All that shine is not gold: modelling the true relation between orthostatic intolerance, fibromyalgia and chronic fatigue syndromes

2008 ◽  
Vol 18 (6) ◽  
pp. 298-298
Author(s):  
Juvenia Bezerra Fontenele ◽  
Luzia Kalyne A. M. Leal ◽  
Francisco Hélder Cavalcante Félix
Keyword(s):  
Orthostatic Intolerance ◽  
Chronic Fatigue ◽  
True Relation

scholarly journals COVID-19 and post-infectious myalgic encephalomyelitis/chronic fatigue syndrome: a narrative review

2021 ◽  
Vol 8 ◽  
pp. 204993612110093
Author(s):  
Sonia Poenaru ◽  
Sara J. Abdallah ◽  
Vicente Corrales-Medina ◽  
Juthaporn Cowan
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Sleep Disturbances ◽  
Q Fever ◽  
Orthostatic Intolerance ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Exercise Intolerance ◽  
Laboratory Findings ◽  
Fatigue Syndrome ◽  
Post Infectious

Coronavirus disease 2019 (COVID-19) is a viral infection which can cause a variety of respiratory, gastrointestinal, and vascular symptoms. The acute illness phase generally lasts no more than 2–3 weeks. However, there is increasing evidence that a proportion of COVID-19 patients experience a prolonged convalescence and continue to have symptoms lasting several months after the initial infection. A variety of chronic symptoms have been reported including fatigue, dyspnea, myalgia, exercise intolerance, sleep disturbances, difficulty concentrating, anxiety, fever, headache, malaise, and vertigo. These symptoms are similar to those seen in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a chronic multi-system illness characterized by profound fatigue, sleep disturbances, neurocognitive changes, orthostatic intolerance, and post-exertional malaise. ME/CFS symptoms are exacerbated by exercise or stress and occur in the absence of any significant clinical or laboratory findings. The pathology of ME/CFS is not known: it is thought to be multifactorial, resulting from the dysregulation of multiple systems in response to a particular trigger. Although not exclusively considered a post-infectious entity, ME/CFS has been associated with several infectious agents including Epstein–Barr Virus, Q fever, influenza, and other coronaviruses. There are important similarities between post-acute COVID-19 symptoms and ME/CFS. However, there is currently insufficient evidence to establish COVID-19 as an infectious trigger for ME/CFS. Further research is required to determine the natural history of this condition, as well as to define risk factors, prevalence, and possible interventional strategies.

Adolescent Chronic Fatigue and Orthostatic Intolerance

2016 ◽  
Vol 56 (1) ◽  
pp. 85-89 ◽  
Author(s):  
Breann N. Kluck ◽  
Ashley N. Junghans-Rutelonis ◽  
Amie E. Jones ◽  
Philip R. Fischer ◽  
Karen E. Weiss
Keyword(s):  
Orthostatic Intolerance ◽  
Chronic Fatigue

Impaired postural cerebral hemodynamics in young patients with chronic fatigue with and without orthostatic intolerance

2002 ◽  
Vol 140 (4) ◽  
pp. 412-417 ◽  
Author(s):  
Hidetaka Tanaka ◽  
Reiko Matsushima ◽  
Hiroshi Tamai ◽  
Yoshinaga Kajimoto
Keyword(s):  
Orthostatic Intolerance ◽  
Young Patients ◽  
Chronic Fatigue ◽  
Cerebral Hemodynamics

Orthostatic intolerance in the chronic fatigue syndrome

1999 ◽  
Vol 75 (2-3) ◽  
pp. 192-201 ◽  
Author(s):  
Ronald Schondorf ◽  
Julie Benoit ◽  
Theodore Wein ◽  
Denis Phaneuf
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Orthostatic Intolerance ◽  
Chronic Fatigue ◽  
Fatigue Syndrome

scholarly journals Numeric Rating Scales Show Prolonged Post-exertional Symptoms After Orthostatic Testing of Adults With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

