TY  - JOUR
AU  - Schaaf, M.E. van der
AU  - Roelofs, K.
AU  - Lange, F.P. de
AU  - Geurts, D.E.M.
AU  - Meer, J.W.M. van der
AU  - Knoop, H.
AU  - Toni, I.
PY  - 2018
UR  - http://hdl.handle.net/2066/190162
AB  - Background: Chronic fatigue syndrome (CFS) is characterized by disabling fatigue, which is suggested to be maintained by dysfunctional beliefs. Fatigue and its maintenance are recently conceptualized as arising from abnormally precise expectations about bodily inputs and from beliefs of diminished control over bodily states, respectively. This study uses functional neuroimaging to identify the neural correlates of fatigue and its maintenance by beliefs during a physical effort task. Methods: We isolate behavioural adjustments and cerebral activity during feedback processing and motor preparation, in the context of a task where CFS patients (N=85) and healthy controls (N=29) produced 30%, 50%, and 70% of their right hand maximal voluntary contraction (MVC), and received directional feedback on performance (e.g. "too little force"). Results: CFS patients showed an effort-dependent behavioural bias towards less effort investment in response to directional feedback for the highest effort level as compared to HC. This bias was associated with reduced feedback-related activity in the DLPFC. These effects were proportional to state-related fatigue and prior beliefs about their ability to perform the task within CFS patients. CFS patients also showed higher activity in the supplementary motor area (SMA), proportional to their state-related fatigue, and reduced connectivity between SMA and sensorimotor cortex during motor preparation as compared to controls. Conclusions: These findings link fatigue symptoms to alterations in behavioural choices on effort investment, prefrontal functioning and SMA connectivity, with the DLPFC being associated with prior beliefs about physical abilities.
TI  - Fatigue is associated with altered monitoring and preparation of physical effort in patients with chronic fatigue syndrome
EP  - 404
SN  - 2451-9022
IS  - iss. 4
SP  - 392
JF  - Biological Psychiatry : Cognitive Neuroscience and Neuroimaging
VL  - vol. 3
PS  - 13 p.
DO  - https://doi.org/10.1016/j.bpsc.2018.01.015
ER  -