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Jane L. Norris, PA-C works as a physician assistant at Stanford University Medical Center and the Study Coordinator on the Stanford Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Research Team headed by Dr. Jose Montoya.
- 2017, Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria
Abstract - Background: Myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS) remains undiagnosed in up to 91% of patients. Recently, the United States-based Institute of Medicine (IOM) developed new diagnostic criteria, naming it systemic exertion intolerance disease (SEID). Purpose: We examined how subjects fit SEID criteria and existing ME/CFS case definitions early in their illness. Methods: A total of 131 subjects fitting 1994 Fukuda CFS criteria at the time of study recruitment completed a survey of symptoms they experienced during their first 6 months of illness. Symptoms were drawn from SEID and existing criteria (1994 Fukuda, 2003 Canadian Consensus Criteria (CCC), and 2011 Myalgic Encephalomyelitis-International Consensus Criteria (ME-ICC)). We calculated and compared the number/percentage of subjects fitting single or combinations of case definitions and the number/percentage of subjects with SEID experiencing orthostatic intolerance (OI) and/or cognitive impairment. Results: At 6 months of illness, SEID criteria identified 72% of all subjects, similar to when Fukuda criteria (79%) or the CCC (71%) were used, whereas the ME-ICC selected for a significantly lower percentage (61%, p < .001). When severity/frequency thresholds were added to the Fukuda criteria, CCC and ME-ICC, the percentage of these subjects also fitting SEID criteria increased to 93%, 97%, and 95%. Eighty-seven percent of SEID subjects endorsed cognitive impairment and 92%, OI; 79% experienced both symptoms. Conclusions: SEID criteria categorize a similar percentage of subjects as Fukuda criteria early in the course of ME/CFS and contain the majority of subjects identified using other criteria while requiring fewer symptoms. The advantage of SEID may be in its ease of use.
- 2015, Right Arcuate Fasciculus Abnormality in Chronic Fatigue Syndrome
Abstract - Methods: Fifteen patients with CFS were identified by means of retrospective review with an institutional review board–approved waiver of consent and waiver of authorization. Fourteen age- and sex-matched control subjects provided informed consent in accordance with the institutional review board and HIPAA...Results: In the CFS population, FA was increased in the right arcuate fasciculus (P = .0015), and in right-handers, FA was also increased in the right inferior longitudinal fasciculus (ILF) (P = .0008). In patients with CFS, right anterior arcuate FA increased with disease severity (r = 0.649, P = .026). Bilateral white matter volumes were reduced in CFS (mean ± standard deviation, 467 581 mm3 ± 47 610 for patients vs 504 864 mm3 ± 68 126 for control subjects, P = .0026), and cortical thickness increased in both right arcuate end points, the middle temporal (T = 4.25) and precentral (T = 6.47) gyri, and one right ILF end point, the occipital lobe (T = 5.36). ASL showed no significant differences...Conclusions: Bilateral white matter atrophy is present in CFS. No differences in perfusion were noted. Right hemispheric increased FA may reflect degeneration of crossing fibers or strengthening of short-range fibers. Right anterior arcuate FA may serve as a biomarker for CFS."
- 2014, Conference paper, EEG peak alpha frequency is associated with chronic fatigue syndrome: A case-control observational study (FULL TEXT)
Abstract - The purpose of this study was to look at the electrophysiology of the brain in patients with chronic fatigue syndrome (CFS) and compare their electrophysiology to that of healthy controls. Using EEG peak alpha frequency (PAF) in a resting-state eyes-closed condition, EEG was recorded from 19 scalp locations using linked-ear reference from 50 patients and 50 matched controls age 28 to 74 years. The Multidimensional Fatigue Inventory (MFI-20) and the Fatigue Severity Scale (FSS) were used to evaluate fatigue. PAF was computed within the 8-12 Hz frequency band based on each participant’s EEG. Differences between patients diagnosed with the Fukuda criteria and healthy controls were evaluated using a mixed effects analysis of variance and regression analyses to evaluate the relationship between PAF and fatigue within each fatigue measure. A small but significant difference was observed with control PAF being higher than participants’ PAF. Bonferroni-corrected follow-up tests indicated significant differences in PAF at multiple (11) electrode sites (p<.05) in frontal, left temporal, central and parietal regions of interest (ROIs), consistently exhibiting a direct relationship between qEEG and fatigue. Linear regression model fits using PAF to predict each fatigue scale and each subscale of the MFI-20 were statistically significant (p=.000). These novel neuropsychological relationships attest to the use of qEEG as a novel and objective measure of fatigue and neurocognitive impairment (NCI) in CFS. Moreover, resting-state PAFs may indicate its potential for use in diagnosis and to evaluate treatment progress in the clinic.
- Stanford ME/CFS Initiative
- Stanford University Medical Center
- Stanford, California, and
- Palo Alto, California
Talks & interviews
- Chu, Lily; Norris, Jane; Valencia, Ian J.; Montoya, Jose G. (2017), "Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria", Fatigue: Biomedicine, Health & Behavior, 5, doi:10.1080/21641846.2017.1299079
- Zeineh, Michael M.; Kang, James; Atlas, Scott W.; Raman, Mira M.; Reiss, Allan L.; Norris, Jane L.; Valencia, Ian; Montoya, Jose G. (Feb 2015), "Right Arcuate Fasciculus Abnormality in Chronic Fatigue Syndrome" (PDF), Radiology, 274 (2): 517-526, doi:10.1148/radiol.14141079
- Zinn, Marcie L; Zinn, Mark A; Norris, Jane; Valencia, Ian; Montoya, Jose G; Maldonad, Jose R (2014), "EEG peak alpha frequency is associated with chronic fatigue syndrome: A case-control observational study", Conference: 2014 Stanford Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome Symposium