2021 ◽  
Vol 7 ◽  
Author(s):  
C (Linda) M. C. van Campen ◽  
Peter C. Rowe ◽  
Freek W. A. Verheugt ◽  
Frans C. Visser
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Pain Perception ◽  
Rating Scales ◽  
Orthostatic Intolerance ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Fatigue Syndrome ◽  
Important Symptom ◽  
Head Up Tilt ◽  
Numeric Rating

Introduction: Muscle pain, fatigue, and concentration problems are common among individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). These symptoms are commonly increased as part of the phenomenon of postexertional malaise (PEM). An increase in the severity of these symptoms is described following physical or mental exercise in ME/CFS patients. Another important symptom of ME/CFS is orthostatic intolerance, which can be detected by head-up tilt testing (HUT). The effect of HUT on PEM has not been studied extensively. For this purpose, we assessed numeric rating scales (NRS) for pain, fatigue, and concentration pre- and post-HUT. As pain is a core symptom in fibromyalgia (FM), we subgrouped ME/CFS patients by the presence or absence of FM.Methods and Results: In eligible ME/CFS patients who underwent HUT, NRS of pain, fatigue, and concentration were obtained pre-HUT, immediately after HUT, at 24 and 48 h, and at 7 days posttest. We studied 174 ME/CFS patients with FM, 104 without FM, and 30 healthy controls (HC). Values for all symptoms were unchanged for HC pre- and post-HUT. Compared with pre-HUT, the three NRS post-HUT were significantly elevated in both ME/CFS patient groups even after 7 days. NRS pain was significantly higher at all time points measured in the ME/CFS patients with FM compared with those without FM. In ME/CFS patients, the maximum fatigue and concentration scores occurred directly post-HUT, whereas pain perception reached the maximum 24 h post-HUT.Conclusion: NRS scores of pain, fatigue, and concentration were significantly increased even at 7 days post-HUT compared with pre-HUT in ME/CFS patients with and without FM, suggesting that orthostatic stress is an important determinant of PEM.

scholarly journals Hemodynamics during the 10-Minute NASA Lean Test: Evidence of circulatory decompensation in a subset of ME/CFS patients

2020 ◽  
Author(s):  
Jihyun Lee ◽  
Suzanne D Vernon ◽  
Patricia Jeys ◽  
Weam Ali ◽  
Andrea Campos ◽  
...  
Keyword(s):  
Heart Rate ◽  
Pulse Pressure ◽  
Orthostatic Intolerance ◽  
Point Of Care ◽  
Venous Pressure ◽  
Chronic Fatigue ◽  
Exercise Intolerance ◽  
Hemodynamic Changes ◽  
Fatigue Syndrome ◽  
Ventricular Filling

Abstract Background. Lightheadedness, fatigue, weakness, heart palpitations, cognitive dysfunction, muscle pain, and exercise intolerance are some of the symptoms of orthostatic intolerance (OI). There is substantial comorbidity of OI in ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome). The 10-minute NASA Lean Test (NLT) is a simple, point-of-care method that can aid ME/CFS diagnosis and guide management and treatment of OI. The objective of this study was to understand the hemodynamic changes that occur in ME/CFS patients during the 10-minute NLT. Methods. A total of 150 ME/CFS patients and 75 age, gender and race matched healthy controls (HCs) were enrolled. We recruited 75 ME/CFS patients who had been sick for less than 4 years (<4 ME/CFS) and 75 ME/CFS patients sick for more than 10 years (>10 ME/CFS). The 10-minute NLT involves measurement of blood pressure and heart rate while resting supine and every minute for 10 minutes while standing with shoulder-blades on the wall for a relaxed stance. Spontaneously reported symptoms are recorded during the test. ANOVA and regression analysis were used to test for differences and relationships in hemodynamics, symptoms and upright activity between groups.Results. At least 5 minutes of the 10-minute NLT were required to detect hemodynamic changes. The <4 ME/CFS group had significantly higher heart rate and abnormally narrowed pulse pressure compared to >10 ME/CFS and HCs. The <4 ME/CFS group experienced significantly more OI symptoms compared to >10 ME/CFS and HCs. The circulatory decompensation observed in the <4 ME/CFS group was not related to age or medication use. Conclusions. Circulatory decompensation characterized by increased heart rate and abnormally narrow pulse pressure was identified in a subgroup of ME/CFS patients who have been sick for <4 years. This suggests inadequate ventricular filling from low venous pressure. The 10-minute NLT can be used to diagnose and treat the circulatory decompensation in this newly recognized subgroup of ME/CFS patients. The >10 ME/CFS group had less pronounced hemodynamic changes during the NLT possibly from adaptation and compensation that occurs over time. The 10-minute NLT is a simple and clinically useful point-of-care method that can be used for early diagnosis of ME/CFS and help guide OI treatment.

