New Name For "Brain Fog"?

My thanks to rvallee for pointing out that "brain fog" has no medical name and therefore no proper, medical recognition. I seem to have internalized the fact so deeply that the obvious had escaped me. The "fog" has been, for me, as bad as the lead overalls. If I could just stay in but still function well mentally, it would be a whole different world. One example that comes to the befuddled brain is from a few years ago after the auto-checkouts came in, at the supermarket. I had a common item, a fruit or vegetable, but I couldn't for the life of me remember the name of it, so bad was the fog; so I couldn't select it in the auto-checkout menu. I stood there for several minutes, feeling more like a fool than usual and trying to look busy until it finally came to me. It's such moments that make one realize that the walls around one's life have just closed in that little bit more. Yet it is still not something that is generally recognized as a thing and it really should be.

While I understand that starting up another name war might well be counter-productive, having a good, precise name for it seems essential. And, while the plain English of "brain fog" has long seemed to me to be perfectly apt, apparently it lacks the respect of medical profession. Neither word has a classical root and, obviously, to be accepted it must have a Latin or Greek root. And such terms as "cognitive dysfunction" are also too broad and imprecise. I've had a little look around and there is a good Latin word that could be applied: "caligo". It means darkness, fog, mist, vapour, gloom and even specifically "mental fogginess". The problem with it is that it has already been used as a medical term, albeit one that is now obselete, meaning: "dimness or obscurity of sight, caused by a speck on the cornea". It would probably be disqualified on that basis so I'm wondering if there is another term. Obviously the idea is to find one that makes medical professionals feel clever by knowing it and being able to define and apply it; and it should be ready and available to hang the appropriate, specific definitions onto as and when they are discovered.

Perhaps one could go Greek with "Idiopathic Omíchli" (another "fog" word). I've also thought that "Idiopathic Idiocy" might appeal to some sections of the medical profession (both words also have Greek roots) but maybe I should shut up now. Any ideas?

 

I've used cognitive impairment when talking to people about my daughter's issues. Or sometimes impaired cognitive processing.

We need something short, that doesn't allow BPSers to reduce it to poor concentration/memory issues.

I agree that it is a huge issue. I think it came out top of a poll on here, for being the worst symptom.

 

In Sweden there's a proper medical neurological term for brain fog: "hjärntrötthet" (literally "brain tiredness") or "mental trötthet" ("mental tiredness").

I believe the official English term for it, used in research papers etc, is "brain fatigue" and/or "mental fatigue".

There are clinical tools too, for example the Mental Fatigue Scale (MFS).

It includes symptoms/cognitive impairments that are common in diagnoses like for example stroke, traumatic brain injury, concussion, MS, Parkinson's, Alzheimer's, narcolepsy, as well as ME.

ETA 1: Here's a very informative website (under development):
http://brainfatigue.se/en/homepage/

ETA 2: Another medical website about "hjärntrötthet" (in Swedish):
https://www.internetmedicin.se/behandlingsoversikter/neurologi/hjarntrotthet/

ETA 3: Here are the items on the MFS:

Fatigue in general
Lack of initiative
Mental fatigue
Mental recovery
Concentration difficulties
Memory problems
Slowness of thiking
Sensitivity to stress
Emotional instability
Irritability
Sensitivity to light
Sensitivity to noise
Decreased sleep
Increased sleep

 

For myself, I've never liked or related to the term 'brain fog'. Dr. Alain Moreau of the OMF uses the term 'foggy brain' when describing ME and OI.

I agree with @MEMarge that difficulty/impairment with processing and absorbing information gives a better description. My cognitive stamina is reduced in PEM and OI. I'm not in a 'fog'.

 

What about mental exhaustion? Double ME/ME.

Edit: I just googled mental exhaustion and 'burnout' kept showing up. Ugh.

 

I only use the germ brain fog when talking to a fellow pwME 'cause it's quicker /feels easier to say.

Otherwise it's cognitive dysfunction or impairment.

I agree with @Trish in that "dysfunction" sounds less permanent. However, to me, impairment more effectively captures the level of the problem. Which can be days, weeks or longer without the ability to read, make decisions, hold a conversation.

Like with physical function I think fatiguability is more accurate for me than cognitive fatigue. I believe this is a downstream symptom though.

The important thing for me is the failure of the ability to process. So I have to work harder which hastens the deterioration.

I agree our terminology doesn't accurately describe it and also that whatever terminology we chose the BPSers will "reinterpret" it if it suits because, let's face it, if they had an original thought among them it would be a very lonely thing.

On the one hand, in an ideal world, the vagueness of the terminology might be a good thing as it might be less likely to blinker researchers. On the other it would be nice to have different terms so it's less confusing when discussing the issue as one person may be talking about complete failure to form coherent thoughts while another might be talking about forgetting the plot to a film they saw the day before - though both are bothersome.

 

Agree. My cognitive impairment isn't permanent, but just like physical PEM, it can develop into less and less stamina over time. I don't think we will ever find a proper descriptive term to describe it though.

 

The piece quoted in the first message is from here:

https://www.s4me.info/threads/possi...ovid-19-long-covid.14074/page-107#post-293367

 

Just to note that in ICD-11:

https://icd.who.int/dev11/l-m/en#/http://id.who.int/icd/entity/1505501372

Chapter: 21 Symptoms, signs or clinical findings, not elsewhere classified

Parents:

• 21 Symptoms, signs or clinical findings, not elsewhere classified
• Mental or behavioural symptoms, signs or clinical findings
• MB20 Symptoms, signs or clinical findings involving consciousness
• MB20.2 Clouding of consciousness

MB20.2 Clouding of consciousness

Description
An impairment in the clarity of consciousness characterised by impaired ability to comprehend aspects of the environment or the self in relation to the environment, inattention, and abnormalities in thought processes, comprehension. It is typically accompanied by subjective experience of mental clouding described as feeling ‘foggy’. Clouding of consciousness is a common form of cognitive disturbance in Delirium, but it is not synonymous with Delirium because Delirium includes additional diagnostic requirements.

