Dorothy Bruck

Dorothy Bruck, BA (Hons) (Uni Tas), PhD (La Trobe), MAPS, is a professor at Victoria University, Melbourne, Australia. Her academic interests include sleep/wake behaviour, mental health, chronic fatigue, arousal thresholds, human behaviour in emergencies and the needs of culturally and linguistically diverse communities.

Books

 * 2017, Chapter 31 - Sleep, Cognitive and Mood Symptoms in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, in The Handbook of Stress and Health: A Guide to Research and Practice"'Abstract - Sleep abnormalities, neurocognitive disturbances and comorbid depressive symptoms are some of the particularly debilitating symptoms experienced by patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This complex condition with currently evasive etiology involves a multisystemic symptom presentation that can reflect dysfunction in several organs and biological systems. The microbiota-gut-brain axis provides one possible pathway where dysfunction in communication between enteric microbiota, the gastro-intestinal system, and the brain may precipitate some ME/CFS symptoms. Sleep, neurocognitive and depressive symptoms are examined with recent microbiome research highlighting the potential etiological role of dysfunction in gut-brain communication. Treatment alternatives are reviewed with a focus on addressing underlying pathophysiology and possible causal mechanisms. The burgeoning field of microbiota research across diverse health fields provides an avenue of hope for future therapeutic advances and improved health outcomes for patients with ME/CFS."

Notable Studies

 * 2017 - Examining clinical similarities between myalgic encephalomyelitis/chronic fatigue syndrome and d-lactic acidosis: a systematic review"Abstract - Background: The pursuit for clarity in diagnostic and treatment pathways for the complex, chronic condition of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) continues. This systematic review raises a novel question to explore possible overlapping aetiology in two distinct conditions. Similar neurocognitive symptoms and evidence of d-lactate producing bacteria in ME/CFS raise questions about shared mechanisms with the acute condition of d-lactic acidosis (d-la). Methods: d-la case reports published between 1965 and March 2016 were reviewed for episodes describing both neurological symptoms and high d-lactate levels. Fifty-nine d-la episodes were included in the qualitative synthesis comparing d-la symptoms with ME/CFS diagnostic criteria. A narrative review of d-la mechanisms and relevance for ME/CFS was provided. Results: The majority of neurological disturbances reported in d-la episodes overlapped with ME/CFS symptoms. Of these, the most frequently reported d-la symptoms were motor disturbances that appear more prominent during severe presentations of ME/CFS. Both patient groups shared a history of gastrointestinal abnormalities and evidence of bacterial dysbiosis, although only preliminary evidence supported the role of lactate-producing bacteria in ME/CFS. Limitations: Interpretation of results are constrained by both the breadth of symptoms included in ME/CFS diagnostic criteria and the conservative methodology used for d-la symptom classification. Several pathophysiological mechanisms in ME/CFS were not examined. Conclusions: Shared symptomatology and underlying microbiota–gut–brain interactions raise the possibility of a continuum of acute (d-la) versus chronic (ME/CFS) presentations related to d-lactate absorption. Measurement of d-lactate in ME/CFS is needed to effectively evaluate whether subclinical d-lactate levels affect neurological symptoms in this clinical population."
 * 2016 - Support for the Microgenderome: Associations in a Human Clinical Population"'Abstract - The ‘microgenderome’ provides a paradigm shift that highlights the role of sex differences in the host-microbiota interaction relevant for autoimmune and neuro-immune conditions. Analysis of cross-sectional self-report and faecal microbial data from 274 patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) suggests that commensal gut microorganisms may play both protective and deleterious roles in symptom expression. Results revealed significant sex-specific interactions between Firmicutes (Clostridium, Streptococcus, Lactobacillus and Enterococcus) and ME/CFS symptoms (including neurological, immune and mood symptoms), regardless of compositional similarity in microbial levels across the sexes. Extending animal studies, we provide support for the microgenderome in a human clinical population. Applied and mechanistic research needs to consider sex-interactions when examining the composition and function of human microbiota.'"
 * 2015, Sleep quality and the treatment of intestinal microbiota imbalance in Chronic Fatigue Syndrome: A pilot study.
 * 2012, Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review "'Abstract - Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a chronic, disabling illness that affects approximately 0.2% of the population. Non-restorative sleep despite sufficient or extended total sleep time is one of the major clinical diagnostic criteria; however, the underlying cause of this symptom is unknown. This review aims to provide a comprehensive overview of the literature examining sleep in CFS/ME and the issues surrounding the current research findings. Polysomnographic and other objective measures of sleep have observed few differences in sleep parameters between CFS/ME patients and healthy controls, although some discrepancies do exist. This lack of significant objective differences contrasts with the common subjective complaints of disturbed and unrefreshed sleep by CFS/ME patients. The emergence of new, more sensitive techniques that examine the microstructure of sleep are showing promise for detecting differences in sleep between patients and healthy individuals. There is preliminary evidence that alterations in sleep stage transitions and sleep instability, and other physiological mechanisms, such as heart rate variability and altered cortisol profiles, may be evident. Future research investigating the etiology of non-restorative sleep in CFS/ME may also help us to undercover the causes of non-restorative sleep and fatigue in other medical conditions."