scholarly journals Redox imbalance links COVID-19 and myalgic encephalomyelitis/chronic fatigue syndrome

2021 ◽  
Vol 118 (34) ◽  
pp. e2024358118
Author(s):  
Bindu D. Paul ◽  
Marian D. Lemle ◽  
Anthony L. Komaroff ◽  
Solomon H. Snyder
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Bacterial Infections ◽  
Orthostatic Intolerance ◽  
Neurological Diseases ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Redox Imbalance ◽  
Fatigue Syndrome ◽  
Unrefreshing Sleep ◽  
Hypometabolic State

Although most patients recover from acute COVID-19, some experience postacute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC). One subgroup of PASC is a syndrome called “long COVID-19,” reminiscent of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). ME/CFS is a debilitating condition, often triggered by viral and bacterial infections, leading to years-long debilitating symptoms including profound fatigue, postexertional malaise, unrefreshing sleep, cognitive deficits, and orthostatic intolerance. Some are skeptical that either ME/CFS or long COVID-19 involves underlying biological abnormalities. However, in this review, we summarize the evidence that people with acute COVID-19 and with ME/CFS have biological abnormalities including redox imbalance, systemic inflammation and neuroinflammation, an impaired ability to generate adenosine triphosphate, and a general hypometabolic state. These phenomena have not yet been well studied in people with long COVID-19, and each of them has been reported in other diseases as well, particularly neurological diseases. We also examine the bidirectional relationship between redox imbalance, inflammation, energy metabolic deficits, and a hypometabolic state. We speculate as to what may be causing these abnormalities. Thus, understanding the molecular underpinnings of both PASC and ME/CFS may lead to the development of novel therapeutics.

scholarly journals Impact of Life Stressors on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Symptoms: An Australian Longitudinal Study

2021 ◽  
Vol 18 (20) ◽  
pp. 10614
Author(s):  
Cassandra Balinas ◽  
Natalie Eaton-Fitch ◽  
Rebekah Maksoud ◽  
Donald Staines ◽  
Sonya Marshall-Gradisnik
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Support Services ◽  
Sleep Disturbances ◽  
Orthostatic Intolerance ◽  
Living Arrangement ◽  
Chronic Fatigue ◽  
Access To Healthcare ◽  
Myalgic Encephalomyelitis ◽  
Life Stressors ◽  
Fatigue Syndrome

(1) Background: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex, multifaceted illness. The pathomechanism, severity and progression of this illness is still being investigated. Stressors have been implicated in symptom exacerbation for ME/CFS, however, there is limited information for an Australian ME/CFS cohort. The aim of this study was to assess the potential effect of life stressors including changes in work, income, or family scenario on symptom severity in an Australian ME/CFS cohort over five months; (2) Methods: Australian residents with ME/CFS responded to questions relating to work, income, living arrangement, access to healthcare and support services as well as symptoms experienced; (3) Results: thirty-six ME/CFS patients (age: 41.25 ± 12.14) completed all questionnaires (response rate 83.7%). Muscle pain and weakness, orthostatic intolerance and intolerance to extreme temperatures were experienced and fluctuated over time. Sleep disturbances were likely to present as severe. Work and household income were associated with worsened cognitive, gastrointestinal, body pain and sleep symptoms. Increased access to healthcare services was associated with improved symptom presentation; (4) Conclusions: life stressors such as work and financial disruptions may significantly contribute to exacerbation of ME/CFS symptoms. Access to support services correlates with lower symptom scores.

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