| CFS Medical Research ExcerptsCompiled by Jim Toomey |
Date last revised: November 16, 1999Please note that the medical references below are largely excerpts, and include peer-reviewed publicatons, CFS/ME World Conference presentations, and clinical findings.
1) Prevalence:
The most sound CFS prevalence study to date was published last month:Leonard A. Jason, PhD, "A Community Based Study of Chronic Fatigue Syndrome", published in the Archives of Internal Medicine 1999;159:2129-2137, found that a minimum of 836,000 Americans now have CFS, and can be viewed in its entirety on the web at
http://archinte.ama-assn.org/issues/v159n18/full/ioi90161.html
"Earlier findings suggesting that CFS is a syndrome primarily affecting white, middle-class patients were not supported by our findings."
Minorities were affected by CFS disproportionate to the white population.
"Individuals in Latino, other (which included 1 Asian American, 1 American Indian, and 1 multiracial individual), and African American groups exhibited higher rates of CFS than whites, with Latino participants demonstrating the highest CFS prevalence. Individuals in the 40- to 49-year-old age range exhibited the highest rates of CFS. In terms of socioeconomic status, the prevalence of CFS was highest among skilled workers and lowest among professionals."
The study found that 522 females per 100,000 were afflicted, as compared to 12 women per 100,000 for AIDS; 26 women per 100,000 for breast cancer; 33 women per 100,000 for lung cancer; and 900 per 100,000 for diabetes.
From the CFS Radio Program; Oct. 24th, 1999; Roger G. Mazlen, M.D. Host with Dr. Leonard Jason, transcribed by Carolyn Viviani, at
http://members.aol.com/rgm1/private/transcr.htm
"One of the most interesting things from our study is that in those individuals who we identify as having Chronic Fatigue Syndrome, we found that over 90% did not have a diagnosis of Chronic Fatigue Syndrome."
Thus, a minimum of 752,000 people in the U.S. feel ill, but are unaware that they have CFS.
Also note that the study did not include CFS patients under 18 yrs of age, households that did not speak English, or possibly the severely ill.
Conservative cost estimate to the U.S. economy -- $7.5 Billion.
Ironically, neither the NIH nor CDC has yet acknowledged this NIH-funded study.
2) The Degree of Suffering:
Many CFS patients are medically disabled, bedridden, housebound, and use electric wheelchairs.
Karnofsky Scale levels (measure of functionality) have been clinically documented to be equivalent to or less than that of near end stage AIDS patients [Dr. Mark Loveless, Oregon Health Sciences University, Portland, OR]
A Medical Outcome Study concluded that CFS has "greater functional severity than heart disease, virtually all forms of cancer, and all other chronic illnesses." (Perfect Health = 100; Avg Health = 75; Rheumatoid Arthritis = High 40s; Myocardial Infarction = Low 40s)
CFS = 16
[Dr. Philip Peterson, Minneapolis, MN, in conjunction with Hennepin County Medical Center]
Other findings include very low aerobic capacities, unexplained by deconditioning. Patients in their mid-30s perform equivalent to advanced 70-year-old cardiac patients in standardized tests [Dr. D. Peterson]
Functional Impairment:
Patients with CFS are more functionally impaired than those suffering from- congestive heart failure
- multiple sclerosis
- end-stage renal disease
- type II diabetes mellitus
(Anderson et al., 1997; Buchwald et al., 1996)
Measuring Fatigue:
Patients with CFS score significantly higher than those with MS or depression on the Fatigue Severity Scale (Krupp et al., 1989) J Nerv Ment Dis 1997 Jun;185(6):359-67
The quality of life of persons with chronic fatigue syndrome.
Anderson JS, Ferrans CE
University of Illinois at Chicago Medical Center, Department of Psychiatry 60612, USA.
PMID: 9205421, UI: 97349500"Overall scores on the quality of life index were significantly lower in CFS than for other chronic illness groups."
