scholarly journals A Paradigm for Post-Covid-19 Fatigue Syndrome Analogous to ME/CFS

2021 ◽  
Vol 12 ◽  
Author(s):  
Angus Mackay
Keyword(s):  
Critical Evaluation ◽  
Significant Proportion ◽  
Chronic Fatigue ◽  
Neural Pathways ◽  
Fatigue Syndrome ◽  
Chronic Neuroinflammation ◽  
Stress Threshold ◽  
Wide Range ◽  
Stress Signals ◽  
The Brain

A significant proportion of COVID-19 patients are suffering from prolonged Post-COVID-19 Fatigue Syndrome, with characteristics typically found in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). However, no clear pathophysiological explanation, as yet, has been provided. A novel paradigm for a Post-COVID-19 Fatigue Syndrome is developed here from a recent unifying model for ME/CFS. Central to its rationale, SARS-CoV-2, in common with the triggers (viral and non-viral) of ME/CFS, is proposed to be a physiologically severe stressor, which could be targeting a stress-integrator, within the brain: the hypothalamic paraventricular nucleus (PVN). It is proposed that inflammatory mediators, released at the site of COVID-19 infection, would be transmitted as stress-signals, via humoral and neural pathways, which overwhelm this stress-center. In genetically susceptible people, an intrinsic stress-threshold is suggested to be exceeded causing ongoing dysfunction to the hypothalamic PVN's complex neurological circuitry. In this compromised state, the hypothalamic PVN might then be hyper-sensitive to a wide range of life's ongoing physiological stressors. This could result in the reported post-exertional malaise episodes and more severe relapses, in common with ME/CFS, that perpetuate an ongoing disease state. When a certain stress-tolerance-level is exceeded, the hypothalamic PVN can become an epicenter for microglia-induced activation and neuroinflammation, affecting the hypothalamus and its proximal limbic system, which would account for the range of reported ME/CFS-like symptoms. A model for Post-COVID-19 Fatigue Syndrome is provided to stimulate discussion and critical evaluation. Brain-scanning studies, incorporating increasingly sophisticated imaging technology should enable chronic neuroinflammation to be detected, even at a low level, in the finite detail required, thus helping to test this model, while advancing our understanding of Post-COVID-19 Fatigue Syndrome pathophysiology.

Heterogeneity of serum tryptophan concentration and availability to the brain in patients with the chronic fatigue syndrome

2005 ◽  
Vol 19 (4) ◽  
pp. 385-391 ◽  
Author(s):  
Abdulla A.-B. Badawy ◽  
Christopher J. Morgan ◽  
Meirion B. Llewelyn ◽  
Selwyn R.J. Albuquerque ◽  
Anne Farmer
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Fatigue Syndrome ◽  
Tryptophan Concentration ◽  
The Brain

scholarly journals Addressing the Long COVID Crisis: Integrative Health and Long COVID

2021 ◽  
Vol 10 ◽  
pp. 216495612110565
Author(s):  
Alan Roth ◽  
Pan San Chan ◽  
Wayne Jonas
Keyword(s):  
Well Being ◽  
Chronic Fatigue ◽  
Lifestyle Changes ◽  
Integrative Health ◽  
Fatigue Syndrome ◽  
Cerebrovascular Events ◽  
Wide Range ◽  
Health Related ◽  
And Behavior ◽  
Patients Experience

While COVID-19 has killed millions of people globally, its lasting effects on the health and well-being of entire populations are just becoming clear. As many as 30% of those diagnosed with COVID-19 report continuing health-related problems, regardless of the severity of the initial infection. Given the infection rate in the world, that translates to between 5.4 and 17.9 million globally; about 700 000 in the US. The syndrome goes by many names; here we call it “long COVID.” Patients experience a wide range of symptoms, including serious organ system effects such as pulmonary fibrosis, myocarditis, new diabetes diagnoses, stroke, and other cerebrovascular events. They also experience ongoing pain, fatigue, and cognitive dysfunction. We suggest here that these patients require an integrative health approach, one that combines traditional medical management, non-pharmacological approaches, and behavior and lifestyle changes. Such an approach has been shown to be beneficial in other chronic illnesses such as fibromyalgia, chronic fatigue syndrome, and post-Lyme disease.

