Journal of Chronic Fatigue Syndrome: Volume 4, Issue 3, 1998

Volume 4, Issue 3, 1998

 * Editorial, by Nancy Klimas & Roberto Patarca
 * Measurement of CO2 in Chronic Fatigue Syndrome Patients"Abstract - 'This sludy has two goals: one, to compare the resting end-tidal pCCb (PctCCh) and heart rate (HR) of chronic fatigue syndrome patients (CFS) with controls; two, to examine the effects of a mouthpiece and noseclips upon measurements of PelC02 and HR. Patients from the CFS Center came to the University Hospital pulmonary function laboratory for one testing session. Arterial (PaCCh), PetCOi, end-nasal (PenCOi) and HR were measured twice; both with and again without the subject breathing through the mouthpiece. We found that PcnCCb was greater and HR lower for both CFS and non-CFS groups when subjects were not confined by the mouthpiece. We conclude that there is no abnormality in the regulation of respiration in CFS patients. Changes in HR accompany changes in PetCOi in this study. Most likely, both result from anxiety associated with mouthpiece breathing."
 * Pain Perception in Chronic Fatigue Syndrome"Abstract - 'Pain complaints (myalgia, arthralgia, headache, sore throat) are commonly associated with chronic fatigue syndrome (CFS), yet to date, these patients' responses to standardized measures of pain perception have not been investigated. Pain perception was measured by pressure dolorimeter and ice water cold pressor tests, and the McGili Pain Questionnaire among 15 female subjects with CFS, 11 subjects with Major Depression and 11 healthy controls. No differences were found between the groups for pain threshold or intolerance levels on the pressure dolorimeter and cold pressor tests. CFS and depressed subjects endorsed significantly more self-reported pain complaints than did control subjects. Although more pain complaints were predicted by greater somatization and lower health perceptions, pain threshold and intolerance were not associated with psychiatric symptoms or functional status. The study yielded some interesting preliminary observations related to variability in pain tolerance among CFS patients. These preliminary observations are discussed in terms of the need for future research and their potential implications for treatment and coping with the illness.'"
 * Relationship Between SPECT Scans and Buspirone Tests in Patients with ME/CFS Abstract - "The purpose of this exercise was to study the relationship between the detail shown on the SPECT brain scans with those seen in the buspirone tests. Thirty-nine patients are included in this study. These patients were selected from a large number who had been referred to Dr. Richardson from various parts of the country by their doctors because of a tentative diagnosis of ME/CFS. All the selected patients were confirmed by Dr. Richardson as suffering from ME/CFS taking into account the subjective scoring methods, clinical examination, virology and buspirone tests. This study is an attempt to link together the results of the previously described techniques to investigate possible areas of impaired cellular function in brain which may have purely neuroneura! effects or possibly neurohormonal effects. All patients within this study displayed hypoperfusion in some brain area as shown by their SPECT scans (see Appendix, Table 1.1).
 * Thirty-five (90%) showed hypoperfusion in the regions comprising:
 * Twenty-four (62%) in the Brain Stem
 * Twenty (51%) in the Caudate Nuclei
 * Nine (23%) showed hypoperfusion in both Brain Stem and Caudate Nuclei regions
 * Thirty (77%) cases demonstrated hypoperfusion in the regions comprising:
 * Twenty-four (62%) in the Temporal Lobes
 * Twelve (31%) in the Parietal Lobes
 * Nine (23%) in the Frontal Lobes
 * The significance of these results is to confirm that there is actual evidence of neurological dysfunction which results in the continuing morbidity in these ME/CFS patients. The completion of this buspirone test and SPECT scan can be deemed to be basic complementary evidence for the positive diagnosis of ME/CFS."


 * Chronic Fatigue Syndrome: An Atopic State"Abstract - 'The cause of the tiredness and depression, may be due to a virus in the acute or recuperative phase, but in the long-term fatigue must be due to other mechanisms. As varied as are our size, shape, skin and eye colour so are the more subtle nuances of antibodies and enzymes which each cell produces. It is postulated that it is mostly atopic patients who will also react abnormally to certain foods, inhalants and skin applications. Sugars (refined foods) play a major role in leading to fatigue by their chemical, physiological, pharmacological and glycosylogical properties. Bread plays a major role in provoking the symptoms of depression in the chronic fatigue syndrome. What is suggested is that in a genetically predisposed group of people food intolerance causes symptoms akin to both the major and minor criteria of CFS.'"
 * Chronic Fatigue Syndrome Among School Children and Their Special Educational Needs"Abstract - 'Objectives: To determine the prevalence of Chronic Fatigue Syndrome (CFS) in school children. To explore their Special Educational Needs (SEN) arrangements. To evaluate the views of their parents, the educational and medical professionals involved in the process of special education needs assessment. Design: A postal questionnaire survey. Setting: The Merton and Sutton Junior and High Schools. Subjects: Pupils diagnosed with CFS. Main Outcome Measures: Responses to CFS about special educational needs and case details. Results: With a 53.8% return rate, 22 cases were identified giving an overall point prevalence of 0.07%. Of these 22 cases, 21 were in Sutton and one in Merton. There were equal numbers of boys and girls. Although the respondent groups generally agreed about Special Educational Needs arrangements, differences existed on home tuition and physical education (PE) at school. Parents were more against PE, 5 (71%) vs. 2 (14%) and 4 (11%) of doctors and educational staff, respectively (P = 0.001). Four out of seven parents (57%) said home tuition was necessary, while only one doctor (7%) and nine educational staffs (25.7%) agreed with this (P = 0.044). Conclusion: The estimated overall prevalence is consistent with previous paediatric studies. Two different findings, however, emerged. The equal prevalence in boys and girls (in contrast to previous studies) and the highly significant difference of case numbers between these two neighbouring boroughs (21 vs. 1). Further research is needed for possible explanation of these differences.'"
 * Characteristics of Fatigued Persons Associated with Features of Chronic Fatigue Syndrome "Abstract - 'Background: Characteristics of persons with chronic fatigue syndrome (CFS) have previously been studied by comparing subjects with CFS to subjects with other conditions or no symptoms of fatigue- In the present study of subjects with idiopalhic chronic fatigue we examined the association between the number and severity of the features of CFS with other characteristics of the subjects. Methods: Data were obtained from a registry of persons over the age of 17 with fatigue for at least six months. All subjects in the registry completed an extensive questionnaire that provided information about fatigue, demographic characteristics, medical conditions, life style, sleeping habits, and psychological characteristics. The characteristics of the subjects were tested for an association with the number of CFS symptoms and the severity of individual CFS symptoms that are considered to be of fundamental importance and may identify more homogeneous subjects with chronic fatigue. Results: The number of CFS symptoms had a bell shaped distribution. This number was strongly associated with the severity of fatigue, the response of fatigue to mental and physical activity, and the following subject characteristics: a greater frequency of sinus and respiratory infections, a higher frequency of migraine headaches, a greater number of somatoform symptoms that were not included as criteria for CFS, and not drinking alcohol. These same subject characteristics were generally associated with at least one of the individual CFS symptoms but more weakly. Psychological complaints only had a statistically significant positive association with one feature of CFS, neurocognitive complaints. Conclusions: Persons with fatigue can be usefully characterized by the extent to which they meet the CFS criteria.'"