3) Organic involvement of the brain in CFS:
Brain hypoperfusion has been documented in CFS patients. The pattern is similar to Lyme Disease or HIV Encephalopathy, distinct for Primary Depression, with noted brainstem involvement. This abnormal hypoperfusive baseline has been found to worsen subseqent to exertion [Dr. Jay Goldstein, CA]. Brain MRIs show significantly greater % of white-matter lesions. Clinical findings include: abnormal EEGs, marked cognitive dysfunction, intermittent partial or complete memory loss, recurrent stupor or stroke-like episodes, IQ drops in excess of 50 points, neurological changes in motor skills (handwriting, walking gait, vision, etc), tremors,aphasia, ataxia, discalcula, delirium, dementia, hyper and hypoacusis, abnormal Evoked Potentials and Deep Tendon Reflexes, severe insomnia / a peculiar disruption in the wake/sleep cycle,. [non-CNS findings: sore throat, "crimson crescents", swollen/tender lymph nodes, around-the-clock sweats, chills, fevers, intractable pain, and more]QJM: monthly journal of the Association of Physicians. Britian and Ireland by the Oxford University Press.
ARTICLE: Costa, D.C., Tannock, C., & Brostoff, J. "Brainstem perfusion is impaired in chronic fatigue syndrome."
"Brainstem hypoperfusion was confirmed in all ME/CFS patients."
VOL: 88 NO: 11 DATE: Nov, 1995 PAGES: 767 - 773
[Preliminary study to the one above]A total of 146 individuals were included in this preliminary study: 67 CFS/ME patients (in 3 sub-categories) and the balance comprised of healthy, depressed, elderly, and epileptics.
"All 67 CFS/ME patients demonstrated brainstem hypoperfusion."
1) AJR Am J Roentgenol 1994 Apr;162(4):943-51
SPECT imaging of the brain: comparison of findings in patients with chronic fatigue syndrome, AIDS dementia complex, and major unipolar depression.
Schwartz RB, Komaroff AL, Garada BM, Gleit M, Doolittle TH, Bates DW, Vasile RG, Holman BL"Also, a significant negative correlation was found between the number of defects and midcerebral uptake index in patients with chronic fatigue syndrome and AIDS dementia complex, but not in depressed patients or control subjects. CONCLUSION. These findings are consistent with the hypothesis that chronic fatigue syndrome may be due to a chronic viral encephalitis"
Nucl Med Commun 1998 Nov;19(11):1065-71
Comparison of SPET brain perfusion and 18F-FDG brain metabolism in patients with chronic fatigue syndrome.
Abu-Judeh HH, Levine S, Kumar M, el-Zeftawy H, Naddaf S, Lou JQ, Abdel-Dayem HM"Thirteen patients had abnormal SPET brain perfusion scans and five had normal scans."
Am J Med 1998 Sep 28;105(3A):54S-58S
Brain positron emission tomography (PET) in chronic fatigue syndrome: preliminary data.
Tirelli U, Chierichetti F, Tavio M, Simonelli C, Bianchin G, Zanco P, Ferlin G
Division of Medical Oncology and Acquired Immunodeficiency Syndrome, Centro di Riferimento Oncologico, Aviano, Italy.
"CFS patients showed a significant hypometabolism in right mediofrontal cortex (P = 0.010) and brainstem (P = 0.013) in comparison with the healthy controls. Moreover, comparing patients affected by CFS and depression, the latter group showed a significant and severe hypometabolism of the medial and upper frontal regions bilaterally (P = 0.037-0.001), whereas the metabolism of brain stem was normal. Brain 18FDG PET showed specific metabolism abnormalities in patients with CFS in comparison with both healthy controls and depressed patients. The most relevant result of our study is the brain stem hypometabolism which, as reported in a perfusion SPECT study, seems to be a marker for the in vivo diagnosis of CFS"AJR Am J Roentgenol 1994 Apr;162(4):935-41
Detection of intracranial abnormalities in patients with chronic fatigue syndrome: comparison of MR imaging and SPECT.
Schwartz RB, Garada BM, Komaroff AL, Tice HM, Gleit M, Jolesz FA, Holman BL
Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115."Patients with chronic fatigue syndrome had significantly more defects throughout the cerebral cortex on SPECT scans than did normal subjects."
NLM CIT. ID: 94186821
SOURCE: J Neurol Sci 1993 Dec 15;120(2):213-7
TITLE: A controlled study of brain magnetic resonance imaging in patients with the chronic fatigue syndrome.
