Chronic Fatigue Syndrome: Texas

Tharakan B, Dhanasekaran M, Brown-Borg HM, Manyam BV. · Plummer Movement Disorders Center, Department of Neurology, Scott & White Clinic, Temple, TX 76508, USA. · Phytother Res. · Pubmed #16617470 No free full text.

Abstract: Chronic fatigue is a complex and little understood symptom for which there is no safe and effective pharmacotherapy. The present study was conducted to investigate the effectiveness of Trichopus zeylanicus whole plant powder on fatigue in young Sprague Dawley rats, and aged normal and long-living mutant Ames dwarf mice. Fatigue was evaluated by subjecting the animals to a forced swim test. Trichopus zeylanicus (250 and 500 mg/kg) treated young Sprague-Dawley rats resisted fatigue at a significant level (p < 0.005) compared with controls by an extended swim time in the forced swim test. Oral Trichopus zeylanicus (500 mg/kg) treatment for 2 weeks significantly increased the mobility time in the aged mutant (p < 0.05) and normal mice (p < 0.01) and significantly increased the swim time in the forced swim test in the aged normal mice (p < 0.05). Amphetamine-mimetic activity in Trichopus zeylanicus was excluded by suitable tests. These results show that Trichopus zeylanicus whole plant powder has anti-fatigue effects in young Sprague-Dawley rats and aged normal and mutant Ames dwarf mice providing scientific evidence for the Kani tribal practice in India.

Kelly KS, Soderlund K, Albert C, McGarrahan AG. · Department of Psychology, University of North Texas, Denton 76203, USA. · Health Commun. · Pubmed #16370968 No free full text.

Abstract: The role of social support was examined in Chronic Fatigue Syndrome (CFS). Social support has been shown to affect illness outcome in medical disorders, likely due in part to communication between patient and support giver on illness-related concerns. Forty-one participants, 25 of whom had a primary support giver, completed the Beck Depression Inventory, the Perceived Stress Scale, the Profile of Mood States, and the Inventory of Socially Supportive Behaviors (ISSB); the primary support giver completed a modified version of the ISSB indicating the level of support he or she provided and a questionnaire assessing beliefs about CFS. Results indicated that there were no differences among individuals with CFS with or without support on measures of mood and perceived stress. Individuals with CFS and their support givers agreed on the amount of support offered, and extent of support was independent of beliefs concerning etiology. Exploratory analyses revealed that verbal emotional-cognitive support generally was more predictive of mental health than was tangible, less communicative support. The lack of positive effect of social support is discussed in relation to the degree of support offered, and implications for future research are discussed.

Haley RW, Vongpatanasin W, Wolfe GI, Bryan WW, Armitage R, Hoffmann RF, Petty F, Callahan TS, Charuvastra E, Shell WE, Marshall WW, Victor RG. · Divisions of Epidemiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8874, USA. · Am J Med. · Pubmed #15464703 No free full text.

Abstract: PURPOSE: To test the hypothesis that subtle abnormalities of the autonomic nervous system underlie the chronic symptoms reported by many Gulf War veterans, such as chronic diarrhea, dizziness, fatigue, and sexual dysfunction. METHODS: Twenty-two ill Gulf War veterans and 19 age-, sex-, and education-matched control veterans underwent measurement of circadian rhythm of heart rate variability by 24-hour electrocardiography, ambulatory blood pressure recording, Valsalva ratio testing, sympathetic skin response evaluation, sweat imprint testing, and polysomnography. Investigators were blinded to case- or control-group status. RESULTS: High-frequency spectral power of heart rate variability increased normally 2.2-fold during sleep in controls but only 1.2-fold in ill veterans (P <0.0001). In ill veterans as compared with controls, it was lower at night (P = 0.0006), higher during the morning (P = 0.007), but no different during the rest of the day (P = 0.8). The mean heart rate of ill veterans also declined less at night (P = 0.0002), and their corrected QT intervals tended to be longer over the full 24 hours (P = 0.07), particularly at night (P = 0.03). Blunting of the nocturnal heart rate dip in ill veterans was confirmed by 24-hour automatic ambulatory blood pressure monitoring (P = 0.05) and polysomnography (P = 0.03). These differences remained significant after adjusting for potential confounders. Cases and controls were similar on measures of sympathetic adrenergic and sudomotor function, sleep architecture, respiratory function, and circadian variation in blood pressure and body temperature. CONCLUSION: Some symptoms of Gulf War syndrome may be due to subtle autonomic nervous system dysfunction.

