Journal of Chronic Fatigue Syndrome: Volume 11, Issue 3, 2003

Titles and abstracts for the Journal of Chronic Fatigue Syndrome, Volume 11, Issue 3, 2003.

Volume 11, Issue 3, 2003

• Editorial by Kenny De Meirleir & Neil McGregor
• 2003, The Symptoms and Psychiatric Status of the Bijlmermeer Plane Crash Disaster: Similarities with Chronic Fatigue Syndrome and Gulf War Syndrome

  "Abstract - On October 4, 1992, the El Al Boeing crashed in the residential quarter ‘Bijlmermeer’ in Amsterdam (The Netherlands). In the years after the plane crash, local residents and assistance personnel began reporting a variety of unusual symptoms not unlike those reported by patients with chronic fatigue syndrome (CFS) and Gulf War Syndrome (GWS). The aim of this study was to define the symptom constellations reported by the patients and assess the possible causes of the illness. Standardized psychological questionnaires (MMPI-II, SCL-90, KPS and a complaints checklist) were used to screen for psychological changes and to describe the symptoms reported by the patients. Differences between local residents and assistance personnel, gender differences, Mycoplasma-infected and Mycoplasma non-infected patients were monitored. The major symptoms reported were extreme fatigue, non-restorative sleep, concentration-problems, memory problems and muscle and joint pains. There were no changes in the SCL-90 responses that indicated any alteration of psychological distress. Assessment using the MMPI-II revealed a profile typically seen in chronic physical illness and assessment of the Harris-Lingoes scales revealed no elevations in pathogenic scales. Twelve subjects (67%) had a positive Mycoplasma PCR response. Victims of the Bijlmermeer plane crash disaster had increases in symptoms similar to patients with Gulf War Syndrome and CFS and no evidence of somatoform disorder, anxiety or depression. Similar to patients with Gulf War Syndrome and CFS, a deregulation of the immune-competence through a combination of toxic material exposure and psychological stressors associated with increased opportunistic infections may be the most likely etiological hypothesis."

• Nutritional Supplement (NT Factor™) Restores Mitochondrial Function and Reduces Moderately Severe Fatigue in Aged Subjects

  "Abstract - Decreased mitochondrial function is a characteristic of aging and fatigue. Here we determined if mild to moderately severe fatigue in a group of aged subjects (mean age > 60 years), as defined by the validated Piper Fatigue Scale (PFS), can be significantly improved by use of a glycophospholipid dietary supplement, NT Factor(tm) (NTF). In addition, we determined if mitochondrial function, as defined by transport of the redox dye Rhodamine-123, is reduced in aging subjects with mild to moderately severe fatigue, and if this can be reversed with NTF supplementation in concert with improvement in fatigue scores. Participants with mild to moderately severe fatigue, who fulfilled the entry requirements were admitted to the study when their fatigue could not be explained by an obvious clinical condition. Twenty of the respondents (mean age = 68.9 ±4.18) completed the first part of the study on NTF for 12 weeks, and 16 of these subjects who agreed to discontinue the product also completed a wash-out period for an additional 12 weeks. Fatigue and mitochondrial function were determined every four weeks during the study. There was a time-dependent reduction in overall fatigue in moderately fatigued subjects (P < .001) but not in mildly fatigued subjects. Mitochondrial function at four and eight weeks of NTF use in moderately fatigued subjects increased by 15% and 26.8%, respectively, and restored mitochondrial function to levels similar to those found in young adults. No further increase was noted between 8 and 12 weeks. Post-NTF there was a slow redevelopment of fatigue and a fall in mitochondrial function in moderately fatigued subjects, indicating that continued use of NTF may be necessary to maintain lower fatigue scores and maintain mitochondrial function. The dietary supplement with NTF reduced moderate fatigue and increased mitochondrial function in aged subjects but had no effect upon mild fatigue expression."

• Hyperbaric Therapy in Chronic Fatigue Syndrome

  "Abstract - The aim of this study was to determine if hyperbaric oxygen treatment (HBOT) could be used as adjunctive therapy and if HBOT could increase the quality of life in such a way that the functional status would improve in patients with an infection. A randomized, controlled trial was conducted on 15 Mycoplasma sp. infected CFS (CDC 1994) patients and 14 CFS (CDC 1994) patients with no evidence of a Mycoplasma infection were enrolled in a convenience randomization sample from our referral clinic. No statistical differences were found by use of univariate repeated measures although Bodily Pain as measured by the SF-36 seems to decrease after hyperbaric therapy (Greenhouse-Geisser: p = .010). Trends were found using paired t-testing for Mycoplasma infected CFS patients. The general perceived fatigue seemed to decrease after hyperbaric therapy (General Fatigue: p = .06). Directly after one week of hyperbaric therapy general fatigue improved (p = .03) but there was a reduction of activity (reduced activity: p = .05) and general perceived health (general health: p = .04). One month later the physical role increased (Role-Physical: p = .07). Although more data is required to make firm conclusions, trends were found. Reduced fatigue, increased levels of activity and an improved reaction time improved significantly their quality of life and therefore, enhanced also their functional status and thus could be used as an adjunctive therapy."