AUTHORS: Natelson BH; Cohen JM; Brassloff I; Lee HJ
AUTHOR AFFILIATION: Department of Neurosciences, UMDNJ-New Jersey Medical School, NewarkBrain MR scans... of 52 patients CFS patients had significantly more abnormal scans than controls--27% vs 2%. Abnormalities seen were foci of increased white matter T2 signal in 9 CFS patients and one control and ventricular or sulcal enlargement in 5 CFS patients. The data indicate that some CFS patients have some organic problem manifesting itself on neuroimaging.
Nucl Med Commun 1992 Oct;13(10):767-72
Assessment of regional cerebral perfusion by 99Tcm-HMPAO SPECT in chronic fatigue syndrome.
Ichise M, Salit IE, Abbey SE, Chung DG, Gray B, Kirsh JC, Freedman M
Department of Radiology (Division of Nuclear Medicine), University of Toronto, Canada.
PMID: 1491843, UI: 93149534"Chronic fatigue syndrome (CFS) is a severely disabling illness of uncertain aetiology."
"99Tcm-HMPAO brain SPECT provided objective evidence for functional impairment of the brain in the majority of the CFS subjects."
Eur J Clin Invest 1997 Apr;27(4):257-67
Chronic fatigue syndrome--aetiological aspects.
Dickinson CJ
Wolfson Institute of Preventive Medicine, St. Bartholomew's & Royal London School of Medicine & Dentistry, London, UK."Studies by modern imaging techniques have not been entirely consistent, but many magnetic resonance imaging (MRI) studies already suggest that small discrete patchy brain stem and subcortical lesions can often be seen in CFS. Regional blood flow studies by single photon-emission computerized tomography (SPECT) have been more consistent. They have revealed blood flow reductions in many regions, especially in the hind brain. Similar lesions have been reported after poliomyelitis and in multiple sclerosis--in both of which conditions chronic fatigue is characteristically present."
Lambrecht from Ghent, Belgium presented work on the clinical, immunological and neuro-imaging correlations in those with CFS. Physicians without knowledge of the clinical history evaluated the neuroSPECTscans. 294 defects were found in 148 patients. Karnofsky scores correlated negatively with significant SPECT anomalies. Immune parameters were also positively correlated with scan results. 17 out of 30 patients had significant abnormalities on MRI, with 10 times the number of lesions than in controls. The findings illustrate the multisystem involvement and disability in CFS supporting encephalomyelitic pathogenesis.
[World CFS Conf, Sydney Feb 1999]NLM CIT. ID: 98002082 NLM - PUBMED CIT. ID: 9342690
SOURCE: J Clin Exp Neuropsychol 1997 Aug;19(4):560-86
TITLE: Neuropsychology of chronic fatigue syndrome: a critical review.
AUTHORS: Tiersky LA; Johnson SK; Lange G; Natelson BH DeLuca J
AUTHOR AFFILIATION: Department of Physical Medicine and Rehabilitation, UMDNJ-New Jersey Medical School, Kessler Institute for Rehabilitation, West Orange 07052, USA.... .preliminary evidence suggests the involvement of cerebral white matter.
NLM CIT. ID: 93183103 - NLM PUBMED CIT. ID: 8442710
SOURCE: Arch Neurol 1993 Mar;50(3):301-4
TITLE: Information processing efficiency in chronic fatigue syndrome and multiple sclerosis.
AUTHORS: DeLuca J; Johnson SK; Natelson BH
AUTHOR AFFILIATION: Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark.OBJECTIVE--To compare the cognitive performance of subjects with chronic fatigue syndrome (CFS), multiple sclerosis (MS), and healthy controls.
CONCLUSIONS--These results indicate that subjects with CFS and subjects with MS show significant impairment on a test of complex concentration when compared with appropriate controls.
NLM CIT. ID: 96040750 - NLM PUBMED CIT. ID:7549414
SOURCE: Clin Auton Res 1995 Jun;5(3):139-43
TITLE: Vagal tone is reduced during paced breathing in patients with the chronic fatigue syndrome.
AUTHORS: Sisto SA; Tapp W; Drastal S; Bergen M; DeMasi I Cordero D; Natelson B
AUTHOR AFFILIATION: Neurobehavioral Unit, VA Medical Center, E. Orange, NJ 07018-1095... . the overall vagal power was significantly lower (p < 0.034) in the CFS group versus healthy controls.
Clin Auton Res 1996 Dec;6(6):329-33
Decreased vagal power during treadmill walking in patients with chronic fatigue syndrome.