Schmaling KB, Fiedelak JI, Katon WJ, Bader JO, Buchwald DS. · Office of the Provost, University of Texas at El Paso, El Paso, TX 79968, USA. · Psychosom Med. · Pubmed #14645784 links to  free full text

Abstract: OBJECTIVES: To determine prospective changes in clinical status related to chronic fatigue over an 18-month period, and to test demographic and clinical predictors of outcome. METHODS: A cohort of 100 patients with unexplained chronic fatigue (UCF), which encompasses both chronic fatigue syndrome (CFS) and idiopathic chronic fatigue (ICF), completed questionnaire measures and medical and psychiatric evaluations on four occasions, each six months apart. RESULTS: Approximately 21% of the sample did not meet criteria for either CFS or ICF at their last research appointment 1.5 years after their index visit. Vitality increased over time, and physical functioning tended to improve, but UCF symptoms did not decrease significantly. Less education, being unemployed, worse mental health, more use of sedating and antidepressant medications, and more somatic attributions for their symptoms were associated with worsening symptom severity over time. Older age, current depression, and more somatic attributions predicted worsening physical functioning. Better mental health, less use of sedating medications, and fewer somatic attributions for illness were significant predictors of increases in vitality. CONCLUSIONS: Demographic and clinical variables predict outcomes over time among a cohort of patients with unexplained chronic fatigue.

Schmaling KB, Lewis DH, Fiedelak JI, Mahurin R, Buchwald DS. · College of Health Sciences, University of Texas, El Paso, Texas 79902, USA. · Psychosom Med. · Pubmed #12554824 links to  free full text

Abstract: OBJECTIVE: The purposes of this study were to compare functional imaging under control and experimental conditions among patients with chronic fatigue syndrome (CFS) and healthy persons and to examine perceived and objective performance on a test of attention and working memory previously found to be difficult for persons with CFS. METHODS: Single-photon emission computerized tomography scans were completed on 15 subjects with CFS and 15 healthy persons twice: at rest and when performing the Paced Auditory Serial Addition Test (PASAT). RESULTS: No group differences were found for performance on the PASAT despite CFS subjects' perceptions of exerting more mental effort to perform the task than healthy subjects. Inspection of the aggregate scans by group and task suggested a pattern of diffuse regional cerebral blood flow among subjects with CFS in comparison with the more focal pattern of regional cerebral blood flow seen among healthy subjects. Between-group region-of-interest analysis revealed that although CFS subjects showed less perfusion in the anterior cingulate region, the change in CFS subjects' activation of the left anterior cingulate region during the PASAT was greater than that observed for healthy subjects. The differences were not attributable to lesser effort by the subjects with CFS, confounding effects of mood perturbation, or to poorer performance on the experimental task. CONCLUSIONS: Further research regarding CFS subjects' diffuse cerebral perfusion and its relationship to inefficient neuropsychological performance is warranted.

Krueger GR, Brandt ME, Wang G, Berthold F, Buja LM. · Department of Pathology & Laboratory Medicine, University of Texas-Houston Medical School, 77030, USA. · Anticancer Res. · Pubmed #12174928 No free full text.

Abstract: OBJECTIVE: The objective of this study was to simulate changes in the human T cell system representing Canale-Smith syndrome using a dynamic computer model of T cell development and comparing with available human data. STUDY DESIGN: Physiological stepwise maturation and function of T lymphocytes in the computer model is altered by introducing functional disturbances following lymphotropic virus infection. In the present model, acute and chronic persistent infection with the human herpesvirus-6 (HHV-6) was simulated, and ensuing changes in T cell populations were compared with those measured in human patients. RESULTS: Using our computer model we previously found that simulated acute HHV-6 infection produced T cell computer data, which resembled an infectious mononucleosis-like disease in patients. Simulated chronic persistent infection, instead, resulted in variable cell changes comparing well to patients with chronic fatigue syndrome. In one setting, however, persistent immature lymphocytosis was observed similar to what initial has been described in this journal as Canale-Smith syndrome. CONCLUSION: Using a computer model developed by us we were able to produce simulations that resemble the immune system features of Canale-Smith syndrome. Further understanding of these simulation results may possibly guide future investigations into this disorder.

