Anonymous
Not logged in
Talk
Contributions
Create account
Log in
Search
Editing
Post-exertional malaise
(section)
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history
Namespaces
Page
Discussion
More
More
Page actions
Read
Edit
Edit source
History
Warning:
You are not logged in. Your IP address will be publicly visible if you make any edits. If you
log in
or
create an account
, your edits will be attributed to your username, along with other benefits.
Anti-spam check. Do
not
fill this in!
=== Healthy controls and idiopathic chronic fatigue === PEM was one of the symptoms in the CDC symptom inventory list that differentiated subjects with ME/CFS from those with [[idiopathic chronic fatigue|long term chronic fatigue]] without ME/CFS.<ref name="Wagner2005">{{Cite journal | last = Wagner | first=Dieter | last2 = Nisenbaum | first2 = Rosane | last3 = Heim | first3 = Christine | last4 = Jones | first4 = James F. | last5 = Unger | first5 = Elizabeth R. | last6 = Reeves | first6 = William C. | date = 2005-07-22 | title = Psychometric properties of the CDC Symptom Inventory for assessment of chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/16042777|journal=Population Health Metrics|volume=3 | pages = 8|doi=10.1186/1478-7954-3-8|issn=1478-7954|pmc=1183246|pmid=16042777}}</ref> It was also the highest loading factor among a data set of 38 measurements used for a principal component analysis of unexplained chronic fatigue.<ref name="Vollmer2006">{{Cite journal | last = Vollmer-Conna | first=Uté | last2 = Aslakson | first2 = Eric | last3 = White | first3 = Peter D | date = Apr 2006 | title = An empirical delineation of the heterogeneity of chronic unexplained fatigue in women|url=https://www.futuremedicine.com/doi/abs/10.2217/14622416.7.3.355|journal=Pharmacogenomics|language=en|volume=7|issue=3|pages=355–364|doi=10.2217/14622416.7.3.355|issn=1462-2416}}</ref> Data for this study came from the epidemiological study in Wichita, Kansas. The other major epidemiological study, carried out in Chicago, also identified PEM as the hallmark symptom of ME/CFS. In a 10 year follow-up study on the 32 patients originally identified as having ME/CFS, all of the contacted patients reported post-exertional malaise at some point in time. This symptom was able to differentiate ME/CFS patients with those with [[idiopathic chronic fatigue]], those with exclusionary illnesses and healthy controls. According to the author: <blockquote>"Among all the variables in this study, only for post-exertional malaise did the CFS group significantly differ from the other three conditions. This reaffirms the importance of this being a cardinal and critical symptom for CFS."<ref name="Jason2011history">{{Cite journal | last= Jason | first = Leonard A. | author-link = Leonard Jason | date = Feb 2011 | title = Natural History of Chronic Fatigue Syndrome|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3171164/|journal=Rehabilitation psychology|volume=56|issue=1|pages=32–42|doi=10.1037/a0022595|issn=0090-5550|pmc=3171164|pmid=21401284}}</ref> </blockquote>Using a large sample of ME/CFS patients from Newcastle, [[Norway]] and the [[Solve_ME/CFS_Initiative#Biobank Solve ME/CFS Biobank]], Jason et al. (2014) conducted an analysis of different case definitions and symptoms. The domain of post-exertional malaise was found to be most adequate at differentiating ME/CFS patients from controls. As the authors noted: <blockquote>Using the latent variables from the empiric criteria, only one factor (PEM) was needed to reach a sensitivity of 90.8%, specificity of 92.5% and accuracy of 91.6%, and this was the only data mining where all percentages were over 90%. […] the fact that PEM came out in all analyses supports the importance of this domain in the case definition.