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The ability to divide one's attention deteriorates in patients with childhood chronic fatigue syndrome (CCFS). We conducted a study using a dual verbal task to assess allocation of attentional resources to two simultaneous activities (picking out vowels and reading for story comprehension) and functional magnetic resonance imaging. Patients exhibited a much larger area of activation, recruiting additional frontal areas. The right middle frontal gyrus (MFG), which is included in the dorsolateral prefrontal cortex, of CCFS patients was specifically activated in both the single and dual tasks; this activation level was positively correlated with motivation scores for the tasks and accuracy of story comprehension. In addition, in patients, the dorsal anterior cingulate gyrus (dACC) and left MFG were activated only in the dual task, and activation levels of the dACC and left MFG were positively associated with the motivation and fatigue scores, respectively. Patients with CCFS exhibited a wider area of activated frontal regions related to attentional resources in order to increase their poorer task performance with massive mental effort. This is likely to be less efficient and costly in terms of energy requirements. It seems to be related to the pathophysiology of patients with CCFS and to cause a vicious cycle of further increases in fatigue.

Background: Development of the ability to divide attention is of crucial importance in the transitional period from elementary to junior high school. The relationship between divided attention and the prevalence of fatigue or low academic motivation is observed in junior high school students. In order to clarify the factors underlying decreased ability to divide attention, we examined the relationships between divided attention, as assessed by the kana pick-out test, lifestyle factors, and academic and family conditions in junior high school students., Methods: The study group consisted of 158 healthy 1st-, 2nd-, and 3rd-grade level junior high school students. Each participant performed the kana pick-out test and questionnaires dealing with lifestyle factors (nocturnal sleeping hours on school days, breakfast, exercise, watching television, and spending time with family members), and academic and family conditions (good friendships at school and praise from family members when participants showed good academic performance)., Results: On multiple regression analyses adjusted for grade and gender, scores on the kana pick-out test were positively associated with spending time with family members. In addition, the comprehension score of the kana pick-out test was positively associated with having breakfast every day and praise by family members. The score was negatively associated with watching television., Conclusion: The present findings suggest that the ability to divide attention is independently associated with good lifestyles and academic and family conditions in junior high school students., (Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

Background: Fatigue is a common complaint among elementary and junior high school students, and is related to poor academic performance. Since grade-dependent development of cognitive functions also influences academic performance, we attempted to determine whether cognitive functions were associated with the prevalence of fatigue., Methods: Participants were 148 elementary school students from 4th- to 6th-grades and 152 junior high school students from 7th- to 9th-grades. Participants completed a questionnaire about fatigue (Japanese version of the Chalder Fatigue Scale) and paper-and-pencil and computerized cognitive tests which could evaluate the abilities of motor processing, immediate, delayed and working memory, selective, divided and alternative attention, retrieve learned material, and spatial construction., Results: We found that in multivariate logistic regression analyses adjusted for grade and gender, slow motor processing was positively correlated with the prevalence of fatigue in the elementary school students and decreases in working memory and divided and alternative attention processing were positively correlated with the prevalence of fatigue in the junior high school students., Conclusion: The grade-dependent development of cognitive function influences the severity of fatigue in elementary and junior high school students., (Copyright © 2010 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

Background: When students proceed to junior high school from elementary school, rapid changes in the environment occur, which may cause various behavioral and emotional problems. However, the changes in cognitive functions during this transitional period have rarely been studied., Methods: In 158 elementary school students from 4th- to 6th-grades and 159 junior high school students from 7th- to 9th-grades, we assessed various cognitive functions, including motor processing, spatial construction ability, semantic fluency, immediate memory, delayed memory, spatial and non-spatial working memory, and selective, alternative, and divided attention., Results: Our findings showed that performance on spatial and non-spatial working memory, alternative attention, divided attention, and semantic fluency tasks improved from elementary to junior high school. In particular, performance on alternative and divided attention tasks improved during the transitional period from elementary to junior high school., Conclusion: Our finding suggests that development of alternative and divided attention is of crucial importance in the transitional period from elementary to junior high school., (Copyright © 2010 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)