Cordero DL, Sisto SA, Tapp WN, LaManca JJ, Pareja JG, Natelson BH Fatigue
Research Center, DVA Medical Center, East Orange, NJ 07018, USA."Patients had significantly less vagal power than the control subjects"
NLM CIT. ID: 99005145 - NLM PUBMED CIT. ID: 9790484
SOURCE: Am J Med 1998 Sep 28;105(3A):59S-65S
TITLE: Influence of exhaustive treadmill exercise on cognitive functioning in chronic fatigue syndrome.
AUTHORS: LaManca JJ; Sisto SA; DeLuca J; Johnson SK; Lange G Pareja J; Cook S; Natelson BH
AUTHOR AFFILIATION: Chronic Fatigue Syndrome Cooperative Research Center, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, USA.We conclude that after physically demanding exercise, CFS subjects demonstrated impaired cognitive processing compared with healthy individuals.
Cortical motor potential alterations in Chronic Fatigue Syndrome.
Authors: Gordon R, Michalewski HJ, Nguyen T, Gupta S, Starr A
Department of Neurology, University of California, Irvine, Med. Surge I, Room 154, Irvine, CA 92697-4290, USA.
Journal: International Journal of Molecular Medicine 1999 Nov;4(5):493-499
NLM citation: PMID: 10534571Patients with CFS showed slowed reaction times and reduced premovement-related potentials, suggesting that central motor mechanisms accompanying motor response preparation were impaired in CFS for some tasks.
NLM CIT. ID: 96061271- NLM PUBMED CIT. ID:7595641
SOURCE: J Neurol Sci 1995 Aug;131(2):156-61
TITLE: Gait abnormalities in chronic fatigue syndrome.
AUTHORS: Boda WL; Natelson BH; Sisto SA; Tapp WN
AUTHOR AFFILIATION: Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, East Orange, USA.To evaluate our clinical impression that patients with the chronic fatigue syndrome (CFS) did not walk normally, we assessed gait kinematics ...The data indicate that CFS patients have gait abnormalities when compared to sedentary controls. These could be due to balance problems, muscle weakness, or central nervous system dysfunction; deciding which will require further research.
NLM CIT. ID: 97027004 - NLM PUBMED CIT. ID: 8873173
SOURCE: Percept Mot Skills 1996 Aug;83(1):51-62
TITLE: Selective impairment of auditory processing in chronic fatigue syndrome: a comparison with multiple sclerosis and healthy controls.
AUTHORS: Johnson SK; DeLuca J; Diamond BJ; Natelson BH
AUTHOR AFFILIATION: Chronic Fatigue Syndrome Research Center, Research Department, Kessler Institute for Rehabilitation, West Orange, NJ 07052, USA.The most consistent deficit observed in individuals with Chronic Fatigue Syndrome has been in efficiency of information processing. The group with Chronic Fatigue Syndrome was differentially impaired on the auditory relative to the visual processing task. The group with Multiple Sclerosis was equally impaired on both versions of the task.
NLM CIT. ID: 98263991- NLM PUBMED CIT. ID: 9601685
SOURCE: Neuroreport 1998 Apr 20;9(6):1153-7
TITLE: Impaired associative learning in chronic fatigue syndrome.
AUTHORS: Servatius RJ; Tapp WN; Bergen MT; Pollet CA
Drastal SD; Tiersky LA; Desai P; Natelson BH
AUTHOR AFFILIATION: New Jersey Medical School, Department of Neuroscience, East Orange 07019, USA.However, CFS patients displayed impaired acquisition of the eyeblink response using a delayed-type conditioning paradigm. In the absence of sensory/motor abnormalities, impaired acquisition of the classically conditioned eyeblink response indicates an associative deficit. These data suggest organic brain dysfunction within a defined neural substrate in CFS patients.
