Researchers from Raboud University Nijmegen investigated whether Cognitive Therapy (CT) affected the cerebral atrophy of patients suffering from Chronic Fatigue Syndrome (CFS). The study appeared in BRAIN: A Journal of Neurology. The study included twenty-two CFS patients and twenty-two control subjects, all of whom underwent a two-step program of CBT. The initial focus of treatment is a "rehabilitative approach of a graded increase in physical activity," while the second part emphasizes a "psychological approach that addresses thoughts and beliefs about CFS which may impair recovery." Upon completion of the CBT treatment, the CFS patients experienced significant improvement in their physical status as well as their cognitive performance. Furthermore, the CFS patients, who had initially shown significantly lower grey matter volume than the control subjects, showed a significant increase in grey matter volume through the work of CBT. The results of this study, which included the partially reversed cerebral atrophy after effective CBT, are an "example of macroscopic cortical plasticity in the adult human brain, demonstrating a surprisingly dynamic relation between behavioural state and cerebral anatomy. Furthermore, (their) results reveal a possible neurobiological substrate of psychotherapeutic treatment." Study authors: F. P. de Lange, A. Koers, J. S. Kalkman, et al.