Krueger GR, Koch B, Hoffmann A, Rojo J, Brandt ME, Wang G, Buja LM. · Department of Pathology & Laboratory Medicine, University of Texas-Houston Medical School, 6431 Fannin St, MSB 2.246, Houston, Texas 77030, USA. Gerhard.Krueger@uthtmcedu · In Vivo. · Pubmed #11887330 No free full text.

Abstract: Ten adult patients with persistent active HHV-6 variant A infection and clinical chronic fatigue syndrome (CFS) were studied over a period of 24 months after initial clinical diagnosis. CFS was diagnosed according to IIIP-revised CDC-criteria as defined by the CFS Expert Advisory Group to the German Federal Ministry of Health in 1994. Changes in HHV-6 antibody titer, viral DNA load, peripheral blood T lymphocytes and subpopulations, as well as CD4/CD8 cell ratio and cell death (apoptosis) were monitored. Data were collected for comparison with respective changes in acute HHV-6 infection and as a basis for future computer simulation studies. The results showed variable but slightly elevated numbers of HHV-6 DNA copies in the blood of patients with CFS, while PBL (peripheral blood lymphocyte) apoptosis rates were clearly increased. CD4/CD8 cell ratios varied from below 1 up to values as seen in autoimmune disorders. Contrary to acute HHV-6 infection, T lymphocytes do not exhibit the usual response to HHV-6, that is elevation of mature and immature populations suggesting a certain degree of unresponsiveness. The data suggest that persistent low-dose stimulation by HHV-6 may favor imbalanced immune response rather than overt immune deficiency. This hypothesis requires confirmation through additional functional studies.

Clapp LL, Richardson MT, Smith JF, Wang M, Clapp AJ, Pieroni RE. · Health, Physical Education, and Recreation Department, Southwest Texas State University, San Marcos 78666, USA. · Phys Ther. · Pubmed #10440661 links to  free full text

Abstract: BACKGROUND AND PURPOSE: Currently, there is no consensus on exercise prescription for patients with chronic fatigue syndrome (CFS). This investigation examined whether light-intensity, intermittent physical activity exacerbated symptoms in patients with CFS immediately following exercise to 7 days following exercise. Subjects. Subjects were 9 women (mean age=44.2 years, SD=8.4, range=29-56; mean weight=74.2 kg, SD=18.8, range=56.36-110.91; and mean height=1.63 m, SD=0.8, range=1.55-1.78) and 1 man (age=48 years, weight=97.1 kg, and height= 1.98 m) who met the Centels for Disease Control and Prevention's criteria fi)r (FS. METHODS: Subjects performed 10 discontinuous 3-minute exercise bouts (separated by 3 minutes of recovery) at a self-selected, comfortable walking pace on a treadmill. Oxygen consumption, minute ventilation, respiratory exchange ratio, and heart rate were measured every minute during the exercise session. To assess degree of disability, general health status, activity level, symptoms, and mood, subjects completed various questionnaires before and after exercise. RESULTS: Results indicated that degree of disability, general health status, symptoms, and mood did not change immediately and up to 7 days following exercise. CONCLUSION AND DISCUSSION: Thirty minutes of intermittent walking did not exacerbate symptoms in subjects with CFS. The physiological data did not show any abnormal response to exercise. Although this study did not determine whether 30 minutes of continuous versus intermittent exercise would exacerbate symptoms, all 10 subjects felt that they could not exercise continuously for 30 minutes without experiencing symptom exacerbation. Despite this limitation, the results indicate that some individuals with CFS may be able to use low-level, intermittent exercise without exacerbating their symptoms.