4) Other Studies:
Mycoplasmal Infections in Chronic Illnesses: Fibromyalgia and Chronic Fatigue Syndromes, Gulf War Illness, HIV-AIDS and Rheumatoid Arthritis
Garth L. Nicolson, PhD, Marwan Y. Nasralla, PhD, Joerg Haier, MD, PhD, Robert Erwin, MD, Nancy L. Nicolson, PhD, Richard Ngwenya, MD
[Medical Sentinel, date?]"Mycoplasma tests were performed on all patients as described previously (1,7,17) either from Chelex-purified DNA or DNA prepared from whole blood using a commercial kit. The targeted Mycoplasma spp. sequence was amplified from DNA extracted from the peripheral blood of 144/203 CFS or FMS patients"
= 71%
In 70 healthy subjects positive results for Mycoplasma spp. were obtained in 6 samples (<9%)."
http://www.haciendapub.com/article24.html
Paspaliaris from Melbourne presented further studies on mycoplasma. It was detected in controls (14%), but the incidence was significantly raised in CFS patients (45%). The DNA load was also significantly higher in individuals than in asymptomatic M. fermentans-positive controls. M. fermentans monocyte/macrophage activator protein expression was performed from RNA isolated from buffy coat layers of peripheral blood and a striking pattern of differentiation was observed in CFS patients compared to asymptomatic individuals.
[World CFS Conference, Sydney, Australia, Feb 1999]Congressional Testimony of Robert J. Suhadolnik, Ph.D., Professor of Biochemistry, Temple University School of Medicine, May 16, 1997:
"Our research has demonstrated that several components of the antiviral pathway are not functioning properly in people with CFIDS. Specifically, the antiviral pathway is upregulated (or overactive) in people with CFIDS."
"RNaseL in people with CFIDS is overactive. In the first study we did with Dr. Peterson, 13 of 15 people with CFIDS had this overactive RNaseL."
"We've learned that there is an enzyme defect in people with CFIDS -- a defect in RNaseL. Something new is going on in CFIDS. RNaseL was overactive, unlike anything we had ever seen before, and we have studied RNaseL activity in people with AIDS, Multiple sclerosis, lupus, human T-cell leukemia, and kidney cancer."
"A NEW FORM OF RNaseL, a smaller form of RNaseL, in all [most recently "all" should be changed to "a subset of"] people with CFIDS. These studies have been accepted for publication and will appear in the Journal of Inerferon and Cytokine Research in a few months "
[The Journal of Interferon & Cytokine Research, 1997]
Suhadolnik reported again on Rnase L research, particularly on the low molecular weight version of the enzyme that is found in peripheral blood monocytes. He says finding the low weight enzyme in those cells correlates with Karnofsky scores. Ampligen can normalize the excess activity of this enzyme.
CFS World Conference, Brussels, Belgium August 1999[this separate study uses a different technique than the above, e.g., upregulated Rnase L has been documented via 2 distinct methods]
RNase L dysfunction disorder (R.E.D.D.) in CFS
Authors: K. De Meirleir*, LCLI, I. Campine+*, P. De Becker, B. Van Steenberge*, C. Bisbal**, T. Salehzada**, B. Lebleu**, C.V. Herst*
*Department of Human Physiology, Free University of Brussels, Brussels, Belgium
**Institute of Molecular Genetics, Montpellier University, Montpellier, France + I.Campine is supported by funds from the Foundation for Scientific Research, Belgium (F.W.O.).Results: A low molecular weight (LMW) 2'-5'A binding polypeptide (37 kDa) was found in 50 out of 57 PBMC pellets of the CFS patients, versus 4 out of 18 healthy individuals. Both sensitivity and specificity of the LMW RNase L in relationship to CFS are high.
Conclusion: The presence of a 37 kDa 2'.-5'A binding polypeptide in the PBMC pellets of CFS patients may objectively contribute to distinguish CFS patients from healthy individuals. These observations could provide the basis for the development of a biochemical assay for the differential diagnosis of CFS and for follow up of its clinical evolution.
The Newcastle group from Australia presented many findings. 75% of CFS patients were found to have elevated Rnase L enzymes, compared with 14% of controls. They are working to refine the correlation of symptoms with cytokine activity, urine volume and urine chemical constituents.
[CFS World Conference, Brussels, Belgium August 1999]K. De Meirleir also found the presence of LMW RnaseL in 680 of 705 patients studied. Presence of the abnormal enzyme also correlated with increased incidence of bronchial hyperactivity. Favourable outcome after ampligen treatment is inversely correlated with the presence of LMW RnaseL.
[CFS World Conference, Brussels, Belgium August 1999]Clin Infect Dis 1994 Jan;18 Suppl 1:S88-95
A controlled clinical trial with a specifically configured RNA drug, poly(I).poly(C12U), in chronic fatigue syndrome.
