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AlMuhaissen S, Abu Libdeh A, ElKhatib Y, Alshayeb R, Jaara A, Bardaweel SK. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and COVID-19: is there a connection? Curr Med Res Opin 2023; 39:1119-1126. [PMID: 37501626 DOI: 10.1080/03007995.2023.2242244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVES Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a chronic systemic disease that leads to neurological, immunological, autonomic, and energy metabolism dysfunction. COVID-19 has been reported to cause similar symptoms to ME/CFS. The study aims to investigate the prevalence of myalgic encephalomyelitis in patients post-COVID-19 infection by assessing acute and long-term COVID-19 symptoms. METHODS A cross-sectional questionnaire was developed based on the ME/CFS diagnostic criteria, as specified by the IOM clinical diagnostic criteria, and administered to participants with confirmed COVID-19 who are more than 18 years old and have BMI below 40 Kg/m2. Data from 437 participants were completed. RESULTS The current study results revealed that 8.1% of the study participants met the ME/CFS diagnostic criteria. Interestingly, 2.8 of the study participants were classified to have COVID-19 related to ME/CFS. While 4.6% of participants were determined to have disease-related fatigue, 0.7% of participants showed ME/CFS that was not related to COVID-19, and 3.7% of participants were considered to have long COVID-19. Almost one-fourth of the study participants had a family history of ME/CFS. The current study demonstrated that the prevalence of ME/CFS is similar to slightly higher than reported in the literature. CONCLUSION The presence of a relationship between ME/CFS and COVID-19 has been supported by the results of our study. Follow-up of COVID-19 patients is strongly recommended to ensure proper management of ME/CFS symptoms.
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Affiliation(s)
- Suha AlMuhaissen
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Amal Abu Libdeh
- Department of Pediatrics, School of Medicine, Al-Balqa Applied University, Amman, Jordan
- Department of Neurology, University of Virginia, Charlottesville, Virginia, USA
| | - Yara ElKhatib
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Rund Alshayeb
- King Hussein Medical Center, Royal Medical Services, Amman, Jordan
| | - Areej Jaara
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Al-ahliyya Amman University, Amman, Jordan
| | - Sanaa K Bardaweel
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Jordan, Amman, Jordan
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The impact of obesity and overweight on response to internet-delivered cognitive behavioural therapy for adults with chronic health conditions. Int J Obes (Lond) 2023; 47:487-495. [PMID: 36869151 DOI: 10.1038/s41366-023-01285-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND There is growing evidence that internet-delivered cognitive behavioural therapy (iCBT) can improve functioning and reduce psychological distress in people with chronic health conditions. Obesity frequently co-occurs with chronic health conditions, yet its impact on response to psychological interventions in this population is not known. The current study examined associations between BMI and clinical outcomes (depression, anxiety, disability, and satisfaction with life) following a transdiagnostic iCBT program targeting adjustment to chronic illness. METHODS Participants from a large randomised controlled trial, who provided information on height and weight, were included (N = 234; mean age= 48.32, SD = 13.80; mean BMI = 30.43, SD = 8.30, range 16.18-67.52; 86.8% female). The influence of baseline BMI range on treatment outcomes at post-treatment and 3-month follow-up was examined using generalized estimating equations. We also examined changes in BMI and in participants' perceived impact of weight on their health. RESULTS Improvement in all outcomes occurred across BMI ranges; additionally, persons with obesity or overweight generally experienced greater symptom reductions than those within a healthy weight range. A greater proportion of participants with obesity achieved clinically significant change on key outcomes (e.g., depression: 32% [95% CI: 25%, 39%]) than participants with a healthy weight (21% [95% CI: 15%, 26%]) or overweight (24% [95% CI: 18%, 29%], p = 0.016). There were no significant changes in BMI from pre-treatment to 3-month follow-up, however there were significant reductions on the self-rated impact of weight on health. CONCLUSIONS Persons with chronic health conditions and with obesity or overweight benefit at least as much as those with a healthy BMI from iCBT programs targeting psychological adjustment to chronic illness, even without changes in BMI. iCBT programs may be an important component in the self-management of this population, and may address barriers implicated in health behaviour change.
