A unifying theory for cognitive abnormalities in functional neurological disorders, Fibromyalgia and CFS (2018), Mark J Edwards et al.

[adambeyoncelowe]

http://jnnp.bmj.com/content/early/2018/05/06/jnnp-2017-317823

I'm not sure if this is the 'biomedical research' MRC claimed to be funding: http://gtr.ukri.org/projects?ref=MR/M02363X/1

They're similar but not identical. Perhaps an early spin-off? They like to make a meal from bad research, don't they? Faggot fallacies, etc.

A unifying theory for cognitive abnormalities in functional neurological disorders, fibromyalgia and chronic fatigue syndrome: systematic review

1. Tiago Teodoro1,2,3,
2. Mark J Edwards1,2,
3. Jeremy D Isaacs1,2

Author affiliations

Abstract
Background Functional cognitive disorder (FCD) describes cognitive dysfunction in the absence of an organic cause. It is increasingly prevalent in healthcare settings yet its key neuropsychological features have not been reported in large patient cohorts. We hypothesised that cognitive profiles in fibromyalgia (FM), chronic fatigue syndrome (CFS) and functional neurological disorders (FNDs) would provide a template for characterising FCD.

Methods We conducted a systematic review of studies with cognition-related outcomes in FM, CFS and FND.

Results We selected 52 studies on FM, 95 on CFS and 39 on FND. We found a general discordance between high rates of subjective cognitive symptoms, including forgetfulness, distractibility and word-finding difficulties, and inconsistent objective neuropsychological deficits. Objective deficits were reported, including poor selective and divided attention, slow information processing and vulnerability to distraction. In some studies, cognitive performance was inversely correlated with pain, exertion and fatigue. Performance validity testing demonstrated poor effort in only a minority of subjects, and patients with CFS showed a heightened perception of effort.

Discussion The cognitive profiles of FM, CFS and non-cognitive FND are similar to the proposed features of FCD, suggesting common mechanistic underpinnings. Similar findings have been reported in patients with mild traumatic brain injury and whiplash. We hypothesise that pain, fatigue and excessive interoceptive monitoring produce a decrease in externally directed attention. This increases susceptibility to distraction and slows information processing, interfering with cognitive function, in particular multitasking. Routine cognitive processes are experienced as unduly effortful. This may reflect a switch from an automatic to a less efficient controlled or explicit cognitive mode, a mechanism that has also been proposed for impaired motor control in FND. These experiences might then be overinterpreted due to memory perfectionism and heightened self-monitoring of cognitive performance.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

 

[Andy]

Functional cognitive disorder

MUPS by another name?

 

[Daisybell]

Reading this abstract just made me say ‘oh, f*** off’.
I’d like to give them the experience and then see how keen they would be to write such offensive twaddle.

 

[James Morris-Lent]

Perusing this piece is quite surreal. You see glimmers of lucidity in which the authors appear to understand that they are driveling... and then they drivel vigorously. Like they know their belief system is warped and nonsensical, but they can't yet bear to leave the cult. I wish I could express this better.
C'mon guys, listen to your doubts... break free! Well, I won't get my hopes up.

twaddle

 

[adambeyoncelowe]

They're definitely overinterpreting. It's a nonsense study that doesn't make sense.

@Jonathan Edwards, what do you think, as a scientist? It was all psychobabble to me!

 

[Cheshire]

Some interesting comments on that thread:

 

[adambeyoncelowe]

It's the opposite of Occam's Razor: they're using torturous arguments to prove their theory, when it makes far more sense that objective neurocognitive problems are precisely that.

 

[Trish]

MUPS by another name?

They seem to be inventing yet another 'functional' disorder, this time it's 'functional cognitive disorder', so I guess an alternative would be MUCS - medically unexplained cognitive symptoms. (where MUPS is medically unexplained physical symptoms).

If we're inventing acronyms, how about medically unexplained cognitive underperformance syndrome (MUCUS). Then they could hold a conference about MUPPETS with MUCUS.

Seriously though, these 'systematic reviews' we keep seeing are rubbish. Take a bunch of unrelated poorly designed studies on ill defined cohorts of patients using a variety of different subjective cognitive tests - GIGO - garbage in, garbage out.