Exclusions

• Delirium (6D70)

All Index Terms

• Clouding of consciousness
• Clouded state
• brain fog
• mental fog
• Subsyndromal delirium

 

If I had to vote on a term listed so far, I'd go for 'cognitive dysfunction'. I imagine it as something subtly altering the functioning of individual neurons.

 

I've come across the term "foggy brain" in a thyroid research paper quite recently. I don't like it. I prefer the term brain fog. Once someone has suffered from it it can't be mistaken, in my opinion.

 

i have always assumed that when you have insufficient energy to function the autonomous part of the brain takes over deciding to expend energy on the vital things like breathing and vascular control thus their is no energy left over for higher mental function . i actually thought this would be common knowledge .

 

My sister has Hashimoto, and she described her 'brain fog' to me which isn't what I would describe as my experience.

 

Could you describe your brain fog? I'm curious.

I know at my worst that I struggled to read a recipe, prepare the ingredients and cook. I often found myself trying to do things in the wrong order, and found that, for example, if a recipe had 6 ingredients I might be able to read the 2nd, 3rd, 5th and 6th, but working out that there were others and what they were was incredibly difficult. I had difficulties measuring anything as well, and had trouble remembering where I kept the carrots or the flour or whatever.

And getting my breakfast became a farce. I ate cereal at that time, so I would need cereal, milk, a bowl, and a spoon and would struggle to remember where they were, often multiple times. I drank coffee from a percolator but often couldn't remember what the ingredients for it were and how to put them together.

And brain work was always, always utterly exhausting.

 

My sister describes her 'brain fog' as not remembering things and feeling fuzzy head.

For me it feels the same as physical PEM except it's my brain. It's full stop. I can no longer process or absorb information and my brain feels sore. I feel nauseous and off-balance. My calf muscles feel sore. I wear ear plugs, eye pads and don't want to interact with anyone.

 

Yeah, short and pithy would be good, as it is so much more than those things, which are just the results, in my experience.

That's all quite interesting, there being an attempt to explain a mechanism of mental tiredness; as well as to measure those aspects of it on that Mental Fatigue Scale. If it can be shown to be general to various brain impairments, that would be very impressive. They'd get the naming rights, for starters. And I, for one, would be happy for it to be in Swedish! But how can they show that it is the same thing? Brain scans?

That goes to the question of whether we do, indeed, have the same malady; and how it can observed; and variants, if there are some, distinguished. My experience of it is of an all-encompassing "fog". And when it's really bad, it's like being crushed by one ton of marshmellow (I imagine). And there's a whole aura and spaced-out feeling that makes it nigh on impossible to persevere with a disciplined train of thought. But that is only an instance of what one cannot do while one has it, not the depressing reality of what it is. And it isn't necessarily a matter of "stamina" as it feels as if there is a resistive murk that takes real work to push through. At some times my mental stamina might be better than at others to push on through the same (perceived) resistance. And the various elements of the "fog" can vary in intensity so there's an ever-varying palette of misery to keep me entertained.

Yes, it not being permanent needs to be accounted for, too. But while "cognitive dysfunction" does certainly apply, it is too general. But I suppose that until the actual mechanism of it is discovered, that is unavoidable.

You'll start a meme if you're not double careful.

Well, this is it. A whole vocabulary is required. But with the variety of experience, it might not be possible. So one must take refuge in vagueness by necessity. Just as well our brains can cope with that...

Thanks for that. I wasn't aware that it was described there. Still, all they do is elaborate the same, old metaphor as was present in the use of caligo as "mental fogginess".

That's more of less what they called "brain fag", in the olden days, in Wodehouse novels and whatnot. And the term was taken up in Nigeria and elaborated into the CFS-like, students' malady of "brain fag syndrome". Again, my experience has been different. I found, a decade or so ago, that one thing that could bring on an brain-fog episode was sulphite preservatives. But even that, while it happenened often enough to convince me, is not reliable. It is, apparently, more complicated. Which should surprize no-one...

 

They are starting to research this phenomenon in Covid-19:

https://www.medrxiv.org/content/10.1101/2020.10.20.20215863v1

 

I had full Ed Psych cognitive testing as part of dyslexia assessment in both 1997 and 2009. The results showed the exact same 'spiky' pattern of results over the individual tests and sub tests (so an 'uninterpretable' general IQ score) but there was a shift to the left of the standardised scores (after adjusting for my age), hence demonstrating a drop of 20 points in my IQ in general. That was really frightening for me.

Edit. I developed M.E. in 1992, so both tests were done after this.

 

Sometimes I get what I might call brain fog where I have trouble thinking and processing and being bit slow, but it is more usual to get a full stop in thinking in the same way I get a full stop in moving. I don't think this is what they mean in other illnesses.

I have heard people talk about brain fog in MS and pregnancy and they tend to mean problems with words or forgetting what they are doing.

When these concepts are not well known it is very easy to assume we all have the same thing but there are most likely lots of different things going wrong. Even writing this I have trouble trying to describe the full stop of thinking but if it was common to other diseases I am sure I would recognise a description of what happens to them if it matched my experience but it doesn't.