This is a retrospective and case–control study. Controls don´t suffer from diseases or take drugs. The exclusion criteria were: be unable to conduct clinical sessions or filling out the research questionnaires, be participating in another study, pregnancy, lactation, major surgical intervention in the last year, treatment with chemotherapy, radiotherapy, immunotherapy or systemic steroids during the investigation period, drug abuse in the past or present, morbid obesity, a history of cranial surgery or severe head-brain trauma. All patients meet the criteria of Fukuda-1994 and/or Carruthers-2011. The inclusion criteria were: age among 18–68 years, of caucasian ethnicity, provide a medical report for CFS/ME diagnose, a general blood-urine analysis in the last 6 months and a normal ECG-rest. All participants sign the informed consent. The study was approved by the Ethics Committee for Research with Human Beings (CEISH) of the University of the Basque Country (nr. One hundred and thirteen participants were recruited, 91 affected with CFS/ME and 22 controls, during the period October 2017–December 2019. The present work is carried out through a simple test, which can be used by the general practitioner in order to orientate the evaluation of patients or by researcher to evaluate the follow up. Īttention is a multidimensional phenomenon, ambiguous and elusive, a central function devotes to control and guide the conscious activity according to a specific objective. There isn´t motor deficit, vocabulary, reasoning and global functioning. The deficit depends mainly on the compromise of attention, memory and reaction time. A meta-analysis concluded that the cognitive deficit is a primary finding independently of emotional state of patients. In spite of the plethora of symptoms showed usually by these patients often neurological manifestations are specially relevant and among them cognitive disorders have been described playing a central role. In any case, all agree that women suffer the disease at least 1.5 to twice more higher than men. Studies about prevalence point to a 0.89%, but with a very wide range depending on authors and the methodology. CFS/ME is considered a neuro-immune-endocrine dysfunction or a post-effort neuro-immune depletion. Although, an immune compromise, such as a viral infection, is often reported by patients at the beginning of the process a morphological or biological correlation is still undefined. Fatigue and post-exertional malaise must not be related to organic or mental pathology, being of idiopathic origin. The nuclear symptoms in this pathology are the chronic central fatigue (> 6 months) and the post-exertional malaise with recovery time longer than 24 h. At the present, there is a large number of scientific contributions, but it is still without clarifying its pathological substrate. It has been attributed, in part, for lacking of specific tests. The pathophysiology is still unknown, remaining elusive for an etiological diagnosis. This nomenclature didn’t aim to replace Myalgic Encephalomyelitis (ME) and both terms (CFS/ME) were assimilated in the first world symposium (Cambridge-1990) for this pathology appearing both under the neurological heading in the ICD-11 (8E49). Chronic Fatigue Syndrome (CFS) was described in 1988 by the Centers for Disease Control and Prevention (CDC). It already appears as a neurological illness in the International Classification of Diseases (ICD-8). Myalgic Encephalomyelitis (ME) was the name proposed by Acheson for a group of epidemic outbreaks that took place between 19 in different countries. Deficits in sustained attention and the perception of fatigue, so effort after performing the proposed test are a sensitive and reliable indicator that allows us to substantiate a clinical suspicion and refer patients for further studies in order to confirm or rule out CFS/ME. There were no significant differences between genders in GIAP or fatigue for CFS/ME however, sick women perceive cognitive effort higher than men. Most of patients maintain normal cognitive function, showing low or very low attention score in the 70% of patients with a marked cognitive fatigue compared to the control group (p < 0.05). The final sample were 84 patients (66 women/18 men) who met diagnostic criteria (Fukuda-1994, Carruthers-2011) and 22 healthy controls (14 women/8 men). Cognitive function is explored using the Montreal Cognitive Assessment, the maintained attention using the Toulouse-Piéron test with which the Global Index of Attention and Perception (GIAP) is obtained, the fatigue using the visual analog scale and the perception of effort using the modified Borg scale. The maintained attention is the cause of great functional limitations in CFS/ME, a disease that mainly affects women in the central period of life.
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