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Sharma M, Vavilala P, Singh A, Baweja R. Effect of milk and mustard oil consumption: A case study on youth in Delhi-NCR. Nutr Health 2023; 29:25-29. [PMID: 35912504 DOI: 10.1177/02601060221116198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: The diet is a major factor affecting the Body Mass Index (BMI) of an individual. BMI has long been the standard for measuring health and its normal range (18.5-24.9, according to the World Health Organization) is considered to be crucial for maintenance of proper health and to prevent various lifestyle disorders which are considered to have either direct or indirect effects on physical and mental well-being of our youth. Aim: To investigate the correlation between diet patterns and BMI, overall stamina and fatigue levels in the youth population residing in Delhi-NCR region of India. Methods: An online survey was conducted using a carefully designed Google form and the respondents were asked to give details about the basic health parameters and dietary lifestyle. Results: 67% of the respondents who consumed milk were found to have an ideal BMI. 64% of the respondents who consumed mustard oil as their predominant dietary fat showed normal BMI and more than 80% showed lower fatigue levels. Conclusion: Milk and mustard oil consumption is important for maintenance of an ideal BMI. Awareness should be created in the youth to have them as part of their daily diet.
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Affiliation(s)
- Maurya Sharma
- Department of Biochemistry, Shivaji College, 28742University of Delhi, New Delhi, India
| | - Pratyusha Vavilala
- Department of Biochemistry, Shaheed Rajguru College of Applied Sciences for Women, 28742University of Delhi, India ∗Equal contribution
| | - Archita Singh
- Department of Biochemistry, Shivaji College, 28742University of Delhi, New Delhi, India
| | - Renu Baweja
- Department of Biochemistry, Shivaji College, 28742University of Delhi, New Delhi, India
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Xiong R, Gunter C, Fleming E, Vernon SD, Bateman L, Unutmaz D, Oh J. Multi-'omics of gut microbiome-host interactions in short- and long-term myalgic encephalomyelitis/chronic fatigue syndrome patients. Cell Host Microbe 2023; 31:273-287.e5. [PMID: 36758521 PMCID: PMC10353054 DOI: 10.1016/j.chom.2023.01.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/14/2022] [Accepted: 12/30/2022] [Indexed: 02/11/2023]
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, debilitating disorder manifesting as severe fatigue and post-exertional malaise. The etiology of ME/CFS remains elusive. Here, we present a deep metagenomic analysis of stool combined with plasma metabolomics and clinical phenotyping of two ME/CFS cohorts with short-term (<4 years, n = 75) or long-term disease (>10 years, n = 79) compared with healthy controls (n = 79). First, we describe microbial and metabolomic dysbiosis in ME/CFS patients. Short-term patients showed significant microbial dysbiosis, while long-term patients had largely resolved microbial dysbiosis but had metabolic and clinical aberrations. Second, we identified phenotypic, microbial, and metabolic biomarkers specific to patient cohorts. These revealed potential functional mechanisms underlying disease onset and duration, including reduced microbial butyrate biosynthesis and a reduction in plasma butyrate, bile acids, and benzoate. In addition to the insights derived, our data represent an important resource to facilitate mechanistic hypotheses of host-microbiome interactions in ME/CFS.
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Affiliation(s)
- Ruoyun Xiong
- The Jackson Laboratory, Farmington, CT 06032, USA; The University of Connecticut Health Center, Farmington, CT 06030, USA
| | | | | | | | | | | | - Julia Oh
- The Jackson Laboratory, Farmington, CT 06032, USA.
