Abstract
Chronic Fatigue Syndrome (CFS) is characterized by severe impairment and multiple symptoms. Autonomic dysregulation has been demonstrated in several studies. We aimed at exploring the relationship between indices of autonomic cardiovascular control, the case definition from Centers for Disease Control and Prevention (CDC criteria), important clinical symptoms, and disability in adolescent chronic fatigue syndrome. 38 CFS patients aged 12–18 years were recruited according to a wide case definition (ie. not requiring accompanying symptoms) and subjected to head-up tilt test (HUT) and a questionnaire. The relationships between variables were explored with multiple linear regression analyses. In the final models, disability was positively associated with symptoms of cognitive impairments (p<0.001), hypersensitivity (p<0.001), fatigue (p=0.003) and age (p=0.007). Symptoms of cognitive impairments were associated with age (p=0.002), heart rate (HR) at baseline (p=0.01), and HR response during HUT (p=0.02). Hypersensitivity was associated with HR response during HUT (p=0.001), high-frequency variability of heart rate (HF-RRI) at baseline (p=0.05), and adherence to the CDC criteria (p=0.005). Fatigue was associated with gender (p=0.007) and adherence to the CDC criteria (p=0.04). In conclusion, a) The disability of CFS patients is not only related to fatigue but to other symptoms as well; b) Altered cardiovascular autonomic control is associated with certain symptoms; c) The CDC criteria are poorly associated with disability, symptoms, and indices of altered autonomic nervous activity.
Highlights
Chronic fatigue syndrome (CFS) is a disabling condition that seriously affects school-attendance and social activities [1]
A) The disability of CFS patients is related to fatigue but to other symptoms as well; b) Altered cardiovascular autonomic control is associated with certain symptoms; c) The Centers for Disease Control and Prevention (CDC) criteria are poorly associated with disability, symptoms, and indices of altered autonomic nervous activity
Subjects During the study period from August 2007 to April 2009, adolescent CFS patients aged 12 – 18 years were recruited from the Paediatric outpatient clinic, Oslo University Hospital, Rikshospitalet, Norway, which serves as a national referral center for children and adolescents with CFS
Summary
Chronic fatigue syndrome (CFS) is a disabling condition that seriously affects school-attendance and social activities [1]. The prevalence among 8–17 years olds has been reported as high as 1% [2,3]; CFS constitutes a substantial health problem in adolescence. CFS patients report a great variety of bodily symptoms. Their experience of overwhelming fatigue is assumed to be the single most important factor for their substantial impairments.
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