Strayer DR, Carter WA, Brodsky I, Cheney P, Peterson D, Salvato P, Thompson C, Loveless M, Shapiro DE, Elsasser W, et al
PMID: 8148460, UI: 94198386After 24 weeks, patients receiving poly(I).poly(C12U) had higher scores for both global performance and perceived cognition than did patients receiving placebo. In particular, patients given poly(I).poly(C12U) had increased Karnofsky performance scores (P < .03), exhibited a greater ability to do work during exercise treadmill testing (P = .01), displayed an enhanced capacity to perform the activities of daily living (P < .04), had a reduced cognitive deficit (P = .05), and required less use of other medications (P < .05).
[The nucleic-acid drug above is currently in Phase III FDA trials, with significant positive response tenatively correlating well to those patients with abnormal RNase L antiviral pathways, presence of a 37 Kilodalton protein (80 kDn is normal), and, to a significant but lesser extent, elevated interferon-alpha]
Acta Neuropathol (Berl) 1991;83(1):61-5
Mitochondrial abnormalities in the postviral fatigue syndrome. Behan WM, More IA, Behan PO
Department of Pathology, University of Glasgow, Scotland.We have examined the muscle biopsies of 50 patients who had postviral fatigue syndrome (PFS) for from 1 to 17 years. We found mild to severe atrophy of type II fibres in 39 biopsies, with a mild to moderate excess of lipid. On ultrastructural examination, 35 of these specimens showed branching and fusion of mitochondrial cristae. Mitochondrial degeneration was obvious in 40 of the biopsies with swelling, vacuolation, myelin figures and secondary lysosomes. These abnormalities were in obvious contrast to control biopsies, where even mild changes were rarely detected. The findings described here provide the first evidence that PFS may be due to a mitochondrial disorder precipitated by a virus infection.
Ciba Found Symp 1993;173:146-54; discussion 154-9
Enteroviruses and postviral fatigue syndrome.
Behan PO, Behan WM, Gow JW, Cavanagh H, Gillespie S
Department of Neurology, University of Glasgow, UK."An increase in the number and size of muscle mitochondria was found in 70% of PFS cases, suggesting an abnormality in metabolic function. Evidence of hypothalamic dysfunction was present, particularly involving 5-hydroxytryptamine metabolism."
In vitro Study of Muscle Aerobic Metabolism in Chronic Fatigue Syndrome
Journal of Chronic Fatigue Syndrome Vol. 5, No. 1, 1999
WIhelmina M. H. Behan, MD, FRCPath, FRCP
Ian J. Holt, PhD
David H. Kay, MBChB
Pamela Moonie, BScMuscle aerobic metabolism in CFS.mitochondrial DNA (mtDNA) volume was measured and mtDNA rearrangements sought. The results showed that myoblasts from ten of 16 cases of CFS had defects in aerobic metabolism.
Impaired oxygen delivery to muscle in chronic fatigue syndrome.
Authors: McCully KK, Natelson BH
Department of Medicine, Medical College of Pennsylvania and Hahnemann University, Philadelphia, PA 19129, U.S.A.
Journal: Clinical Science (Colch) 1999 Nov 1;97(5):603-608
NLM citation: PMID: 10545311The authors found that oxygen delivery was reduced in CDC-defined CFS patients compared with that in sedentary controls, consistent with previous studies showing abnormal autonomic control of blood flow.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10545311&form=6&db=m &Dopt=b
NLM CIT. ID: 96189166 - NLM PUBMED CIT. ID: 8618560
SOURCE: Muscle Nerve 1996 May;19(5):621-5
TITLE: Reduced oxidative muscle metabolism in chronic fatigue syndrome
AUTHORS: McCully KK; Natelson BH; Iotti S; Sisto S; Leigh JS Jr
AUTHOR AFFILIATION: Department of Medicine, Medical College of Pennsylvania, Philadelphia 19131, USA."In conclusion, oxidative metabolism is reduced in CFS patients compared to sedentary controls."
Neuromuscul Disord 1998 May;8(3-4):204-9
Heterogeneity in chronic fatigue syndrome: evidence from magnetic resonance spectroscopy of muscle.
