Following is news of current publications and research efforts under way related to chronic fatigue syndrome (CFS)-also called chronic fatigue and immune dysfunction syndrome (CFIDS).

Overlapping conditions studied
A study published in the January 24 issue of Archives of Internal Medicine found that patients with chronic fatigue syndrome (CFS), fibromyalgia (FM), or temporomandibular joint disorder (TMJ) suffered from overlapping conditions, including interstitial cystistis and chronic tension-type headache. Irritable bowel syndrome was a missed diagnosis in 92% of the CFS patients.

The patients shared generalized pain sensitivity, sleep and concentration difficulties and gastrointestinal complaints, but a number of distinguishing symptoms emerged.

Patients with CFS and FM had fatigue, joint aches and burning or shooting muscle pain. Unique symptoms for CFS included fever or sore throat, while individuals with FM had more frequent history of low back pain.

Aaron LA et al. Overlapping conditions among patients with chronic fatigue syndrome, fibromyalgia, and temporomandibular disorder. Arch Intern Med. 2000; 160: 221-7.

Long-term symptom patterns
A study of 398 patients who have had CFS for more than 10 years showed those individuals report a larger number of specific cognitive problems that are greater in severity than those reported by individuals who were ill for a shorter period of time (less than seven years).

This was the first published study to describe a large sample of patients with a long duration of illness. Most long-term sufferers (ill an average of 16 years) experienced onset at a young age and showed a higher percentage of infection with viral and immune-related illnesses, including allergies, chronic sinus infections and hepatitis. The study was funded by The CFIDS Association of America.

Friedberg F et al., Symptom patterns in long-duration chronic fatigue syndrome. J Psycho-somatic Res. 2000; 48: 59-68.

Personality not a factor
A study of 100 individuals with CFS and 40 rheumatoid arthritis patients found no difference in measures such as perfectionism, harm avoidance and depression, even when fatigue-related questions were removed. The researchers concluded that their findings fail to support the stereotype of the CFS patients as overachievers prone to depressive disorders.

Wood B and Wessely S. Personality and social attitudes in chronic fatigue syndrome. J Psychosomatic Res. 1999: 47: 385-97.

Seasonal onset?
A small study has looked at the dates when 69 CFS patients whose onset was sudden (over two days) became ill. The dates were nonrandom-peaking from November through January and lowest from April through May. This supports the hypothesis that infectious illness may trigger onset.

Zhang QW et al. Chronic fatigue syndrome beginning suddenly occurs seasonally over the year. Chronobio Intl. 2000; 17: 95-9.

British researchers found that majority of 50 children studied developed the illness between September and December. They speculate that onset may coincide with the beginning of secondary school and an increased risk for stress and infection.

Rangle L et al. The course of severe chronic fatigue syndrome in childhood. J Royal Soc Med. 2000; 93:128-33.

Impact of psychiatric history
Individuals with CFS sometimes present with a history of unexplained physical symptoms. How much does that prior history influence your treatment decisions?

Researchers at the University of Iowa mailed questionnaires presenting two hypothetical patient cases involving sudden onset of severe headaches or abdominal pain to 300 randomly selected family doctors. Doctors who were told that the patients had a prior history of psychiatric disorders were much less likely to detect serious illness.

Graber MA et al. Effect of a patient's psychiatric history on physicians' estimation of probability of disease. J Gen Intern Med. 2000; 15: 204-6.

Possible role of HHV-6
Reactivated Human Herpesvirus 6 (HHV-6) may play a role in CFS, multiple sclerosis and other diseases, according to research from Georgetown University.

A small sample of MS and CFS patients followed clinically for more than two years were found to have elevated levels of antibodies against HHV-6 compared to healthy controls. Persistent HHV-6 infection was found in two of the CFS patients. A decrease in cellular immune responses was also detected in the CFS patients.

Ablashi DV et al. Frequent HHV-6 reactivation in multiple sclerosis and chronic fatigue syndrome patients. J Clin Virol.  2000; 16: 179-91.

Submit abstracts
The fifth international American Association for Chronic Fatigue Syndrome conference will be held January 26-29, 2001, in Seattle.
If you would like to register or submit an abstract, visit the conference web site at http://faculty.washington.edu/dedra/uwindex.htm. All abstracts should be postmarked by July 1, 2000.

Neurosurgery for CFS?
Following a segment on ABC’s "20/20" in March, many CFS and fibromyalgia (FM) patients are wondering whether neurosurgery might help their condition. The show discussed treatment for Chiari malformation and cervical stenosis, which involve narrowing of the opening at the base of the skull or neck that compresses the lower part of the brain or spinal cord and can cause neurological symptoms similar to CFS.

One source of information for patients is The CFIDS Association of America’s web site at www.cfids.org
Another good resource is the World Arnold-Chiari Malformation Association’s web site and Internet discussion list at www.pressenter.com/~wacma/ , which includes diagnostic criteria and a list of neurologists and neurosurgeons who have experience with these conditions.