scholarly journals Fibromyalgia and Associated Disorders: From Pain to Chronic Suffering, From Subjective Hypersensitivity to Hypersensitivity Syndrome

2021 ◽  
Vol 8 ◽  
Author(s):  
Yves Maugars ◽  
Jean-Marie Berthelot ◽  
Benoit Le Goff ◽  
Christelle Darrieutort-Laffite
Keyword(s):  
Hypersensitivity Syndrome ◽  
Chronic Fatigue ◽  
Cognitive Disorder ◽  
Imaging Data ◽  
Fatigue Syndrome ◽  
Wide Range ◽  
Associated Symptoms ◽  
Post Traumatic ◽  
The Many ◽  
Definition Of

The concept of fibromyalgia has progressed to achieve a certain consensus regarding the definition of the condition. We summarize what is known in 2020, be it in terms of diagnosis, with the criteria that have changed over the years, or at the level of the psychological profile, via the notions of “catastrophizing” and “coping” and post-traumatic syndrome. The importance of fatigue and sleep disorders is underlined, with the chronological sequence of post-traumatic syndrome, chronic fatigue, and then amplification of the pain and the onset of multiple associated symptoms. The etiopathogenic debate has been enriched thanks to neuro-imaging data to discover the start of the central neurological signature. The many associated symptoms are reanalyzed in the context of so-called sister conditions which form sometimes more or less separate entities, such as chronic fatigue syndrome or restless legs syndrome for example. What these conditions have in common is hypersensitivity, not just to pain, but also to all exteroceptive stimuli, from deep sensitivity in the neuro-vegetative system, the sense organs and certain functions of the central nervous system, to the psychological aspects and sleep control. In summary, it is possible to define fibromyalgia as a cognitive disorder of cortical integration of chronic pain, with amplification of painful and sensory nociception, decrease in the threshold for the perception of pain, and persistence of a stimulus that maintains the process in chronicity. Fibromyalgia is part of a group of chronic hypersensitivity syndromes of central origin, with a very wide range of means of expression.

scholarly journals Oxygen-ozone therapy in meningoencephalitis and chronic fatigue syndrome. Treatment in the field of competitive sports: case report

Ozone Therapy ◽  
2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Luca Morelli ◽  
Simona Carla Bramani ◽  
Federico Carlo Morelli
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Nuclear Antigen ◽  
Weekly Basis ◽  
Serological Tests ◽  
Barr Virus ◽  
Fatigue Syndrome ◽  
Epstein Barr ◽  
The Brain ◽  
Post Infectious

Our study was born from the observation of a clinical case of a boy who arrived in the Emergency Room of our hospital for persistent hyperpyrexia, headache and prolonged emetic episodes and complaining of objective photophobia and dizziness. The patient underwent haematochemical tests, chemical-physical examination of Chronic Fatigue Syndrome (CFS), negative for bacteria, negative for Neisseria Meningitidis, Escherichia Coli 121, Haemophilus Influenzae, Stafilococcus Pneumoniae, Stafilococcus Agalactiae and with slightly positive reaction to Pandy’s test; he was subjected to neurological examination, to Nuclear Magnetic Resonance of the brain and encephalic trunk with contrast agent which resulted negative, and to EEG that showed a slightly slowed-down brain electrical activity, in right occipital region, and frontal irritative abnormalities. Given these clinical and instrumental investigations, an acute meningoencephalitis was diagnosed. During his hospitalization, the patient was treated with intravenous antibiotic therapy and intravenous antiviral therapy for 12 days. At discharge, in the absence of specific therapy, and considering the protraction of the cephalic, dizzying, asthenic and myalgic symptoms and in relation to hematochemical and serological tests (positive for antibodies to Herpes 1 IgG), Epstein Barr Virus antibodies (positive for Viral Capsid Antigen IgG and IgGE BNA, for Extractable Nuclear Antigen and IgG Cytomegalovirus) he was diagnosed a Post-infectious CFS. The patient was treated with Oxygen Ozone Rectal Insufflative Therapy on a bi-weekly basis for 4 weeks, associated with Micetrin, a dietary supplement with sweetener based on Vitamin C, Shitake, Reishi, Maitake, Cordyceps, Magnesium and SOD, continued the treatment on a weekly basis for a further 4 weeks until the complete remission of the symptoms of asthenic, neurological and clinical parameters.

