Comparing autonomic nervous system function in patients with functional somatic syndromes, stress-related syndromes and healthy controls

BACKGROUND

The goal of this study was to examine autonomic nervous system function by measuring heart rate (HR), heart rate variability (HRV), skin conductance levels (SCL), and peripheral skin temperature (ST) in response to and during recovery from psychosocial stressors in patients with functional somatic syndromes (FSS; fibromyalgia and/or chronic fatigue syndrome), stress-related syndromes (SRS; overstrain or burn-out), and healthy controls (HC).

METHODS

Patients with FSS (n = 26), patients with SRS (n = 59), and HC (n = 30) went through a standardized psychosocial stress test consisting of a resting phase (120 s), the STROOP color word task (120 s), a mental arithmetic task (120 s) and a stress talk (120 s), each followed by a 120 s recovery period. HR, HRV, SCL, and ST were monitored continuously.

RESULTS

Average HR and SCL were higher, and HRV was lower, in both patient groups compared to HC during rest (0.50 < Cohen's d < 0.97). A larger SC response to psychosocial stress was found in FSS compared to HC (d = 0.71). However, HR increased less during psychosocial stress and showed a smaller reduction during recovery in both patient groups compared to HC (0.68 < d < 0.98). HRV was lower in both patient groups compared to HC during recovery (0.91 < d < 0.98). There were no differences in ST levels or responses between groups.

CONCLUSIONS

Our results indicate a dominance of the sympathetic nervous system in both patient groups compared to controls, suggesting that autonomic nervous system dysfunction is a transdiagnostic feature for stress-related and functional somatic syndromes.

The effects of traditional Chinese manual therapy (Tuina) for chronic fatigue syndrome: A protocol for systematic review and meta-analysis

BACKGROUND

Chronic fatigue syndrome (CFS) is a common disease and characterized by fatigue, exhaustion, heavy limbs, and dizziness. Tuina, as a traditional Chinese manual therapy, is usually used for CFS in China. Several studies have reported that Tuina can improve fatigue exhaustion, and dizziness of patients with CFS. However, the effects of Tuina for CFS still remain controversial. Therefore, the current systematic review and meta-analysis will be conducted to investigate the effects of Tuina in the management of CFS.

METHODS

The comprehensive electronic search of PubMed, Web of Science, Chinese National Knowledge Infrastructure, Wanfang Database, Embase, Cochrane Library, Chinese Science Citation Database, Technology Periodical Database from their inception to October 2021 will be conducted. Randomized controlled trials of Tuina for CFS will be included in the review. Two independent reviewers will complete the study selection, data extraction, and the risk of bias. The meta-analysis will be conducted using the Review Manager Version 5.3 software. The heterogeneity will be assessed using the I2 statistic and Q statistic. The standardized mean difference and 95% confidence intervals will be calculated based on different heterogeneity. The subgroup analysis will be conducted based on the duration of treatment, age, gender, duration of CFS. Quality of evidence will be assessed using the Grades of Recommendation, Assessment, Development and Evaluation.

RESULTS

The current systematic review and meta-analysis will be to investigate the effects of Tuina in the management of CFS.

CONCLUSION

The conclusion of this study will provide the evidence for the treatment of CFS in the future. It is expected that the conclusions drawn from this review will benefit patients, clinical practitioners and policy makers.

'A life I can cope with'. An alternative model of cognitive behavioural therapy (CBT) for CFS/ME

Objectives

This study aimed to explore the experience of cognitive behavioural therapy (CBT) aimed at better management of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), rather than increasing activity.

Design

This was a qualitative study using grounded theory analysis.

Methods

Semi‐structured interviews were conducted with 13 adults who had engaged in CBT at a specialist CFS/ME service in which CBT is aimed at improved management of the condition.

Results

A model was produced in which participants felt more able to cope with CFS/ME. Reduced fatigue did not seem to be a necessary precondition to managing. This has implications for CBT for CFS/ME.

Conclusions

Specialist CBT for CFS/ME may result in improved coping and reduced distress, independently of changes in fatigue.

Patient or Public Contribution

The researcher met with a representative from the university's service user advisory group (SAGE), who had lived experience of CFS/ME. They commented on possible questions for the interview topic guide and provided advice on ways in which ethical issues specific to CFS/ME could be considered, for example, prevention of harm during interviews. Second, for quality assurance as part of respondent validation, a proposed draft of the grounded theory was discussed with participants.