• Pathogenesis of Chronic Fatigue Syndrome, a Multisystem Hypothesis

  "Abstract - Fatigue is a very common complaint with a number of meanings. If the fatigue lasts for more than 6 months, it fulfills the definition of “chronic.” The Center for Disease Control (CDC) has established specific criteria for the diagnosis of CFS. This is characterized by a persistent or relapsing debilitating fatigue for at least 6 months in the absence of a medical diagnosis that would otherwise explain the clinical presentation. CFS represents a heterogeneous group of patients that manifest symptom complexes with varying degrees of fatigue, limited exertional reserve and cognitive dysfunction. This treatise explores the pathogenesis of CFS as it relates to a complex multidimensional systemic process and offers a hypothesis for the disease processes. In particular, an up-regulated immune system, affecting mitochondrial dysfunction is described. These pathophysiologic mechanisms impact and in turn are being impacted by the neuroendocrine system and the HPA axis. In addition, the cardiovascular system involving blood pressure and heart rate anomalies along with neurocognitive pathology is characterized."

• Critical Reviews and Comments on Current Research

Therapy of Circadian Rhythm Disorders in Chronic Fatigue Syndrome: No Symptomatic Improvement with Melatonin or Phototherapy. Reviewed by Williams G, Waterhouse J, Mugarza J, Minors D, Hayden K. European Journal of Clinical Investigation 2002;32:831-837.

Abnormal Sensitization and Temporal Summation of Second Pain (Wind-Up) in Patients with Fibromyalgia Syndrome Reviewed by Staud R, Vierck CJ, Cannon RL, Mauderli AP, Price DD. Pain 2001;91:165-175.

See also

• Journal of Chronic Fatigue Syndrome for other Issues

flare-up A symptoms flare in ME/CFS is a temporary increase in symptoms, alternatively known as experiencing post-exertional malaise. May be referred to as a "crash" or "collapse".

flare-up A symptoms flare in ME/CFS is a temporary increase in symptoms, alternatively known as experiencing post-exertional malaise. May be referred to as a "crash" or "collapse".

somatic symptom disorder A psychiatric term to describe an alleged condition whereby a person's thoughts somehow cause physical symptoms. The actual existence of such a condition is highly controversial, due to a lack of scientific evidence. It is related to other psychiatric terms, such as "psychosomatic", "neurasthenia", and "hysteria". Older terms include "somatization", "somatoform disorder", and "conversion disorder". Such terms refer to a scientifically-unsupported theory that claims that a wide range of physical symptoms can be created by the human mind, a theory which has been criticized as "mind over matter" parapsychology, a pseudoscience.

etiology The cause of origin, especially of a disease.

mitochondria Important parts of the biological cell, with each mitochondrion encased within a mitochondrial membrane. Mitochondria are best known for their role in energy production, earning them the nickname "the powerhouse of the cell". Mitochondria also participate in the detection of threats and the response to these threats. One of the responses to threats orchestrated by mitochondria is apoptosis, a cell suicide program used by cells when the threat can not be eliminated.

mitochondria Important parts of the biological cell, with each mitochondrion encased within a mitochondrial membrane. Mitochondria are best known for their role in energy production, earning them the nickname "the powerhouse of the cell". Mitochondria also participate in the detection of threats and the response to these threats. One of the responses to threats orchestrated by mitochondria is apoptosis, a cell suicide program used by cells when the threat can not be eliminated.

Centers for Disease Control and Prevention (CDC) - The Centers for Disease Control and Prevention is a U.S. government agency dedicated to epidemiology and public health. It operates under the auspices of the Department of Health and Human Services.

Short Form 36-Item Health Survey (SF-36) - A 36-item patient-reported questionnaire, used to determine patient health status and quality of life.

Centers for Disease Control and Prevention (CDC) - The Centers for Disease Control and Prevention is a U.S. government agency dedicated to epidemiology and public health. It operates under the auspices of the Department of Health and Human Services.

cognition Thought processes, including attention, reasoning, and memory.

neuroendocrine relating to hormones that influence the nervous system

heart rate (HR) - the number of times the heart beats within a certain time period, usually a minute