Chronic Fatigue Syndrome: What Role Does the Autonomic Nervous System Play in the Pathophysiology of This Complex Illness?

2002 ◽  
Vol 10 (3) ◽  
pp. 134-141 ◽  
Author(s):  
Timothy R. Gerrity ◽  
Janet Bates ◽  
David S. Bell ◽  
George Chrousos ◽  
Gloria Furst ◽  
...  
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Autonomic Nervous ◽  
Fatigue Syndrome

scholarly journals Chronic fatigue syndrome: a hypothesis focusing on the autonomic nervous system

1999 ◽  
Vol 96 (1) ◽  
pp. 117-125 ◽  
Author(s):  
Massimo PAGANI ◽  
Daniela LUCINI
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Chronic Fatigue Syndrome ◽  
Systolic Arterial Pressure ◽  
Chronic Fatigue ◽  
Autonomic Nervous ◽  
Fatigue Syndrome ◽  
Sympathetic Modulation ◽  
Autonomic Activation ◽  
The Common

Chronic fatigue syndrome is a debilitating illness of unknown aetiology, with estimated levels of prevalence of up to about 8.7/100 000 in the U.S.A. Like pain fatigue it is a personal, emotionally rich experience, which may originate from peripheral or central sites (or both). The nature of the symptoms is complex and reflects the interaction of the patient with the environment and cultural milieu. Accordingly the common use of the same terminology for different types of fatigue may be misleading. Autonomic activation is a key component of both real and simulated physical exercise. Alterations in autonomic nervous system activity are a key component of several physiopathological conditions. In chronic fatigue syndrome disturbances in autonomic activity, and in other homoeostatic mechanisms, such as the hormonal and immune systems, have been reported recently. In this review we followed the hypothesis that in chronic fatigue syndrome the paradoxical condition of disturbing somatic symptoms in the absence of organic evidence of disease might be addressed by focusing on attending functional correlates. In particular we addressed possible alterations in cardiovascular autonomic control, as can be assessed by spectral analysis of R–R interval and systolic arterial pressure variability. With this approach, in subjects complaining of unexplained fatigue, we obtained data suggesting a condition of prevailing sympathetic modulation of the sino-atrial node at rest, and reduced responsiveness to excitatory stimuli. Far from considering the issue resolved, we propose that in the context of the multiple physiological and psychological interactions involved in the perception and self-reporting of symptoms, attendant changes in physiological equivalents might furnish a convenient assessment independent from subjective components. Indices of sympathetic modulation could, accordingly, provide quantifiable signs of the interaction between subject's efforts and environmental demands, independently of self descriptions, which could provide convenient measurable outcomes, both for diagnosis and treatment titration in chronic fatigue syndrome.

scholarly journals Brain Responses in CFS and TMD to Autonomic Challenges: An Exploratory fMRI Study

2019 ◽  
Vol 5 (3) ◽  
pp. 224-232
Author(s):  
Q.C. Vuong ◽  
J.R. Allison ◽  
A. Finkelmeyer ◽  
J. Newton ◽  
J. Durham
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Chronic Fatigue Syndrome ◽  
Temporomandibular Disorder ◽  
Insular Cortex ◽  
Chronic Fatigue ◽  
Autonomic Functions ◽  
Autonomic Nervous ◽  
Fatigue Syndrome ◽  
Brain Responses

Introduction: Dysfunction of the autonomic nervous system (ANS) is seen in chronic fatigue syndrome (CFS) and temporomandibular disorders (TMDs). Both conditions have poorly understood pathophysiology. Several brain structures that play a role in pain and fatigue, such as the insular cortex and basal ganglia, are also implicated in autonomic function. Objectives: ANS dysfunction may point to common neurophysiologic mechanisms underlying the predominant symptoms for CFS and TMD. No studies to date have investigated the combination of both conditions. Thus, our aim was to test whether patients with CFS with or without TMD show differences in brain responses to autonomic challenges. Methods: In this exploratory functional imaging study, patients with CFS who screened positive for TMD (n = 26), patients who screened negative for TMD (n = 16), and age-matched control participants (n = 10) performed the Valsalva maneuver while in a 3-T magnetic resonance imaging scanner. This maneuver is known to activate the ANS. Results: For all 3 groups, whole-brain F test showed increased brain activation during the maneuver in the superior and inferior frontal gyri, the left and right putamen and thalamus, and the insular cortex. Furthermore, group contrasts with small-volume correction showed that patients with CFS who screened positive for TMD showed greater activity in the left insular cortex as compared with patients who screened negative and in the left caudate nucleus as compared with controls. Conclusion: Our results suggest that increased activity in the cortical and subcortical regions observed during autonomic challenges may be modulated by fatigue and pain. ANS dysfunction may be a contributing factor to these findings, and further work is required to tease apart the complex relationship among CFS, TMD, and autonomic functions. Knowledge Transfer Statement: Brain activity related to activation of the autonomic nervous system in patients with chronic fatigue syndrome who screened positive for painful temporomandibular disorder was greater than in patients who screened negative; activity was seen in brain regions associated with autonomic functions and pain. These findings suggest that autonomic dysfunction may play a role in the pathophysiology of both conditions, explain some of the apparent comorbidity between them, and offer avenues to help with treatment.

scholarly journals Involvement of Cervical Muscle Lesions and Autonomic Nervous System in Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS)

2020 ◽  
Author(s):  
Takayoshi Matsui ◽  
Kazuhiro Hara ◽  
Makoto Iwata ◽  
Shuntaro Hojo ◽  
Nobuyuki Shitara ◽  
...  
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Chronic Fatigue Syndrome ◽  
Pupil Diameter ◽  
Local Therapy ◽  
Chronic Fatigue ◽  
Autonomic Nervous ◽  
Cervical Muscles ◽  
Fatigue Syndrome ◽  
Hospitalization Period

Abstract Background: Patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) sometimes coincide with stiffness of cervical muscles. This study examined the effect of local modulation of the cervical muscles on ME/CFS and the underlying mechanism.Methods: In total, 1,226 inpatients with ME/CFS who were resistant to outpatient care were enrolled in this study for 11 years. All patients underwent daily physical therapies to the cervical muscles during hospitalization. Self-rated records documenting the presence and absence of ME/CFS and the representative eight disorders that frequently accompany it at admission and discharge were compared. The pupil diameter was also measured to examine involvement of autonomic nervous system function.Results: The recovery rate of ME/CFS after local therapy was 55.5%, and did not differ significantly by sex, age strata, and hospitalization period. The recovery rates of the eight disorders were variable (36.6－86.9%); however, those of ME/CFS in the disorder subpopulations were similar (52.3－55.8%). The recovery rates of all disorders showed strong associations with that of ME/CFS (p<0.001). The pupil diameter was decreased at discharge, and the change was significantly higher in the ME/CFS-recovered patients than ME/CFS-unrecovered patients in the total population and the subpopulations stratified by sex, age, and hospitalization period.Conclusions: Local therapy to the cervical muscles led to recovery in more than half of patients with ME/CFS, at least partly through amelioration of the autonomic nervous system. There may be a causal relationship between recoveries of ME/CFS and these related whole-body disorders.Trial registration ID: UMIN000036634. Registered 1 May 2019 - Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/index.cgi

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