Fatigue: Biomedicine, Health & Behavior - Volume 6, Issue 3, 2018

Volume 6, Issue 3, 2018

 * Mitochondrial DNA copy number is not associated with fatigue status in Primary Sjögren’s Syndrome"Abstract - Background: Primary Sjögren’s syndrome (pSS) is a heterogeneous disease characterized by lymphocytic infiltrates to the exocrine glands, causing sicca symptoms and other manifestations. Fatigue is one of the most prominent symptom in pSS; up to 70% suffer from chronic fatigue. Fatigue has been shown to be common and severe in patients suffering from primary mitochondrial DNA (mtDNA) disease. In a number of chronic diseases, mitochondrial DNA copy number (mtDNAcn) has been reported to be altered. Purpose: The aim of the study was to examine if mtDNAcn was altered in fatigued versus non-fatigued pSS. Methods: We quantified mtDNAcn using quantitative polymerase chain reaction (qPCR) with mitochondrial ND2 as a target gene normalized to nuclear HβB (mtDNA:nDNA). Results: In 204 participants, 108 fatigued and 96 non-fatigued, relative mtDNAcn did not distinguish fatigue status (p = 0.7) nor was it correlated with severity of fatigue (p = 0.21). Conclusions: MtDNAcn is not altered with fatigue status in blood in pSS. Our analysis suggests that when conducting mtDNAcn analysis with large sample numbers over multiple days a two-way-ANOVA should be used in preference to a one-way-ANOVA or t-test to allow detection of batch effects."


 * Double-blinded placebo-controlled cross-over pilot trial of naltrexone to treat Gulf War Illness Abstract - Background: 30% of Gulf War veterans developed Gulf War Illness (GWI) with chronic fatigue, pain, and neuropsychological disabilities. Purpose: To assess the efficacy of low-dose naltrexone to treat GWI. Methods: A double-blinded, placebo-controlled crossover trial of naltrexone 4.5 mg/day was conducted. The Clinical global impression scale (CGIS), visual analogue scales (VAS), SF-36 Health Survey, and the Connors Continuous Performance Test assessed treatment response. ClinicalTrials.gov registry Identifier is NCT02206490. Results: Thirty-seven participants completed the protocol. 100% had upper airway inflammation on examination. 88% were overweight or obese. The CGIS detected improvement in 38% of patients (n = 14) (responders), with 6 of these patients reporting much improvement. Non-responders were rated as showing no change from baseline (n = 18; 49%), or were rated minimally worse (n = 5; 13%). On the SF-36 Health Survey, responders showed significantly less disability than non-responders with respect to emotional limitations (p = 0.01) as well as greater improvement on VAS scales for confusion (p < 0.01), vertigo (p = 0.03) and depression (p = 0.05). All enrolled participants had detectable levels of naltrexone in their serum at the end of the treatment period, with values ranging from 1.5to 18 ng/ml. Anecdotally, some subjects and their spouses felt that naltrexone should be continued after the study ended. Conclusions: This pilot trial suggests low-dose naltrexone may be effective for some with GWI. Further study and consideration of other doses is needed.


 * Liver volume is lower and associates with resting and dynamic blood pressure variability in chronic fatigue syndrome
 * The prevalence of fatigue, sleepiness, and sleep disorders among petrochemical employees in Iran
 * Latent class analysis of a heterogeneous international sample of patients with myalgic encephalomyelitis/chronic fatigue syndrome