Tetramethoxyluteolin for the Treatment of Neurodegenerative Diseases

2019 ◽  
Vol 18 (21) ◽  
pp. 1872-1882 ◽  
Author(s):  
Theoharis C. Theoharides ◽  
Irene Tsilioni
Keyword(s):  
Mast Cells ◽  
Substance P ◽  
Neurodegenerative Diseases ◽  
Oral Absorption ◽  
Chronic Fatigue ◽  
Autism Spectrum ◽  
Medline Search ◽  
Fatigue Syndrome ◽  
The Brain

Background: Most neurodegenerative and other brain disorders, especially Myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS) and autism spectrum disorder (ASD) continue to elude objective biomarkers and effective treatments. Increasing evidence indicates that such diseases involve focal inflammation of the brain. Objective: To review the role of cytokine-neuropeptide interactions in the pathogenesis of inflammation of the brain and the beneficial role of natural flavonoids. Methods: Medline search was conducted (2000-2017) for articles using the terms allergy, amygdala, atopy, autism, brain, chemokines, cytokines, hypothalamus, immunity, inflammation, mast cells, microglia, neurotensin, peptides, substance P, and TNF. Results: Neuropeptides and cytokine stimulation of mast cells and microglia can result in focal inflammation in the hypothalamus and amygdala, thus explaining most of the symptoms at least in ME/CFS and ASD. Some of the triggers may be corticotropin-releasing hormone (CRH), neurotensin (NT), and substance P (SP), which have synergistic action on IL-33. The natural flavonoids luteolin and tetramethoxyluteolin inhibit these processes and have neuroprotective actions. Tetramethoxyluteolin is also more metabolically stable and has greater oral absorption. Conclusion: Inhibition of inflammatory processes unique to the brain with intranasal formulations of tetramethoxyluteolin could provide new possibilities for the understanding and treatment of neurodegenerative diseases.

Bioelectric activity of the women’s brain with vulvar lichen sclerosus

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 68-73
Author(s):  
Victor V. Loginov ◽  
Alexander V. Vartanov ◽  
Semyon A. Feigin ◽  
Anastasiia V. Sokolova ◽  
Inna A. Apolikhina
Keyword(s):  
Brain Activity ◽  
Lichen Sclerosus ◽  
External Genitalia ◽  
Chronic Fatigue ◽  
Acute Stage ◽  
Average Score ◽  
Bioelectric Activity ◽  
Fatigue Syndrome ◽  
The Brain ◽  
Vulvar Lichen Sclerosus

Aim. To study the characteristics of bioelectric activity of the brain in patients with vulvar lichen sclerosus (VLS), as well as the interaction between certain structures of the brain and their relationship with the manifestations of VLS. Materials and methods. 102 patients aged 21 to 78 years (average age 50.5713.92 years) were questioned about the VLS symptoms, the quality of sleep and presence of phobias, of which 30 patients aged 21 to 72 years (average age 46.0715.42 years) after signing informed consent underwent electroencephalographic (EEG) study. Inclusion criteria were patients aged 18 and older, vulvar lichen sclerosus in the acute stage, confirmed by histological examination. Results. The common complaint was itching in external genitalia (73.3%), which was statistically evident in the analysis of brain activity. Itching of external genitalia in patients with VLS could account for systemic changes in the activity and interactions of such structures as the brain stem and globus pallidus, ventral striatum, islet, parietal cortex, field 40 according to Broadman (supramarginal gyrus), as well as areas of the primary visual cortex (field 17 according to Broadman). Conclusion. VLS is often accompanied by itching in the external genitalia (73.3%), and has an average score of 5.6 on a ten-point scale. EEG is recommended with a disease duration of more than 6 years and an itch level of 56 points or more. The main feature of brain bioelectric activity in patients with VLS is evident signs of organic brain damage. The disease is accompanied by impairment of the visceral regulatory mechanisms of the brain, which leads to the formation of a low-complementary viscerom and neurodegenerative signs in the EEG. A frequent combination of disorders in the central nervous system and immune system gives reason to consider VLS associated with chronic fatigue syndrome.

