Abstract
Post-exertional malaise (PEM) is regarded as the hallmark symptom in chronic fatigue syndrome (CFS). The aim of the current study is to explore differences in CFS patients with and without PEM in indicators of aortic stiffness, autonomic nervous system function, and severity of fatigue. One-hundred and one patients met the Fukuda criteria. A Chronic Fatigue Questionnaire (CFQ) and Fatigue Impact Scale (FIS) were used to assess the level of mental and physical fatigue. Aortic systolic blood pressure (sBPaortic) and the autonomic nervous system were measured with the arteriograph and Task Force Monitor, respectively. Eighty-two patients suffered prolonged PEM according to the Fukuda criteria, while 19 did not. Patients with PEM had higher FIS scores (p = 0.02), lower central systolic blood pressure (p = 0.02) and higher mental fatigue (p = 0.03). For a one-point increase in the mental fatigue component of the CFQ scale, the risk of PEM increases by 34%. For an sBPaortic increase of 1 mmHg, the risk of PEM decreases by 5%. For a one unit increase in sympathovagal balance, the risk of PEM increases by 330%. Higher mental fatigue and sympathetic activity in rest are related to an increased risk of PEM, while higher central systolic blood pressure is related to a reduced risk of PEM. However, none of the between group differences were significant after FDR correction, and therefore conclusions should be treated with caution and replicated in further studies.
Highlights
Chronic Fatigue Syndrome (CFS) is characterized by a substantial deterioration of symptoms that could be provoked in response to physical exercise in patients with postexertional malaise (PEM) [1]
The results of the present study have shown that CFS patients with PEM had sigThe results of the present have shown that CFS
PEM, as had measured by Fatigue Impact Scale (FIS), higher one of the three fatigueand scales usedfatigue in the above significantly mental fatigue overall than research. They had higher mental fatigue and sympathetic activity compared with those without PEM, as measured by FIS, one of the three fatigue scales used in the above parasympathetic activity during rest and lower central systolic blood pressure
Summary
Chronic Fatigue Syndrome (CFS) is characterized by a substantial deterioration of symptoms that could be provoked in response to physical exercise in patients with postexertional malaise (PEM) [1]. The National Academy of Medicine reports the prevalence of PEM among CFS patients as being from 69 to 100% [2]. PEM is regarded as a hallmark symptom of CFS [3]. Some criteria, such as the Fukuda case definition [4], do not require PEM to be present for a CFS diagnosis. The majority of patients, i.e., 73.4%, reported the duration of PEM as being equal to or longer than 24 h [5]. The exact mechanism that underlies PEM is as yet unknown. Disruption of the resting respiratory rate induced by PEM has been observed [7]
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