Definition of hypothesise = make stuff up.

 

[Cheshire]

When inconsistency becomes a proof your "unifying theory" is correct, you'd better start it all over again and throw your model in the dustbin...

Patients with CFS showed an increased intraindividual variability on performance on repeated neuropsychological testing.140 Significant variability of self-reported mental fatigue was also observed on repeated assessment.141

These findings can be regarded as evidence for internal inconsistency, which is considered a cardinal feature of functional neurological symptoms in general.6

 

[Hoopoe]

These guys need to work on their obfuscation skills. It's too obvious this is just bullshit.

 

[Amw66]

Seen in context with @Dx Revision Watch being " sacked" and IAPT roll outs, this is potentially more dangerous than would first appear

 

[Hutan]

When inconsistency becomes a proof your "unifying theory" is correct, you'd better start it all over again and throw your model in the dustbin...

Significant variability of self-reported mental fatigue was also observed on repeated assessment.141

These findings can be regarded as evidence for internal inconsistency, which is considered a cardinal feature of functional neurological symptoms in general.6

I was amazed by this bit too @Cheshire. By this argument, people with peanut allergy must be just making it all up. I mean, 'one minute they're fine and the next minute they are carrying on, claiming they can't breathe and feel sick'.

How long would the authors have to really listen to people with ME/CFS before they understood that, in all but the most severe cases, cognitive symptoms change over time? Well rested, cognitive function may be fine. After repeated exertion or during PEM, cognitive function may be extremely compromised.

You see glimmers of lucidity in which the authors appear to understand that they are driveling... and then they drivel vigorously.

Yes, it's clear that prejudice is triumphing over intellect. But every now and then, the intellect is visible before dogma just spews all over it.

 

[Luther Blissett]

Routine cognitive processes are experienced as unduly effortful. This may reflect a switch from an automatic to a less efficient controlled or explicit cognitive mode, a mechanism that has also been proposed for impaired motor control in FND. These experiences might then be overinterpreted due to memory perfectionism and heightened self-monitoring of cognitive performance.

or... They might be noticed by third parties who know the patient well and remarked upon as being unusual and out of character you absolute maroons. They might even independently notice a pattern. Is memory perfectionism contagious?

The fact that a person with arthritis will be effected differently by weather conditions is not a sign that they believe arthritis is secretly controlled by the sky gods.

 

[Trish]

Told my daughter (with ME) about this over lunch. In the spirit of helpfulness to those producing this stellar piece of research, she's come up with two new acronyms for those of us who have both cognitive and physical symptoms:
Medically Unexplained Cognitive & Unexplained Physical Symptoms
Functional Unexplained Cognitive & Unexplained Physical Symptoms.

 

[Hutan]

To Trish's daughter -

 

[Sean]

We hypothesise that pain, fatigue and excessive interoceptive monitoring produce a decrease in externally directed attention. This increases susceptibility to distraction and slows information processing, interfering with cognitive function, in particular multitasking. Routine cognitive processes are experienced as unduly effortful. This may reflect a switch from an automatic to a less efficient controlled or explicit cognitive mode, a mechanism that has also been proposed for impaired motor control in FND. These experiences might then be overinterpreted due to memory perfectionism and heightened self-monitoring of cognitive performance.

Same old, same old.

 

[TiredSam]

Well I didn't need to read past the first sentence ...

Abstract
Background Functional cognitive disorder (FCD) describes cognitive dysfunction in the absence of an organic cause.

What does "in the absence of an organic cause" mean? There was an absence of an organic cause for stomach ulcers. Until there wasn't. Get in the lab and do some work instead of hypothesising and making up new mental disorders.

 

[arewenearlythereyet]

 

[Barry]

Working memory was often reported to be abnormal only in more effortful tasks ...

Those would be the ones with the greatest energy demand then.

 

[NelliePledge]

They just take the same handful of terms and pull out a new random combination. Shuffling the pack to make it appear like a new idea when it really is just the same old BS. It’s not even old wine in new bottles it is old wine in recycled bottles that haven’t even been washed before refilling.....

I think @Trish daughter sums it up especially with her second new acronym it is a total one of those