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Kan J, Cheng J, Hu C, Chen L, Liu S, Venzon D, Murray M, Li S, Du J. A Botanical Product Containing Cistanche and Ginkgo Extracts Potentially Improves Chronic Fatigue Syndrome Symptoms in Adults: A Randomized, Double-Blind, and Placebo-Controlled Study. Front Nutr 2021; 8:658630. [PMID: 34901100 PMCID: PMC8662561 DOI: 10.3389/fnut.2021.658630] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 11/04/2021] [Indexed: 11/13/2022] Open
Abstract
Dietary therapy may be beneficial in alleviating symptoms of chronic fatigue syndrome (CFS), a disorder that is characterized by extreme fatigue and other symptoms, but the cause of which remains unclear. The aim of this study was to evaluate the protective effect of a botanical product containing cistanche (Cistanche tubulosa [Schenk] Wight) and ginkgo (Ginkgo biloba L.) extracts on adults with CFS in a randomized, double-blind, placebo-controlled clinical trial. A total of 190 subjects (35-60 years old, non-obese) with CFS were randomized to receive one tablet of a low dose (120-mg ginkgo and 300-mg cistanche), a high dose (180-mg ginkgo and 450-mg cistanche) or a placebo once daily for 60 days. Blood samples and responses on the Chalder fatigue scale (CFQ 11), the World Health Organization's quality of life questionnaire (WHOQOL), and the sexual life quality questionnaire (SLQQ) were collected at baseline and post-intervention. CFS symptoms of impaired memory or concentration, physical fatigue, unrefreshing sleep, and post-exertional malaise were significantly improved (p < 0.001) in both of the treatment groups. The botanical intervention significantly decreased physical and mental fatigue scores of CFQ 11 and improved WHOQOL and SLQQ scores of the subjects (p < 0.01). Levels of blood ammonia and lactic acid in the treatment groups were significantly lower than those of the placebo group (low-dose: p < 0.05; high-dose: p < 0.01). In addition, the change in lactic acid concentration was negatively associated with the severity of CFS symptoms (p = 0.0108) and was correlated with the change in total physical fatigue score of the CFQ (p = 0.0302). Considering the trivial effect size, the results may lack clinical significance. In conclusion, this botanical product showed promising effects in ameliorating the symptoms of CFS. Clinical trials with improved assessment tools, an expanded sample size, and an extended follow-up period are warranted to further validate the findings. Clinical Trial Registration: https://clinicaltrials.gov/, identifier: NCT02807649.
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Affiliation(s)
- Juntao Kan
- Nutrilite Health Institute, Shanghai, China
| | - Junrui Cheng
- Nutrilite Health Institute, Shanghai, China
- Plants for Human Health Institute, North Carolina State University, Kannapolis, NC, United States
| | - Chun Hu
- Nutrilite Health Institute, Buena Park, CA, United States
| | - Liang Chen
- Nutrilite Health Institute, Shanghai, China
| | - Siyu Liu
- Nutrilite Health Institute, Shanghai, China
| | - Dawna Venzon
- Nutrilite Health Institute, Buena Park, CA, United States
| | - Mary Murray
- Nutrilite Health Institute, Buena Park, CA, United States
| | - Shuguang Li
- School of Public Health, Fudan University, Shanghai, China
| | - Jun Du
- Nutrilite Health Institute, Shanghai, China
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Impact of Life Stressors on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Symptoms: An Australian Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010614. [PMID: 34682360 PMCID: PMC8535742 DOI: 10.3390/ijerph182010614] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 11/29/2022]
Abstract
(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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Gu M, Xiao L, Wang J, Cai Q, Liu Y, Xu P, Liu Y, Huang X, Hu W, Sun W. Obesity and Poststroke Fatigue: A 2-Year Longitudinal Study. Neurol Ther 2021; 10:955-969. [PMID: 34436757 PMCID: PMC8571443 DOI: 10.1007/s40120-021-00276-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/17/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Obesity is associated with fatigue in many diseases, but the correlation between obesity and poststroke fatigue (PSF) is unclear. The study aimed to investigate the relationship between body mass index (BMI) and the occurrence of and recovery from PSF. Methods Within 3 days of the onset of ischemic stroke, patients were consecutively recruited. We assessed PSF at admission and at 6, 12, and 24 months with the Fatigue Severity Scale (FSS). Multivariable logistic regression and restricted cubic spline function were used to explore the relationships between baseline BMI and the risk of PSF at different time points. The correlation between baseline BMI and the dynamic changes in the natural logarithm transformation of the FSS (lnFSS) score during the follow-up period was analyzed by the piecewise linear mixed-effects model. Results A total of 1026 stroke patients were included. Multivariable analyses indicated that obesity was associated with a decreased risk of early PSF (fatigue diagnosed at baseline) [odds ratio (OR) 0.61, 95% confidence interval (CI) 0.41–0.93] but an increased risk of late PSF (fatigue diagnosed 6 months after the index stroke) (OR 1.63, 95% CI 1.06–2.50 for 6 months; OR 1.87, 95% CI 1.18–2.96 for 12 months; OR 2.11, 95% CI 1.28–3.49 for 24 months). Longitudinal analyses indicated that in the late stage of fatigue, the higher the BMI category, the slower the rate of decrease was for the FSS score. Conclusion Obese patients are less likely to develop fatigue in the acute stage of ischemic stroke. However, they are more prone to late fatigue and exhibit a slower decline in the FSS score in the long term. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-021-00276-x.