Lane RJ, Barrett MC, Taylor DJ, Kemp GJ, Lodi R
Division of Clinical Neuroscience and Psychological Medicine, Imperial College School of Medicine, Charing Cross Hospital, London, UK.".but at the end of exercise, intracellular pH in the SATET +ve patients was significantly lower than in both the SATET -ve cases and controls (P < 0.03), and the SATET +ve patients also showed a significantly lower ATP synthesis rate during recovery (P < 0.01), indicating impaired mitochondrial oxidative phosphorylation..
This cannot be explained satisfactorily by the effects of 'inactivity' or 'deconditioning'."
TNF-alpha and chronic fatigue syndrome.
Authors: Moss RB, Mercandetti A, Vojdani A
The Immune Response Corporation, Carlsbad, California 92008, USA. shotdoc@imnr.com
Journal of Clinical Immunology 1999 Sep;19(5):314-6
NLM citations: PMID: 10535608, UI: 20004266[Note: TNF-alpha is the human tumor necrosis factor alpha, a protein of 157 amino acids with a wide range of pro-inflammatory actions, usually considered to be a cytokine.]
This study suggests a significant increase of serum TNF-alpha in patients with CFS compared to non-CFS controls, supporting further examination of the role of proinflammatory mediators in CFS and the clinical testing of TNF-alpha blockers and other anti-inflammatory agents for treatment.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10535608&form=6&db=m&Dopt=b
Rev Infect Dis 1991 Jan-Feb;13 Suppl 1:S39-44
Chronic fatigue syndrome in northern Nevada.
Daugherty SA, Henry BE, Peterson DL, Swarts RL, Bastien S, Thomas RS
Department of Family Medicine, University of Nevada School of Medicine, Reno 89557.
PMID: 1850542, UI: 91212807The clinical and laboratory findings from studies of patients with chronic fatigue syndrome (CFS) from northern Nevada are summarized. Physicians caring for these patients have estimated that greater than 400 patients with CFS from northern Nevada and nearby communities in California were identified between 1984 and 1988. As a result of these studies, a cluster of clinical and laboratory features associated with the illness in moderately to severely affected patients has been identified: profound fatigue of prolonged duration; cervical lymphadenopathy; recurrent sore throat and/or symptoms of influenza; loss of cognitive function manifested by loss of memory and loss of ability to concentrate; myalgia; impairment of fine motor skills; abnormal findings on magnetic resonance imaging brain scan; depressed level of antibody to Epstein-Barr virus (EBV) nuclear antigen; elevated level of antibody to EBV early antigen restricted component; elevated ratio of CD4 helper to CD8 suppressor cells; and strong evidence of association of this syndrome with infection with human herpesvirus 6. More-serious and longer-lasting neurologic impairments, including seizures, psychosis, and dementia, have also been observed in some of these patients.
Small adrenal glands in chronic fatigue syndrome: a preliminary computer tomography study.
Authors: Scott LV, Teh J, Reznek R, Martin A, Sohaib A, Dinan TG
Department of Psychiatry, Trinity College Dublin Medical School, St. James's, Hospital, Ireland.
Journal: Psychoneuroendocrinology 1999 Oct;24(7):759-68
NLM citations: PMID: 10451910, UI: 99381217The right and left adrenal gland bodies were reduced by over 50% in the CFS subjects, a result with implications for CFS pathophysiology and possibly for therapies.
Dr Clifton Bligh, Royal Northshore Hospital CFS Unit, Department of Endocrinology, St Leonards, NSW 2065, Australia in conjunction with C P R Unit, Bioanalytical Research Group, Dept of Biological Sciences, University of Newcastle, Callaghan, NSW 2308
The most striking difference between CFS patients and controls was a reduction in urine asparginine (p<0.0001) and a reduction in urinary succinic acid (p<0.0003) in patients with CFS. Both of those correlated together (p<0.00001). Phenalanine were also significantly reduced. Also urinary tyrosine (p<0.04) and urinary 3-methyl histidine (p<0.03) were significantly increased in CFS. Increased tyrosine was associated with fatigue, muscle pain, lymph node pain and cognitive disturbance.
[CFS World Conference, Sydney, Australia, Feb 1999]CHRONIC PAIN and PROTEIN TURNOVER in POLYSYMPTOMATIC PATIENTS Dr Neil McGregor, CPRU Unit University of Newcastle, Callaghan NSW 2308, in collaboration with Royal Northshore Hospital CFS Unit
Increased Rnase L is a good predictor of CFS fatigue
The increased urinary tyrosine : leucine ratio is found to be a good predictor of CFS pain/infectious symptoms. Tyrosine is a marker breakdown of protein, leucine is a marker for protein synthesis, therefore there is an increase in breakdown yet synthesis is impaired.
