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Sir, We thank Dr Bramsen for her interest in our recently published article (de Lange et al. 2008). In this article, we report on an increase in prefrontal grey matter volume following cognitive behavioural therapy (CBT) in a group of patients suffering from the chronic fatigue syndrome (CFS).Dr Bramsen raises two points of criticism. First, she questions the lack of a control group of patients receiving no treatment or a different treatment. While this limitation was already emphasized in the discussion section of de Lange et al. (2008), it remains unclear how the observed behavioral and cerebral changes could be accounted for by generic and CBT-independent factors. Dr …

Reply to: can CBT substantially change grey matter volume in chronic fatigue syndrome?