when any letter except “X” appeared on the monitor. They have to respond as fast but also as accurate as they can.

ME/CFS patients performed worse than controls on most outcomes. The authors write in their conclusion:

"The high variability of the response speed and the slow reaction time obtained indicate that ME/CFS suffer dysfunctions in the efficiency of information processing and commit more errors of omission, commission, and perseverance than healthy controls, presenting not only more attention problems, but being slower and with greater inconsistency in response speed when performing this test."​

 

I feel so sorry for the Barcelona patients who are being referred to a ‘central sensitization service’. It sounds like they are doomed from the get go.

 

I have done several of these computer-based, science calibre neuro-cognitive tests. They can be challenging and cause PEM. I developed a tactic over time, to get through them with the least amount of pain. Of course, knowing what test is being administered helps (say, remembering playing cards, or find a path). I guess over time I got better for my tests because I knew how to do them. But I found that focusing on speed, ie, getting it done as fast as possible reduced the amount of time I was in physical pain while doing the tests.

I do not think that neuro-cognitive tests tell the whole picture though. You have to factor in the amount of energy it takes to get on site, the amount of pre-emotive rest, the severity and you have to follow the patients up afterwards in the same manner as a 2 days CPET.

 

Easy to do a large scale internet test. Even when I was much less severe I had the same problem which is easily measured. Things like memorising numbers or tracking things on the screen I manage well for the first few times then I get slower then I can't control my arms to hit the buttons accurately then I collapse. It is the repetitive nature of the thing that causes the problem.