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Affiliation(s)
- Mengmeng Gu
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Lulu Xiao
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jinjing Wang
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qiankun Cai
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yujing Liu
- Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, China
| | - Pengfei Xu
- Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yuanlu Liu
- Department of Neurology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, China
| | - Xianjun Huang
- Department of Neurology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui Province, China
| | - Wei Hu
- Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
| | - Wen Sun
- Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
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8
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Foster CG, Landowski LM, Sutherland BA, Howells DW. Differences in fatigue-like behavior in the lipopolysaccharide and poly I:C inflammatory animal models. Physiol Behav 2021; 232:113347. [PMID: 33529685 DOI: 10.1016/j.physbeh.2021.113347] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/18/2021] [Accepted: 01/29/2021] [Indexed: 11/30/2022]
Abstract
Central fatigue is a condition associated with impairment of the central nervous system often leading to the manifestation of a range of debilitating symptoms. Fatigue can be a consequence of systemic inflammation following an infection. Administration of lipopolysaccharide (LPS) and polyriboinosinic:polyribocytidlic (poly I:C) to animals can induce systemic inflammation by mimicking a bacterial or viral infection respectively and therefore have been used as models of fatigue. We evaluated a range of phenotypic behaviors exhibited in the LPS and poly I:C animal models to assess whether they adequately replicate fatigue symptomology in humans. In addition to standard observation- and intervention-based behavioral assessments, we used powerful in-cage monitoring technology to quantify rodent behavior without external interference. LPS and poly I:C treated Sprague Dawley rats displayed 'sickness behaviors' of elevated temperature, weight loss and reduced activity in the open field test and with in-cage monitoring within 24 h post-treatment, but only LPS-treated rats displayed these behaviors beyond these acute timepoints. Once sickness behavior diminished, LPS-treated rats exhibited an increase in reward-seeking and motivation behaviors. Overall, these results suggest that the LPS animal model produces an extensive and sustained fatigue-like phenotype, whereas the poly I:C model only produced acute effects. Our results suggest that the LPS animal model is a more suitable candidate for further studies on central fatigue-like behavior.
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Affiliation(s)
- Catherine G Foster
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Lila M Landowski
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Brad A Sutherland
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - David W Howells
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Australia.
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Huth TK, Eaton-Fitch N, Staines D, Marshall-Gradisnik S. A systematic review of metabolomic dysregulation in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis/Systemic Exertion Intolerance Disease (CFS/ME/SEID). J Transl Med 2020; 18:198. [PMID: 32404171 PMCID: PMC7222338 DOI: 10.1186/s12967-020-02356-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 04/25/2020] [Indexed: 02/07/2023] Open
Abstract
Background Chronic Fatigue Syndrome/Myalgic Encephalomyelitis/Systemic Exertion Intolerance Disease (CFS/ME/SEID) is a complex illness that has an unknown aetiology. It has been proposed that metabolomics may contribute to the illness pathogenesis of CFS/ME/SEID. In metabolomics, the systematic identification of measurable changes in small molecule metabolite products have been identified in cases of both monogenic and heterogenic diseases. Therefore, the aim of this systematic review was to evaluate if there is any evidence of metabolomics contributing to the pathogenesis of CFS/ME/SEID. Methods PubMed, Scopus, EBSCOHost (Medline) and EMBASE were searched using medical subject headings terms for Chronic Fatigue Syndrome, metabolomics and metabolome to source papers published from 1994 to 2020. Inclusion and exclusion criteria were used to identify studies reporting on metabolites measured in blood and urine samples from CFS/ME/SEID patients compared with healthy controls. The Joanna Briggs Institute Checklist was used to complete a quality assessment for all the studies included in this review. Results 11 observational case control studies met the inclusion criteria for this review. The primary outcome of metabolite measurement in blood samples of CFS/ME/SEID patients was reported in ten studies. The secondary outcome of urine metabolites was measured in three of the included studies. No studies were excluded from this review based on a low-quality assessment score, however there was inconsistency in the scientific research design of the included studies. Metabolites associated with the amino acid pathway were the most commonly impaired with significant results in seven out of the 10 studies. However, no specific metabolite was consistently impaired across all of the studies. Urine metabolite results were also inconsistent. Conclusion The findings of this systematic review reports that a lack of consistency with scientific research design provides little evidence for metabolomics to be clearly defined as a contributing factor to the pathogenesis of CFS/ME/SEID. Further research using the same CFS/ME/SEID diagnostic criteria, metabolite analysis method and control of the confounding factors that influence metabolite levels are required.