Chronic Fatigue Syndrome and the Central Nervous System

2008 ◽  
Vol 36 (5) ◽  
pp. 867-874 ◽  
Author(s):  
R Chen ◽  
FX Liang ◽  
J Moriya ◽  
J Yamakawa ◽  
H Sumino ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Chronic Fatigue Syndrome ◽  
Neurotrophic Factors ◽  
Focal Point ◽  
Chronic Fatigue ◽  
Fatigue Syndrome ◽  
The Central Nervous System ◽  
The Brain

An increasing amount of neuroimaging evidence supports the hypothesis that chronic fatigue syndrome patients have structural or functional abnormalities within the brain. Moreover, some neurotrophic factors, neurotransmitters and cytokines have also been evaluated in order to elucidate the mechanism of abnormal neuropsychic findings in chronic fatigue syndrome. In this review, we suggest that the focal point of chronic fatigue syndrome research should be transferred to the central nervous system.

scholarly journals Sleep problems in adolescents with CFS: A case-control study nested within a prospective clinical cohort

2020 ◽  
Vol 25 (4) ◽  
pp. 816-832
Author(s):  
Maria Elizabeth Loades ◽  
Katharine A Rimes ◽  
Trudie Chalder
Keyword(s):  
Sleep Problems ◽  
Negative Impact ◽  
Significant Proportion ◽  
Chronic Fatigue ◽  
The Body ◽  
Healthy Controls ◽  
Fatigue Syndrome ◽  
School Attainment ◽  
Treatment Naïve

Sleep problems have a negative impact on a range of outcomes and are very common in adolescents with chronic fatigue syndrome (CFS). We aimed to (a) establish whether adolescents with CFS have more self-reported sleep problems than illness controls as well as healthy controls, (b) investigate changes in sleep problems and (c) explore the extent to which sleep problems at baseline predict fatigue and functioning at follow-up in adolescents with CFS. The Insomnia Scale was completed by 121 adolescents with CFS, 78 healthy adolescents and 27 adolescents with asthma. Eighty (66%) treatment-naïve adolescents with CFS completed questionnaires approximately 3 months later. Adolescents with CFS reported increased sleep problems compared to healthy controls and adolescents with asthma. In CFS, there was no significant change in sleep problems without treatment over a 3-month follow-up. Sleep problems at baseline predicted a significant proportion of the variance in sleep problems at follow-up. Sleep problems should be targeted in treatment. Regulating the ‘body clock’ via the regulation of sleep could influence outcomes not assessed in this study such as school attainment.

scholarly journals Seroepidemiology of Chronic Fatigue Syndrome: A Case-Control Study

1995 ◽  
Vol 21 (6) ◽  
pp. 1386-1389 ◽  
Author(s):  
Alison C. Mawle ◽  
Rosane Nisenbaum ◽  
James G. Dobbins ◽  
Howard E. Gary ◽  
John A. Stewart ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Case Control Study ◽  
Chronic Fatigue ◽  
Case Control ◽  
Infectious Agents ◽  
Serological Testing ◽  
Fatigue Syndrome ◽  
Wide Range ◽  
Control Study

Abstract We performed serological testing for a large number of infectious agents in 26 patients from Atlanta who had chronic fatigue syndrome (CFS) and in 50 controls matched by age, race, and sex. We did not find any agent associated with CFS. In addition, we did not find elevated levels of antibody to any of a wide range of agents examined. In particular, we did not find elevated titers of antibody to any herpesvirus, nor did we find evidence of enteroviral exposure in this group of patients.

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