Teruhisa Miike, MD, was a professor at the Department of Child Development, Faculty of Life Sciences, Kumamoto University, Japan and is afflitiated with the Hyogo Children's Sleep and Development Medical Research Center, Hyogo Rehabilitation Centre, Central Hospital 1070 Akebono-cho, Nishi-ku, Kobe, Hyogo, Japan. He was one of the authors of the 2006 pediatric case definition of childhood chronic fatigue syndrome.
Pediatric Case Definition
- 2006, "A Pediatric Case Definition for Myalgic Encephalomyelitis and Chronic Fatigue Syndrome"
"Summary: For a diagnosis of chronic fatigue syndrome (CFS), most researchers use criteria that were developed by Fukuda et al. (1994), with modifications suggested by Reeves et al. (2003). However, this case definition was established for adults rather than children. A Canadian Case Definition (ME/CFS; Myalgic Encephalomyelitis/CFS) has recently been developed, with more specific inclusion criteria (Carruthers et al., 2003). Again, the primary aim of this case definition is to diagnose adult CFS. A significant problem in the literature is the lack of both a pediatric definition of ME/CFS and a reliable instrument to assess it. These deficiencies can lead to criterion variance problems resulting in studies labeling children with a wide variety of symptoms as having ME/CFS. Subsequently, comparisons between articles become more difficult, decreasing the possibility of conducting a meta-analysis. This article presents recommendations developed by the International Association of Chronic Fatigue Syndrome Pediatric Case Definition Working group for a ME/CFS pediatric case definition. It is hoped that this pediatric case definition will lead to more appropriate identification of children and adolescents with ME/CFS."
- 2015, Frontier studies on fatigue, autonomic nerve dysfunction, and sleep-rhythm disorder (FULL TEXT)
Abstract - Fatigue is defined as a condition or phenomenon of decreased ability and efficiency of mental and/or physical activities, caused by excessive mental or physical activities, diseases, or syndromes. It is often accompanied by a peculiar sense of discomfort, a desire to rest, and reduced motivation, referred to as fatigue sensation. Acute fatigue is a normal condition or phenomenon that disappears after a period of rest; in contrast, chronic fatigue, lasting at least 6 months, does not disappear after ordinary rest. Chronic fatigue impairs activities and contributes to various medical conditions, such as cardiovascular disease, epileptic seizures, and death. In addition, many people complain of chronic fatigue. For example, in Japan, more than one third of the general adult population complains of chronic fatigue. It would thus be of great value to clarify the mechanisms underlying chronic fatigue and to develop efficient treatment methods to overcome it. Here, we review data primarily from behavioral, electrophysiological, and neuroimaging experiments related to neural dysfunction as well as autonomic nervous system, sleep, and circadian rhythm disorders in fatigue. These data provide new perspectives on the mechanisms underlying chronic fatigue and on overcoming it.
- 2015, Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome (FULL TEXT)
Abstract - The ability to divide one's attention deteriorates in patients with childhood chronic fatigue syndrome (CCFS). We conducted a study using a dual verbal task to assess allocation of attentional resources to two simultaneous activities (picking out vowels and reading for story comprehension) and functional magnetic resonance imaging. Patients exhibited a much larger area of activation, recruiting additional frontal areas. The right middle frontal gyrus (MFG), which is included in the dorsolateral prefrontal cortex, of CCFS patients was specifically activated in both the single and dual tasks; this activation level was positively correlated with motivation scores for the tasks and accuracy of story comprehension. In addition, in patients, the dorsal anterior cingulate gyrus (dACC) and left MFG were activated only in the dual task, and activation levels of the dACC and left MFG were positively associated with the motivation and fatigue scores, respectively. Patients with CCFS exhibited a wider area of activated frontal regions related to attentional resources in order to increase their poorer task performance with massive mental effort. This is likely to be less efficient and costly in terms of energy requirements. It seems to be related to the pathophysiology of patients with CCFS and to cause a vicious cycle of further increases in fatigue.
- 2007, Event-related potentials in Japanese childhood chronic fatigue syndrome (FULL TEXT)
- 2005, Cytokine production and modulation: comparison of patients with chronic fatigue syndrome and normal controls
Abstract - We studied cytokine production in 15 patients with chronic fatigue syndrome (CFS) and 23 controls. CFS patients' peripheral blood mononuclear cells were cultured with lipopolysaccharide or phytohemagglutinin. Enzymatic immunoassay indicated cytokine concentration in culture supernatants. CFS patients showed significantly lower mRNA levels and transforming growth factor-beta1 (TGF-beta1) production. Cytokine dysregulation affects CFS pathogenesis. TGF-beta1 may aid treatment because it affects CFS inflammatory characteristics.
- 2004, Learning and memorization impairment in childhood chronic fatigue syndrome manifesting as school phobia in Japan
Abstract - For the last 15 years, we have tried to understand the pathophysiology of childhood chronic fatigue syndrome (CCFS) in Japan. In this condition, two major symptoms are important: easy fatigability and disturbed learning and memorization. In CCFS patients we clinically evaluated autonomic nervous system function, circadian rhythm of hormonal secretion (melatonin, cortisol and 3-endorphin), core body temperature, and sleep-wake pattern. Most patients showed autonomic nervous system dysfunction and circadian rhythm disturbances, similar to those observed in jet lag. Radiological imaging studies (SPECT, Xe-CT, and MRS) revealed decreased blood flow in the frontal and thalamic areas, and accumulation of choline in the frontal lobe. We analyzed the relationship between the laboratory data and clinical symptoms in CCFS.
Talks & interviews
- Jason, Leonard A; Jordan, Karen; Miike, Teruhisa; Bell, David S; Lapp, Charles; Torres-Harding, Susan; Rowe, Kathy; Gurwitt, Alan; De Meirleir, Kenny; Van Hoof, Elke LS (2006), "A Pediatric Case Definition for Myalgic Encephalomyelitis and Chronic Fatigue Syndrome", Journal of Chronic Fatigue Syndrome, 13 (2-3): 1-44, doi:10.1300/J092v13n02_01
- FTanaka, M., Tajima, S., Mizuno, K., Ishii, A., Konishi, Y., Miike, T., & Watanabe, Y. (2015). Frontier studies on fatigue, autonomic nerve dysfunction, and sleep-rhythm disorder. The Journal of Physiological Sciences, 65(6), 483–498. http://doi.org/10.1007/s12576-015-0399-y
- Mizuno, K., Tanaka, M., Tanabe, H. C., Joudoi, T., Kawatani, J., Shigihara, Y., … Watanabe, Y. (2015). Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome. NeuroImage : Clinical, 9, 355–368. http://doi.org/10.1016/j.nicl.2015.09.001
- Tomoda, Akemi et al. (2005). Cytokine production and modulation: Comparison of patients with chronic fatigue syndrome and normal controls. Psychiatry Research , Volume 134 , Issue 1 , 101 - 104
- Miike, T., Tomoda, A., Jhodoi, T., Iwatani, N., & Mabe, H. (2004). Learning and memorization impairment in childhood chronic fatigue syndrome manifesting as school phobia in Japan. Brain and Development, 26(7), 442-447. DOI: 10.1016/j.braindev.2003.10.004