Email Tweet this Like this
Home

Cognitive dysfunction (brain fog)

Cognitive dysfunction (also known as brain fog) is the loss of intellectual functions such as thinking, remembering, and reasoning of sufficient severity to interfere with daily functioning. Patients with cognitive dysfunction have trouble with verbal recall, basic arithmetic, and concentration.

According to the Marshall Pathogenesis, cognitive dysfunction is caused by microbes. More severe forms of cognitive dysfunction are seen in diseases such as Alzheimer's, diseases for which there is strong evidence of a bacterial etiology. Often associated with chronic fatigue syndrome,1 cognitive dysfunction is also seen in patients with multiple sclerosis,2 depression,3 fibromyalgia,4 and dozens of others diseases.

Like all symptoms of inflammatory disease, cognitive dysfunction may temporarily increase during periods of immunopathology. Cognitive dysfunction can be managed using the generic strategies for managing immunopathology, and should resolve over the course of the Marshall Protocol (MP).

Some studies seem to suggest that sick women experience cognitive dysfunction more frequently and more severely than their male counterparts.5 6

Management of symptoms

If symptoms are debilitating, consider decreasing the doses of antibiotics. Note that stopping one's antibiotics may make symptoms worse for at least a certain length of time.

The systematic use of stimulants such as modafinil (Provigil) to manage symptoms of fatigue or cognitive dysfunction is not recommended.

Biological basis

  • cognitive and functional decline often follow severe sepsis – The researchers focused their attention on 516 individuals who survived hospitalization for severe sepsis and 4517 who survived a nonsepsis hospitalization. The average age of survivors at hospitalization was 76.9 years. Following severe sepsis hospitalization, but not nonsepsis general hospitalization, there was a significant increase in the odds of developing both cognitive and physical dysfunction that persisted throughout the 8-year follow-up period, the researchers report.7
  • aging immune cells in animal models – The decline in brain function associated with disease and old age could be due to the decline in the function of immune cells, which is likely caused by infection. As described in New Scientist, prompted by studies suggesting immune responses can help repair the nervous system, Jonathan Kipnis and colleagues at the University of Virginia created mice that lack CD4 cells, a kind of T-cell. They found the mice performed extremely poorly in tasks involving learning and memory, but when they were injected with CD4 cells from healthy mice, their memories improved.8 Similarly, when he killed CD4 cells in healthy mice, their memory declined. Further animal studies by Kipnis and others show that learning new tasks triggers a mild stress response within the brain, which prompts CD4 cells to rally to the meninges, the membranes that surround the brain. Here, they release IL-4, which both switches off the stress response and tells brain cells called astrocytes to release brain-derived neurotrophic factor, a protein that enhances learning.9 Whether these animal studies are relevant to human learning and memory remains unclear, but there is some indirect evidence to support it. For example, many chemotherapy drugs suppress the immune system, which might explain why some people with cancer develop “chemobrain” - a term used to describe the cognitive problems and memory loss associated with chemotherapy. Sluggish immune cells might also explain why our brains slow down as we age. “The number one cell affected by ageing is the T-cell,” says Kipnis. “I'm not saying it's the only factor leading to age-related dementia, but it could definitely be one of them.”

Patients experiences

In my 20s, I started 'losing the nouns' although I could describe the thing I could not name. Then, I started mixing up 3s with 8s and Es with Is when typing or using a calculator. And my reading speed slowed even more and I noticed that I was transposing not only letters but also words…. When considering a legal issue [Claire was a corporate attorney], it was like I was standing at the edge of a vast city neighborhood that I used to know like the back of my hand. “Before I lost my ability to problem solve, I could see in my mind’s eye many ways to get from one side of the neighborhood. After that skill slipped away, I would stand there helplessly on the edge of the neighborhood while remembering that I used to know the way. Making any decision became increasingly difficult…. Sometimes when people are talking, it is as if with some words they are speaking in a foreign language. I hear the words, but they don’t make sense. If feels like a form of age-related deafness, having to do with the inability to comprehend due to the loss of stereophonic sound (if that’s what it is called–I really can’t remember), but seems to be mainly word specific.

Claire, Bacteriality.com

On the MP, my brain has been steadily healing over the past 26 months. My parents (academics) see me every 6 months or so and are able to describe the changes for me, which is great. I can read books again, although if they’re too intense or convoluted, it takes me time to understand them fully. My reasoning abilities are far improved as well, my math skills have returned (although I’m not sure I could teach it now), word recall is far better and I find myself at times uttering words I haven’t used for years.

