Christodoulou, C, DeLuca, J, Lange, G et al. · Journal of neurology, neurosurgery, and psychiatry · 1998 · DOI
This study looked at whether memory and attention problems in ME/CFS patients are linked to how much their daily activities are limited. Researchers tested 53 ME/CFS patients and 32 healthy people on memory and concentration, and found that patients with more failing test scores reported spending significantly more days inactive. Importantly, this connection held true even when accounting for depression, suggesting the cognitive problems themselves—not just mood—contribute to disability.
This research provides evidence that cognitive impairment in ME/CFS is not merely a psychological symptom but an independent contributor to functional disability. Demonstrating that cognitive deficits remain associated with inactivity even after controlling for depression strengthens the case that objective cognitive dysfunction deserves clinical attention and resource allocation in ME/CFS care.
The study does not establish whether cognitive impairment causes functional disability or vice versa—only that they are correlated. It also does not clarify the biological mechanisms underlying cognitive impairment, measure post-exertional malaise specifically, or track whether cognitive rehabilitation improves functional outcomes.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Christodoulou, C, DeLuca, J, Lange, G, Johnson, S K, Sisto, S A, Korn, L, et al. (1998). Relation between neuropsychological impairment and functional disability in patients with chronic fatigue syndrome.. Journal of neurology, neurosurgery, and psychiatry. https://doi.org/10.1136/jnnp.64.4.431
BibTeX
@article{mecfsatlas-christodoulou-1998-relation-between,
author = {Christodoulou, C and DeLuca, J and Lange, G and Johnson, S K and Sisto, S A and Korn, L and Natelson, B H},
title = {Relation between neuropsychological impairment and functional disability in patients with chronic fatigue syndrome.},
journal = {Journal of neurology, neurosurgery, and psychiatry},
year = {1998},
doi = {10.1136/jnnp.64.4.431},
note = {PubMed: 9576531},
url = {https://www.mecfsatlas.com/evidence/christodoulou-1998-relation-between},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/christodoulou-1998-relation-between
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