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C F S
- Information International ME/
CFS & FM Subgroups
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ME/ CFS Subgroups
The
need for subgrouping is stressed by the argument that research - or treatment
trials - involving patients with CFS/ ME, cannot be compared as long as the
disease definition(s) encounter several subgroups, Jason et al., 2003., and demitrack06.txt. Patients who fulfill the
CDC-1994 (Fukuda et al.) definition, differ markedly according to whether or
not they acquired CFS sporadically, from the Gulf War, or by exposure to
insecticides, kennedy.etal04.txt, kennedy.etal04.pdf. Baseline cortisol levels
predict treatment outcomes in CFS non-pharmacologic clinical trial, jason.etal07.txt. Types of Subgroups
Four CFS subgroups was
suggested based on symptoms from either organ system [the nervous system, the
musculo-sceletal system, the endocrine system, and the immune/infectious
system], Tan et al., 2002, Tan et al., 2002 (pdf). Dr. Jason's research group in one study suggested that patients were divided
according to disease onset, occupation
etc., Jason et al., 2000, and in
another by symptoms, Jason et al., 2001. In a third
study, using factor analysis Jason et al. suggest the same grouping as Dr.
Tan (above),
Jason et al., 2002. In a very large study Jason & Taylor used
cluster analysis,
Jason & Taylor, 2002 (1), Jason & Taylor, 2002 (2). A short paper
on the existence of subgroupings based on socio-economical factors, Jason et al., 2003. Most recently, Dr. Jason has suggested subtyping
individuals with CFS on sociodemographic,
functional disability, viral, immune, neuroendocrine, neurology, autonomic,
and genetic biomarkers providing clarification for researchers and
clinicians who encounter CFS' characteristically confusing heterogeneous
symptom profiles, jason.etal05.txt, jason.etal05.pdf. Clear distinction from
psychiatric disease based fatigue, song.jason05.txt,
song.jason05.pdf. Attempts by Dr. Natelson's group in A Belgian study using multiple varians analysis concluded
that CFS patients fulfilling Holmes et al. 1988 definition were more serious
ill compared to other CFS definitions,
De Becker et al., 2001. The CFS Name Change proposal argues for the umbrella
term NDS with 4 subgroups: ME, CFS-Fukuda, Canadian CFS-definition and
GWS, Name Change Draft, 2003. Despite the recognition of subgroups defined by
factor analysis, respected researchers from the CDC also point out that there
is considerable overlap between groups, nisenbaum.etal04.txt,
nisenbaum.etal04.pdf. Sub-typing CFS patients on the basis of 'minor'
symptoms, janal.etal06.txt, janal.etal06.pdf. Using NKCA (natural killer cells) as an
immunological subgroup marker in CFS, siegel.etal06.txt, siegel.etal.06.txt, siegel.etal06.pdf. FM Subgroups
FM expert Dr. Russell wrote an
interesting editorial on FM subgroups, editorial, Russell, 2002. Another article covers
the difficulties inherent in defining subgroups, Walen et al., 2002. Artificial Neural Network
Complex diseases can be
analyzed by a method named Artificial Neural Network (ANN) here used by a
German group to distinguish CFS from SLE and FM, Linder et al., 2002. Contradictory Beliefs – Psychiatrists coming
to light
One traditional psychiatric
belief is contradictory to the above. Here psychiatrists believe all
syndromes have more in common than what separates them. CFS patients
attending hospital clinics in immunology or psychiatry units share most
symptoms, White et al., 2002, White et al., 2002. However even psychiatrists read new research:
Further research is needed in improving the current case definition;
investigating overlaps and boundaries among various functional somatic
syndromes, cho.etal06.txt, cho.etal06.pdf.
To "lump" or to "split" the functional somatic
syndromes: can infectious and emotional risk factors differentiate between
the onset of CFS and irritable bowel syndrome, moss-morris.etal06.txt, moss-morris.etal06.pdf. |
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