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Affiliation(s)
- Teilah Kathryn Huth
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute, Griffith University, Gold Coast, Australia. .,School of Medicine, University of Notre Dame, Sydney, Australia.
| | - Natalie Eaton-Fitch
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute, Griffith University, Gold Coast, Australia
| | - Donald Staines
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute, Griffith University, Gold Coast, Australia
| | - Sonya Marshall-Gradisnik
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute, Griffith University, Gold Coast, Australia
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10
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Eaton-Fitch N, Johnston SC, Zalewski P, Staines D, Marshall-Gradisnik S. Health-related quality of life in patients with myalgic encephalomyelitis/chronic fatigue syndrome: an Australian cross-sectional study. Qual Life Res 2020; 29:1521-1531. [PMID: 31970624 PMCID: PMC7253372 DOI: 10.1007/s11136-019-02411-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a serious and debilitating disorder associated with significant disruptions in daily life including. This study aimed to examine the impact of sociodemographic and patient symptom characteristics on health-related quality of life (HRQoL) of Australians with ME/CFS. METHODS Self-reported data collected from 480 individuals diagnosed with ME/CFS were obtained between August 2014 and August 2018. This cross-sectional survey analysed sociodemographic, symptom characteristics and HRQoL according to the 36-Item Health Survey (SF-36). Multivariate linear regression models were used to determine ME/CFS symptoms associated with eight domains of HRQoL. RESULTS Reported HRQoL was significantly impaired in ME/CFS patients across all domains compared with the general population. Scores were the lowest for physical role (4.11 ± 15.07) and energy/fatigue (13.54 ± 13.94). Associations with females, higher body mass index (BMI), employment status, cognitive difficulties, sensory disturbances and cardiovascular symptoms were observed in the physical functioning domain. Impaired pain domain scores were associated with high BMI, annual visits to their general practitioner, flu-like symptoms and fluctuations in body temperature. Reduced well-being scores were associated with smoking status, psychiatric comorbidity, cognitive difficulties, sleep disturbances and gastrointestinal difficulties. CONCLUSION This study provides evidence that ME/CFS has a profound and negative impact on HRQoL in an Australian cohort.
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Affiliation(s)
- N Eaton-Fitch
- School of Medical Science, Griffith University, Gold Coast, Australia. .,National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia. .,Consortium Health International for Myalgic Encephalomyelitis, Griffith University, Gold Coast, Australia.
