Journal of Chronic Fatigue Syndrome: Volume 14, Issue 3, 2007

Volume 14, Issue 3, 2007

 * Editorial by Elke Van Hoof, Kenny De Meirleir & Neil McGregor
 * Transcriptome Analysis of Peripheral Blood Mononuclear Cells from Patients with Chronic Fatigue Syndrome"'Abstract - Objective: Chronic fatigue syndrome (CFS) is an illness defined by unexplained disabling fatigue lasting longer than six months, together with at least four out of eight specified symptoms. The etiology and pathophysiology of CFS are to a large degree unknown. Since much remains unclear about CFS we wanted to investigate transcript expression levels in peripheral blood mononuclear cells to identify genes that are involved in CFS. Method: Transcript expression profiles for 20 CFS patients were compared with 14 healthy controls using microarray technology. Results were verified with real-time PCR. Results: We have identified significantly differentially expressed genes comparing a female CFS patient subgroup with gradual illness onset and no previously documented infection with female healthy controls. We have also created a list of genes with indicated, but not verified, expression differences from comparisons between other subgroups and healthy controls. These genes are candidates for further study of potential involvement in CFS. Conclusion: Our results stress the necessity of subgrouping the heterogeneous CFS patient cohort. The mRNA expression differences identified here may be causal factors for the illness or symptoms observed in these patients, or a result of altered functions of other cellular components involved in the illness. The role of these genes in the CFS pathology needs further investigation.'"
 * Prospective Study of Body Mass Index, Weight Change, and Fatigue in Acute Infectious Mononucleosis"'Abstract - Objective: To examine the influence of body mass index (BMI) and weight change on fatigue severity and failure to recover in individuals with acute infectious mononucleosis. Methods: We prospectively studied 148 individuals presenting with a positive monospot test. We obtained measured weights and vitality subscale scores from the Short Form-36 Health Survey (SF-36) at the index visit and at 6 months. Results: The mean age of the participants was 21 years and 24% were overweight or obese. During acute illness, overweight and obese participants had an adjusted odds ratio for low vitality scores of 2.9 (confidence interval 1.2–7.1) compared to normal weight subjects. Neither index BMI nor 6-month weight gain was significantly associated with prolonged fatigue or failure to recover. Conclusion: Overweight and obese patients with acute infectious mononucleosis are more likely to experience severe fatigue. In contrast, neither baseline weight nor weight gain appear to impede recovery.'"
 * Descriptors of Fatigue in Chronic Fatigue Syndrome"'Abstract - Objective: To explore how individuals with chronic fatigue syndrome (CFS) describe their fatigue experience and examine how this differs from descriptions of fatigue in healthy controls. Methods: Fifty-two individuals with CFS and 27 controls listed words that described their fatigue. These words were grouped into 18 categories. Results: Individuals with CFS used more categories to describe their fatigue and more descriptors within each category. The most popular category used by both groups was energy depletion/physical weakness. CFS participants also experienced their fatigue as limiting their ability to function, frustrating, permanent/persistent, out of their control, depressing, and pervading all aspects of their lives. Controls reported that when they experienced fatigue, it was temporary, and they felt unmotivated, sleepy, and comfortable. Conclusion: The multidimensional descriptive pattern characterizing the fatigue of individuals with CFS differs dramatically from the experienced fatigue of healthy individuals, suggesting their “language of fatigue” has a distinctive quality.'"
 * Protein Nutrition in Fibromyalgia"'Abstract - Background: Fibromyalgia (FM) is a soft-tissue disease of unknown origin. It causes soft-tissue pain and stiffness, often with chronic fatigue, disrupted sleep, headaches and irritable bowel. Fibromyalgia affects an estimated six million Americans of which 80 to 90 percent are female. Objective: To determine whether dietary intake of protein, Tryptophan, and Branched Chain Amino Acids (BCAA) meet Dietary Reference Intake (DRI) recommendations, and whether there is a difference in animal and vegetable protein intake in subjects with FM compared to healthy controls. Methods: Thirty subjects with FM and an equal number of controls completed a Food Frequency Questionnaire (FFQ) regarding dietary intake over the previous month. The FFQs were then computer analyzed to determine dietary intake. Results: Protein intake of all subjects was more than adequate to meet DRI recommendations and there was no significant difference in intake of protein, BCAA, Tryptophan, animal or vegetable protein. Subjects with FM had significantly higher body weight and Body Mass Index (BMI) than controls, and reported having a higher incidence of Irritable Bowel Syndrome (IBS) symptoms than controls. Conclusion: There was no significant difference in dietary intake of protein, Tryptophan, BCAA, or amounts of animal or vegetable protein in FM subjects compared to healthy controls. Significant differences in body weight and BMI in FM subjects might be related to less physical activity or possibly to malabsorption problems associated with IBS. Malabsorption related to IBS might increase the potential for protein malnutrition, FM, and associated symptoms like chronic fatigue.'"
 * Diagnosis and Treatment of Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysfunction in Patients with Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM)"'Abstract - There is controversy regarding the incidence and significance of hypothalamic-pituitary-adrenal (HPA) axis dysfunction in chronic fatigue syndrome (CFS) and fibromyalgia (FM). Studies that utilize central acting stimulation tests, including corticotropin-releasing hormone (CRH), insulin stress testing (IST), d-fenfluramine, ipsapirone, interleukin-6 (IL-6) and metyrapone testing, have demonstrated that HPA axis dysfunction of central origin is present in a majority of these patients. However, ACTH stimulation tests and baseline cortisol testing lack the sensitivity to detect this central dysfunction and have resulted in controversy and confusion regarding the incidence of HPA axis dysfunction in these conditions and the appropriateness of treatment. While both CFS and FM patients are shown to have central HPA dysfunction, the dysfunction in CFS is at the pituitary-hypothalamic level while the dysfunction in FM is more related to dysfunction at the hypothalamic and supra-hypothalamic levels. Because treatment with low physiologic doses of cortisol (<15 mg) has been shown to be safe and effective and routine dynamic ACTH testing does not have adequate diagnostic sensitivity, it is reasonable to give a therapeutic trial of physiologic doses of cortisol to the majority of patients with CFS and FM, especially to those who have symptoms that are consistent with adrenal dysfunction, have low blood pressure or have baseline cortisol levels in the low or low-normal range.'"
 * Chronic Fatigue Syndrome and Its Association with Obsession Compulsion Among a Non-Clinical Sample Using Questionnaires"'Abstract - The present study investigated the possible association between the Chronic Fatigue Syndrome (CFS) and Obsession Compulsion (OC). A non-clinical sample of 427 volunteer Kuwaiti male and female college students was recruited. Their ages ranged from 17 to 40 years. They completed the Arabic Scale of CFS (ASCFS) and the Arabic Scale of Obsession Compulsion (ASOC). Both have good reliability and validity. Females had significantly higher mean score on the ASCFS than did their male counterparts. All the intercorrelations between the 20 items as well as the total score of the ASCFS were statistically significant (p < 0.01) with the total ASOC score in males and females. It was concluded that there is an obsessive compulsive element in CFS, and both disorders share specific common elements.'"