Krupp, L B, Sliwinski, M, Masur, D M et al. · Archives of neurology · 1994 · DOI
This study compared thinking and memory problems in people with ME/CFS, multiple sclerosis (MS), and healthy controls. People with ME/CFS showed some cognitive difficulties, particularly in processing speed and memory tasks, and had higher rates of depression. However, their cognitive problems were less widespread than those seen in MS patients, and some thinking difficulties in ME/CFS appeared linked to depression rather than the illness itself.
This study provides objective neuropsychological evidence that ME/CFS involves real cognitive impairment beyond depression, helping validate patients' reported thinking difficulties. It also helps distinguish ME/CFS cognitive patterns from other neurological conditions like MS, which is important for diagnosis and understanding the distinct mechanisms underlying each illness.
This study does not prove that depression *causes* cognitive problems in ME/CFS—only that depression and certain cognitive deficits tend to occur together. It is a small, cross-sectional study that cannot establish causation. The findings may not generalize to all ME/CFS patients, only those with cognitive complaints, potentially overestimating cognitive impairment in the broader ME/CFS population.
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
Krupp, L B, Sliwinski, M, Masur, D M, Friedberg, F, & Coyle, P K (1994). Cognitive functioning and depression in patients with chronic fatigue syndrome and multiple sclerosis.. Archives of neurology. https://doi.org/10.1001/archneur.1994.00540190089021
BibTeX
@article{mecfsatlas-krupp-1994-cognitive-functioning,
author = {Krupp, L B and Sliwinski, M and Masur, D M and Friedberg, F and Coyle, P K},
title = {Cognitive functioning and depression in patients with chronic fatigue syndrome and multiple sclerosis.},
journal = {Archives of neurology},
year = {1994},
doi = {10.1001/archneur.1994.00540190089021},
note = {PubMed: 8018045},
url = {https://www.mecfsatlas.com/evidence/krupp-1994-cognitive-functioning},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/krupp-1994-cognitive-functioning
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