| | - S C Johnston
- School of Medical Science, Griffith University, Gold Coast, Australia.,National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Consortium Health International for Myalgic Encephalomyelitis, Griffith University, Gold Coast, Australia
| | - P Zalewski
- Consortium Health International for Myalgic Encephalomyelitis, Griffith University, Gold Coast, Australia.,Department of Hygiene, Epidemiology and Ergonomy, Uniwersytet Mikolaja Kopernika Collegium Medicum, Bydgoszcz, Poland
| | - D Staines
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Consortium Health International for Myalgic Encephalomyelitis, Griffith University, Gold Coast, Australia
| | - S Marshall-Gradisnik
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Consortium Health International for Myalgic Encephalomyelitis, Griffith University, Gold Coast, Australia
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Fox A, Helmer D, Tseng CL, Patrick-DeLuca L, Osinubi O. Report of Autonomic Symptoms in a Clinical Sample of Veterans with Gulf War Illness. Mil Med 2017. [DOI: 10.1093/milmed/usx052] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Apollonia Fox
- War Related Illness and Injury Study Center, VA New Jersey Health Care System, 385 Tremont Ave
- Mailstop 129, East Orange, NJ 07018
| | - Drew Helmer
- War Related Illness and Injury Study Center, VA New Jersey Health Care System, 385 Tremont Ave
- Mailstop 129, East Orange, NJ 07018
| | - Chin-Lin Tseng
- War Related Illness and Injury Study Center, VA New Jersey Health Care System, 385 Tremont Ave
- Mailstop 129, East Orange, NJ 07018
| | - Lydia Patrick-DeLuca
- War Related Illness and Injury Study Center, VA New Jersey Health Care System, 385 Tremont Ave
- Mailstop 129, East Orange, NJ 07018
| | - Omowunmi Osinubi
- War Related Illness and Injury Study Center, VA New Jersey Health Care System, 385 Tremont Ave
- Mailstop 129, East Orange, NJ 07018
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12
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Bozzini S, Albergati A, Capelli E, Lorusso L, Gazzaruso C, Pelissero G, Falcone C. Cardiovascular characteristics of chronic fatigue syndrome. Biomed Rep 2017; 8:26-30. [PMID: 29399336 DOI: 10.3892/br.2017.1024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 09/29/2017] [Indexed: 11/06/2022] Open
Abstract
Patients with chronic fatigue syndrome (CFS) commonly exhibit orthostatic intolerance. Abnormal sympathetic predominance in the autonomic cardiovascular response to gravitational stimuli was previously described in numerous studies. The aim of the current study was to describe cardiological and clinical characteristics of Italian patients with CFS. All of the patients were of Caucasian ethnicity and had been referred to our center, the Cardiology Department of the University Hospital of Pavia (Pavia, Italy) with suspected CFS. A total of 44 patients with suspected CFS were included in the present study and the diagnosis was confirmed in 19 patients according to recent clinical guidelines. The characteristics at baseline of the population confirm findings from various previous reports regarding the prevalence in females with a female to male ratio of 4:1, the age of onset of the pathology and the presence of previous infection by the Epstein-Barr virus, cytomegalovirus and other human herpesviruses. Despite the current data indicating that the majority of the cardiological parameters investigated are not significantly different in patients with and without CFS, a significant association between the disease and low levels of blood pressure was identified. Other pilot studies revealed a higher prevalence of hypotension and orthostatic intolerance in patients with CFS. Furthermore, many of the CFS symptoms, including fatigue, vertigo, decreased concentration, tremors and nausea, may be explained by hypotension.
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Affiliation(s)
- Sara Bozzini
- Interdepartmental Center for Research in Molecular Medicine (CIRMC), University of Pavia, I-27100 Pavia, Italy
| | - Andrea Albergati
- Department of Neurology, Istituti Clinici di Pavia e Vigevano, University Hospital, I-27100 Pavia, Italy.,IRCCS San Donato Hospital, San Donato Milanese, I-20097 Milan, Italy
| | - Enrica Capelli
- Department of Earth and Environmental Sciences, University of Pavia, I-27100 Pavia, Italy
| | - Lorenzo Lorusso
- Department of Neurology, Mellino Mellini Hospital, I-25082 Chiari BS, Italy
| | - Carmine Gazzaruso
- Interdepartmental Center for Research in Molecular Medicine (CIRMC), University of Pavia, I-27100 Pavia, Italy.,IRCCS San Donato Hospital, San Donato Milanese, I-20097 Milan, Italy.,Internal Medicine, Diabetes and Endocrine-Metabolic Diseases Unit and the Centre for Applied Clinical Research (Ce.R.C.A.), Clinical Institute Beato Matteo, I-27029 Vigevano, Italy
| | | | - Colomba Falcone