<ref name="Jason2014criteria">{{Cite journal | last= Jason | first = Leonard A. | author-link = Leonard Jason | last2 = Kot | first2 = Bobby | last3 = Sunnquist | first3 = Madison | last4 = Brown | first4 = Abigail | last5 = Reed | first5 = Jordan | last6 = Furst | first6 = Jacob | last7 = Newton | first7 = Julia L. | authorlink7 = Julia Newton | last8 = Strand | first8 = Elin Bolle | authorlink8 = Elin Strand | last9 = Vernon | first9 = Suzanne D. | authorlink9 = Suzanne Vernon | date = 2014-04-01 | title = Comparing and Contrasting Consensus versus Empirical Domains|url=https://www.ncbi.nlm.nih.gov/pubmed/26977374|journal = Fatigue: Biomedicine, Health & Behavior |volume=3|issue=2 | pages = 63–74|doi=10.1080/21641846.2015.1017344|issn=2164-1846|pmc=4788637|pmid=26977374}}</ref> </blockquote>A 2014 examination, using 236 patients and 86 controls, showed that three symptoms accurately classified 95.4% of participants as patient or control: fatigue/extreme tiredness, inability to focus on multiple things simultaneously, and experiencing a dead/heavy feeling after starting to exercise.<ref name="Jason2014">{{Cite journal | last= Jason | first = Leonard A. | author-link = Leonard Jason | last2 = Sunnquist | first2 = Madison | last3 = Brown | first3 = Abigail | last4 = Evans | first4 = Meredyth | last5 = Vernon | first5 = Suzanne D. | last6 = Furst | first6 = Jacob | last7 = Simonis | first7 = Valerie | date = 2014-01-01 | title = Examining case definition criteria for chronic fatigue syndrome and myalgic encephalomyelitis|url=https://www.ncbi.nlm.nih.gov/pubmed/24511456|journal = Fatigue: Biomedicine, Health & Behavior |volume=2|issue=1 | pages = 40–56|doi=10.1080/21641846.2013.862993|issn=2164-1846|pmc=3912876|pmid=24511456}}</ref> Another data mining study by the same research group, suggested the selection of four symptoms: next to extreme tiredness, unrefreshing sleep and [[Word-finding problems|difficulty finding the right word to say]] or [[Aphasia|expressing thoughts]], PEM was once again represented with the item “physically drained/sick after mild activity.”<ref name="Jason2015case">{{Cite journal | last= Jason | first = Leonard A. | author-link = Leonard Jason | last2 = Kot | first2 = Bobby | last3 = Sunnquist | first3 = Madison | last4 = Brown | first4 = Abigail | last5 = Evans | first5 = Meredyth | last6 = Jantke | first6 = Rachel | last7 = Williams | first7 = Yolonda | last8 = Furst | first8 = Jacob | last9 = Vernon | first9 = Suzanne D. | date = 2015 | title=Chronic Fatigue Syndrome and Myalgic Encephalomyelitis: Toward An Empirical Case Definition|url=https://www.ncbi.nlm.nih.gov/pubmed/26029488|journal=Health Psychology and Behavioral Medicine|volume=3|issue=1 | pages = 82–93|doi=10.1080/21642850.2015.1014489|issn=2164-2850|pmc=4443921|pmid=26029488}}</ref> [[Michael Maes|Maes]] et al. (2012) divided ME/CFS patients into two groups: those with or without PEM lasting for more than 24 hours. Analysis showed this to be a meaningful division as the former group (45% of the sample) not only had higher symptom scores on concentration difficulties and a subjective experience of infection, but also higher markers of immune-activation such as [[Interleukin 1|IL-1]], [[TNFα]], [[lysozyme]] and [[neopterin]], than the CFS group without PEM. According to the authors their findings, "underscore the relevance of post-exertional malaise to identify a subgroup of CFS patients that should be diagnosed as ME".<ref name="Maes2012">{{Cite journal | last = Maes | first = Michael | authorlink = Michael Maes | last2 = Twisk | first2 = Frank N.M. | author-link2 = Frank Twisk | last3 = Johnson | first3 = Cort | authorlink3 = Cort Johnson | date = 2012-12-30 | title = Myalgic Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS), and Chronic Fatigue (CF) are distinguished accurately: results of supervised learning techniques applied on clinical and inflammatory data|url=https://www.ncbi.nlm.nih.gov/pubmed/22521895|journal=Psychiatry Research|volume=200|issue=2-3 | pages = 754–760|doi=10.1016/j.psychres.2012.03.031|issn=1872-7123|pmid=22521895}}</ref>
Summary:
Please make sure your edits are consistent with
MEpedia's guidelines
.
By saving changes, you agree to the
Terms of use
, and you irrevocably agree to release your contribution under the
CC BY-SA 3.0 License
and the
GFDL
. You agree that a hyperlink or URL is sufficient attribution under the Creative Commons license.
Cancel
Editing help
(opens in new window)
Navigation
Navigation
Skip to content
Main page
Browse
Become an editor
Random page
Popular pages
Abbreviations
Glossary
About MEpedia
Links for editors
Contents
Guidelines
Recent changes
Pages in need
Search
Help
Wiki tools
Wiki tools
Special pages
Page tools
Page tools
User page tools
More
What links here
Related changes
Page information
Page logs