Muscle fatigability
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history
Muscle fatigability in ME is a symptom in which muscles become weaker after minor exertion and a long period (3-5 days or longer) may elapse before full muscle power is restored. According to Melvin Ramsay, it is the defining feature of myalgic encephalomyelitis, without which a diagnosis of ME should not be made,[1] though this symptom is noted to improve during remission. Similar muscle effects are known to occur in other neurological diseases such as multiple sclerosis[2] and post-polio syndrome.[3]
Prevalence[edit | edit source]
- In a 2001 Belgian study, 84.3% of patients meeting the Fukuda criteria and 88.3% of patients meeting the Holmes criteria, in a cohort of 2073 CFS patients, reported muscle weakness.[4]
- Katrina Berne, PhD, reports a prevalence of 85-95% for muscle weakness.[5]
Symptom recognition[edit | edit source]
- In the Holmes criteria, unexplained generalized muscle weakness is an optional criteria for diagnosis, under the section Minor Symptom Criteria.[6]
Notable studies[edit | edit source]
Possible causes[edit | edit source]
- Muscle biopsies have shown evidence of mitochondrial degeneration,[7] deletions of mitochondrial DNA,[8][9] and the reduction of mitochondrial activity.[10]
- In addition, evidence of oxidative damage to muscles has been found in CFS.[11]
- Studies have found reduced levels of serum carnitine which return to normal after recovery and correlate with symptom severity.[12]
- Exercise has also been found to induce both early and excessive lactic acid formation in the muscles[13] with a reduced intraceullar concentrations of ATP and acceleration of glycolysis.[14]
- Neurologist Peter Behan noted that ME patients were found to lack an important muscle enzyme called myoadenylate deaminase. A small peer-reviewed study found this present in only 5.5% of patients, and associated primarily with muscle pain rather than fatigue.[15] Myoadenylate deaminase has since been ruled out as the sole cause of ME/CFS.[16]
Potential treatments[edit | edit source]
Learn more[edit | edit source]
See also[edit | edit source]
References[edit | edit source]
- ↑ "Ramsay's Definition of M.E., 1986". cfids-me.org. Retrieved August 28, 2019.
- ↑ Managing MS Symptoms - Fatigue and Fatigability
- ↑ "The Late Effects of Polio: An Overview". post-polio.org. Retrieved August 28, 2019.
- ↑ De Becker, Pascale; McGregor, Neil; De Meirleir, Kenny (December 2001). "A definition‐based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome". Journal of Internal Medicine. 250 (3): 234–240. doi:10.1046/j.1365-2796.2001.00890.x.
- ↑ Berne, Katrina (December 1, 1995). Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS) (2nd ed.). Hunter House. p. 59. ISBN 978-0897931915.
- ↑ "Holmes Definition of Chronic Fatigue Syndrome, U.S. CDC 1988". cfids-me.org. Retrieved August 28, 2019.
- ↑ Behan, W.M.H.; More, I.A.R.; Behan, P.O. (December 1991). "Mitochondrial abnormalities in the postviral fatigue syndrome". Acta Neuropathologica. 83 (1): 61–65. doi:10.1007/BF00294431. ISSN 0001-6322.
- ↑ Vecchiet, L.; Montanari, G.; Pizzigallo, E.; Iezzi, S.; de Bigontina, P.; Dragani, L.; Vecchiet, J.; Giamberardino, M.A. (April 19, 1996). "Sensory characterization of somatic parietal tissues in humans with chronic fatigue syndrome". Neuroscience Letters. 208 (2): 117–120. doi:10.1016/0304-3940(96)12559-3. ISSN 0304-3940. PMID 8859904.
- ↑ Zhang, C.; Baumer, A.; Mackay, I.R.; Linnane, A.W.; Nagley, P. (April 1995). "Unusual pattern of mitochondrial DNA deletions in skeletal muscle of an adult human with chronic fatigue syndrome". Human Molecular Genetics. 4 (4): 751–754. doi:10.1093/hmg/4.4.751. ISSN 0964-6906. PMID 7633428.
- ↑ Vecchiet, L.; Montanari, G.; Pizzigallo, E.; Iezzi, S.; de Bigontina, P.; Dragani, L.; Vecchiet, J.; Giamberardino, M.A. (April 19, 1996). "Sensory characterization of somatic parietal tissues in humans with chronic fatigue syndrome". Neuroscience Letters. 208 (2): 117–120. doi:10.1016/0304-3940(96)12559-3. ISSN 0304-3940. PMID 8859904.
- ↑ Fulle, S.; Mecocci, P.; Fanó, G.; Vecchiet, I.; Vecchini, A.; Racciotti, D.; Cherubini, A.; Pizzigallo, E.; Vecchiet, L. (December 15, 2000). "Specific oxidative alterations in vastus lateralis muscle of patients with the diagnosis of chronic fatigue syndrome". Free Radical Biology & Medicine. 29 (12): 1252–1259. doi:10.1016/s0891-5849(00)00419-6. ISSN 0891-5849. PMID 11118815.
- ↑ Kuratsune, H.; Yamaguti, K.; Takahashi, M.; Misaki, H.; Tagawa, S.; Kitani, T. (January 1994). "Acylcarnitine deficiency in chronic fatigue syndrome". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 18 (Suppl 1): S62–67. doi:10.1093/clinids/18.supplement_1.s62. ISSN 1058-4838. PMID 8148455.
- ↑ Plioplys, A.V.; Plioplys, S. (1995). "Serum levels of carnitine in chronic fatigue syndrome: clinical correlates". Neuropsychobiology. 32 (3): 132–138. doi:10.1159/000119226. ISSN 0302-282X. PMID 8544970.
- ↑ McCully, K.K.; Natelson, B. H.; Iotti, S.; Sisto, S.; Leigh, J.S. (May 1996). "Reduced oxidative muscle metabolism in chronic fatigue syndrome". Muscle & Nerve. 19 (5): 621–625. doi:10.1002/(SICI)1097-4598(199605)19:53.0.CO;2-Q. ISSN 0148-639X. PMID 8618560.
- ↑ R.H. Edwards, H. Gibson, J.E. Clague, T. Helliwell Muscle histopathology and physiology in chronic fatigue syndrome. CIBA Found. Symp., 173 (1993), pp. 102-117 (discussion 117–131)
- ↑ Edwards, R. H.T.; Gibson, H.; Clague, J.E.; Helliwell, T. (September 28, 2007), "Muscle Histopathology and Physiology in Chronic Fatigue Syndrome", Ciba Foundation Symposium 173‐Chronic Fatigue Syndrome, Chichester, UK: John Wiley & Sons, Ltd., pp. 102–131, ISBN 978-0-470-51438-2