- Interdepartmental Center for Research in Molecular Medicine (CIRMC), University of Pavia, I-27100 Pavia, Italy.,IRCCS San Donato Hospital, San Donato Milanese, I-20097 Milan, Italy.,Department of Cardiology, Istituti Clinici di Pavia e Vigevano, University Hospital, I-27100 Pavia, Italy
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Increased Incidence of Fatigue in Patients with Primary Immunodeficiency Disorders: Prevalence and Associations Within the US Immunodeficiency Network Registry. J Clin Immunol 2017; 37:153-165. [PMID: 28124237 DOI: 10.1007/s10875-016-0367-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 12/20/2016] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Patients with primary immunodeficiency (PID) often report fatigue, yet this symptom has not been studied in PID. Fatigue affects 6-7.5% of healthy adults. The goal of this study is to estimate the prevalence of fatigue in patients with PID and investigate its associated factors. METHODS We analyzed 2537 PID patients registered in USIDNET to determine responses to the field "fatigue" in the core registry form. Demographics, immune phenotypes, and comorbid conditions were compared between fatigued and non-fatigued patients to identify relevant associations and potential drivers. A focused analysis was performed for patients with predominantly antibody deficiency disorders (PADs). RESULTS Fatigue was reported in 25.9% (95% CI 23.7-28.3) of PAD patients, compared to 6.4% (95% CI 4.9-8.2) of non-PAD. Patients with common variable immunodeficiency (CVID) had the highest prevalence of fatigue (p < 0.001) among all PID diagnoses. Other factors that were associated with a higher rate of fatigue among PAD patients included female sex, higher BMI, depression, bronchiectasis, and autoimmunity. Additionally, fatigued PAD patients had lower absolute lymphocyte, CD3, CD4, and CD8 counts compared to non-fatigued patients. CONCLUSION Our findings suggest that fatigue is overrepresented in PAD patients. Prospective studies to estimate prevalence, risk factors, and fatigue etiology in PID are warranted, so therapeutic interventions can be considered.
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Johnston SC, Staines DR, Marshall-Gradisnik SM. Epidemiological characteristics of chronic fatigue syndrome/myalgic encephalomyelitis in Australian patients. Clin Epidemiol 2016; 8:97-107. [PMID: 27279748 PMCID: PMC4878662 DOI: 10.2147/clep.s96797] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND No epidemiological investigations have previously been conducted in Australia according to the current clinical definitions of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). The aim of this study was to describe sociodemographic and illness characteristics of Australian patients with CFS/ME. METHODS A cross-sectional survey on the medical history of patients enrolled in an Australian CFS/ME research database between April 2013 and April 2015. Participants were classified according to Fukuda criteria and International Consensus Criteria. RESULTS A total of 535 patients diagnosed with CFS/ME by a primary care physician were identified. The mean age of all patients was 46.4 years (standard deviation 12.0); the majority were female (78.61%), Caucasian, and highly educated. Of these, 30.28% met Fukuda criteria. A further 31.96% met both Fukuda criteria and International Consensus Criteria. There were 14.58% reporting chronic fatigue but did not meet criteria for CFS/ME and 23.18% were considered noncases due to exclusionary conditions. Within those meeting CFS/ME criteria, the most common events prior to illness included cold or flu, gastrointestinal illness, and periods of undue stress. Of the 60 symptoms surveyed, fatigue, cognitive, and short-term memory symptoms, headaches, muscle and joint pain, unrefreshed sleep, sensory disturbances, muscle weakness, and intolerance to extremes of temperature were the most commonly occurring symptoms (reported by more than two-thirds of patients). Significant differences in symptom occurrence between Fukuda- and International Consensus Criteria-defined cases were also identified. CONCLUSION This is the first study to summarize sociodemographic and illness characteristics of a cohort of Australian CFS/ME patients. This is vital for identifying potential risk factors and predictors associated with CFS/ME and for guiding decisions regarding health care provision, diagnosis, and management.
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Affiliation(s)
- Samantha C Johnston
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Parklands, QLD, Australia; School of Medical Sciences, Griffith University, Parklands, QLD, Australia
| | - Donald R Staines
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Parklands, QLD, Australia
| | - Sonya M Marshall-Gradisnik
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Parklands, QLD, Australia; School of Medical Sciences, Griffith University, Parklands, QLD, Australia
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