Alayne, Bacteriality.com

After 18 months I find my memory returning, I am able to do housework, organise and tidy up. DH who thought I should be with a psychiatrist, not a GP, is apparently changing his mind about MP and suggests his daughter could see my doctor! :-)

Sallie Q, CureMyTh1.org

Beause most my problems are mentally based it is hard for me to recognize improvement at times but I can tell when I'm better when things just seem easier to me, like I'll be thinking about something and realize, “Hey, that's not so hard after all.”

Jimmy_jimjim, MarshallProtocol.com

After two years on the MP, I would say that any episodes of brainfog that I have are comparable to the occasional “vagueness” that any normal person has.

Vicki SA, MarshallProtocol.com

Read more

Related publications and presentations

Notes and comments

  • Legacy content

Joint Bone Spine. 2010 Jul;77(4):366-7. Epub 2010 May 15. Improvement of cognition, a potential benefit of anti-TNF therapy in elderly patients with rheumatoid arthritis. Chen YM, Chen HH, Lan JL, Chen DY. PMID: 20478733

Gut. 2010 Oct 21. [Epub ahead of print] Bacterial infection causes stress-induced memory dysfunction in mice. Gareau MG, Wine E, Rodrigues DM, Cho JH, Whary MT, Philpott DJ, Macqueen G, Sherman PM.

Hospital for Sick Children, University of Toronto, Toronto, Canada. Abstract Background The brain-gut axis is a key regulator of normal intestinal physiology; for example, psychological stress is linked to altered gut barrier function, development of food allergies and changes in behaviour. Whether intestinal events, such as enteric bacterial infections and bacterial colonisation, exert a reciprocal effect on stress-associated behaviour is not well established. Objective To determine the effects of either acute enteric infection or absence of gut microbiota on behaviour, including anxiety and non-spatial memory formation. Methods Behaviour was assessed following infection with the non-invasive enteric pathogen, Citrobacter rodentium in both C57BL/6 mice and germ-free Swiss-Webster mice, in the presence or absence of acute water avoidance stress. Whether daily treatment with probiotics normalised behaviour was assessed, and potential mechanisms of action evaluated. Results No behavioural abnormalities were observed, either at the height of infection (10 days) or following bacterial clearance (30 days), in C rodentium-infected C57BL/6 mice. When infected mice were exposed to acute stress, however, memory dysfunction was apparent after infection (10 days and 30 days). Memory dysfunction was prevented by daily treatment of infected mice with probiotics. Memory was impaired in germ-free mice, with or without exposure to stress, in contrast to conventionally reared, control Swiss-Webster mice with an intact intestinal microbiota. Conclusions The intestinal microbiota influences the ability to form memory. Memory dysfunction occurs in infected mice exposed to acute stress, while in the germ-free setting memory is altered at baseline.

PMID: 20966022

Cognitive and Functional Decline Often Follow Severe Sepsis

References

1 , 3 Claypoole KH, Noonan C, Mahurin RK, Goldberg J, Erickson T, Buchwald D A twin study of cognitive function in chronic fatigue syndrome: the effects of sudden illness onset. Neuropsychology. 2007;21:507-13.
2 Wallin MT, Wilken JA, Kane R Cognitive dysfunction in multiple sclerosis: Assessment, imaging, and risk factors. J Rehabil Res Dev. 2006;43:63-72.
4 Glass JM, Park DC Cognitive dysfunction in fibromyalgia. Curr Rheumatol Rep. 2001;3:123-7.
5 Evans MA, Golomb BA Statin-associated adverse cognitive effects: survey results from 171 patients. Pharmacotherapy. 2009;29:800-11.
6 Hogue CW, Lillie R, Hershey T, Birge S, Nassief AM, Thomas B, Freedland KE Gender influence on cognitive function after cardiac operation. Ann Thorac Surg. 2003;76:1119-25.
9 Derecki NC, Cardani AN, Yang CH, Quinnies KM, Crihfield A, Lynch KR, Kipnis J Regulation of learning and memory by meningeal immunity: a key role for IL-4. J Exp Med. 2010;207:1067-80.
Last modified: 01.02.2012
© 2014, Autoimmunity Research Foundation. All Rights Reserved.