[CFS World Conference, Sydney, Australia, Feb 1999]This syndrome, in fact, is emerging to be a purely physical illness, as shown by the 36 features it shares with Addison disease, an indisputable organic condition that no one would treat with CBT. All the physical symptoms and neuropsychological complaints that affect patients with CFS are found in addisonian subjects too, as a result of their shared adrenal insufficiency.
Baschetti, R. Investigations of hydrocortisone and fludrocortisone in the treatment of CFS. J Clin Endocrinol Metab.1999; 84-2263-2264A recent U.S. study reports a 4% recovery rate (Archives of Physical Medicine and Rehabilitation 1999;80:1090-1093;).
To date, none of Dr. Peterson's 180 patients have recovered [CNN - Oct 1999].
5) Psychiatric Study:
NLM CIT. ID: 98236068 - NLM PUBMED CIT. ID: 9576531 SOURCE: J Neurol Neurosurg Psychiatry 1998 Apr;64(4):431-4
TITLE: Relation between neuropsychological impairment and functional disability in patients with chronic fatigue syndrome
AUTHORS: Christodoulou C; DeLuca J; Lange G; Johnson SK Sisto SA; Korn L; Natelson BH
AUTHOR AFFILIATION: University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, USA.CONCLUSION: A relation was found between cognitive impairment and functional disability which could not be explained entirely on the basis of psychiatric factors.
NLM CIT. ID: 97200886 - NLM PUBMED CIT. ID: 9048715
SOURCE: J Neurol Neurosurg Psychiatry 1997 Feb;62(2):151-5
TITLE: Cognitive functioning is impaired in patients with chronic fatigue syndrome devoid of psychiatric disease.
AUTHORS: DeLuca J; Johnson SK; Ellis SP; Natelson BH.
AUTHOR AFFILIATION: University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, USA.CONCLUSION: Impaired cognition in chronic fatigue syndrome cannot be explained solely by the presence of a psychiatric condition.
NLM CIT. ID: 96432598 - NLM PUBMED CIT. ID: 8835650
SOURCE: J Affect Disord 1996 Jun 20;39(1):21-30
TITLE: Depression in fatiguing illness: comparing patients with chronic fatigue syndrome, multiple sclerosis and depression.
AUTHORS: Johnson SK; DeLuca J; Natelson BH
AUTHOR AFFILIATION: Chronic Fatigue Syndrome Center, University of Medicine and Dentistry of New Jersey--New Jersey Medical School, West Orange, USA.The CFS and MS groups exhibited a significantly lower percentage of self-reproach symptoms than clinically depressed subjects (DEP), whereas the DEP group showed a lower percentage of somatic symptoms than the CFS and MS groups.
NLM CIT. ID: 96347072 - NLM PUBMED CIT. ID: 8736462
SOURCE: J Psychiatr Res 1996 Jan-Feb;30(1):9-20
TITLE: Personality dimensions in the chronic fatigue syndrome: a comparison with multiple sclerosis and depression
AUTHORS: Johnson SK; DeLuca J; Natelson BH
AUTHOR AFFILIATION: Chronic Fatigue Syndrome Research Center, West Orange, NJ 07052, USA.The depressed group had significantly more personality disorders and elevated neuroticism scores compared with the other three groups. The CFS and MS subjects had intermediary personality scores which were significantly higher than healthy controls.
MEDICAL DIAGNOSIS, SUICIDE and CHRONIC FATIGUE SYNDROME: Upon which side of the desk lies the neurosis?
Dr Michael King, PhD, MSc, M.A.P.S
172 Albert St, Sebastopol Victoria
3356, AustraliaPresentation on the very serious issue of CFS and suicide - morbidity, debilitation, secondary depression, social dysfunction
[World CFS Conf, Sydney Feb 1999]Nippon Rinsho 1992 Nov;50(11):2630-4
[Neuro-psychiatric aspects of chronic fatigue syndrome].
[Article in Japanese]
Shimizu T"The results clearly imply that CFS is not a hysterical or psychogenic disease"