Kawatani, Junko, Mizuno, Kei, Shiraishi, Seishi et al. · Brain & development · 2011 · DOI
This study looked at thinking and attention problems in children with ME/CFS using a specialized test that measures how quickly and accurately the brain can process information. Children with ME/CFS performed worse on attention tasks compared to healthy children, especially when they had to switch between different tasks. After 6 months of combined treatment with therapy and medication, children showed improvements in both their thinking ability and fatigue levels.
This study demonstrates that cognitive dysfunction—particularly in attention switching and working memory—is measurable and may be a neurobiological feature of pediatric ME/CFS. The finding that treatment improvements correlate with improved attention performance suggests that cognitive deficits are not simply psychological but may reflect underlying neurological changes worth investigating further.
This study does not establish which components of combined treatment (CBT, medication, or both) drive improvement, nor does it prove that attention deficits cause fatigue or vice versa—only that they co-occur and may improve together. The small sample size and lack of control groups receiving only CBT or only medication limit generalizability. It also does not clarify whether cognitive dysfunction is primary to ME/CFS pathogenesis or secondary to fatigue and deconditioning.
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
Kawatani, Junko, Mizuno, Kei, Shiraishi, Seishi, Takao, Miyuki, Joudoi, Takako, Fukuda, Sanae, et al. (2011). Cognitive dysfunction and mental fatigue in childhood chronic fatigue syndrome--a 6-month follow-up study.. Brain & development. https://doi.org/10.1016/j.braindev.2010.12.009
BibTeX
@article{mecfsatlas-kawatani-2011-cognitive-dysfunction,
author = {Kawatani, Junko and Mizuno, Kei and Shiraishi, Seishi and Takao, Miyuki and Joudoi, Takako and Fukuda, Sanae and Watanabe, Yasuyoshi and Tomoda, Akemi},
title = {Cognitive dysfunction and mental fatigue in childhood chronic fatigue syndrome--a 6-month follow-up study.},
journal = {Brain & development},
year = {2011},
doi = {10.1016/j.braindev.2010.12.009},
note = {PubMed: 21530119},
url = {https://www.mecfsatlas.com/evidence/kawatani-2011-cognitive-dysfunction},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/kawatani-2011-cognitive-dysfunction
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