Following is news of current publications and research efforts underway related
to chronic fatigue
syndrome (CFS)--also called chronic fatigue and immune dysfunction syndrome (CFIDS).
MRI results predict symptoms
Brain abnormalities detected by MRI are significantly
to self-reports of low physical function in CFS patients, according to a study in the International
Journal of Neuroscience.
The study looked at 48 CFS patients who underwent MRI procedures after filling out Medical
Study SF-36, which measures patientsí self-reported health status. Abnormalities were grouped into five
categories: lateral ventricular enlargement; gray matter and/or brain stem hyperintensities; subcortical
white matter hyperintensities; cerebral atrophy; and left-right cerebral hemisphere asymmetries. Twenty-five
of the 48 subjects showed brain abnormalities that fell into one of the five categories.
Researchers discovered a significant negative correlation between brain abnormalities
function as self-reported on SF-36. This effect held after controlling for the increased age of the subjects
found to have abnormal MRI results (43.0 years +/- 9.7 vs. 33.5 years =/- 6.5 years).
The authors suggest that brain abnormalities in CFS are "as functionally significant
as has been shown
in the case of multiple sclerosis."
Cook DB et al. Relationship of brain MRI abnormalities and physical functional status
fatigue syndrome. Intern J. Neuroscience. 2001; 107:1-6.
Study: Urinary free cortisol low in CFS patients
A new report in the American
of Psychiatry confirms that mild hypocortisolism accompanies CFS in many patients.
Researchers at Kingís College Hospital in London report that urinary free cortisol levels
lower in CFS patients than healthy controls, regardless of comorbid psychiatric conditions. Twenty-four
hour urine samples were collected from 121 consecutive patients at the hospitalís CFS clinic and com-pared
to 64 healthy controls.
Because the study was cross-sectional, researchers say they are unable to tell whether
are a potential cause or by-product of CFS. The study is also limited because it drew from a tertiary-care
Cleare AJ et al. Urinary Free Cortisol in Chronic Fatigue Syndrome. American
Journal of Psychiatry.
CFS may increase lipoprotein peroxidation
CFS patients are at higher risk
of both low-density lipoproteins (LDL) and very-low-density lipoproteins (VLDL), write the authors of
a new study published in the journal Life Sciences.
The study compared 61 people with varying complaints of fatigue. The subjects were divided
groups: those who met 1988 guidelines for CFS (n=33) and those with unexplained fatigue lasting at least
one month (n=28). The CFS group showed significantly higher peroxidation levels, measured in vitro by
formation of Thiobar-bituric Acid Reactive Substances (TBARS).
Researchers attribute the higher levels to the shorter amount of time that LDL and VLDL
in vitro peroxidation in the CFS patients as compared to controls. They write that the intrinsic ability
to resist peroxidation in somehow impaired by CFS.
The CFS patients also displayed lower levels of serum transferrin. The researchers speculate
coupled with phagocyte hyperactivity and lipid peroxidation, can cause extra oxidative stress in people
with CFS. After additional study, antioxidant supplementation may be advisable.
Manuel y Keenoy B et al. Antioxidant status and lipoprotein peroxidation in chronic
Life Sciences. 2001; 68:2037-2049.
CFS abstracts wanted for scientific meeting
Abstracts are being sought for
The Third International
Clinical and Scientific Meeting for Chronic Fatigue Syndrome, to be held Dec. 1-2, 2001 in Sydney, Australia.
All CFS-related topics are welcome, including clinical case studies; physical findings;
persistent infection; cytokines and symptomatology; membrane integrity (e.g., BBB & GIT); environmental
exposures; and health management models.
Abstracts should be no longer than 300 words. Please indicate whether you would prefer
an oral or poster
presentation. The title should be brief and must clearly identify the nature of the study and the content
of the presentation.
For questions about submission formats and deadlines, please contact Ellie Stein, MD,
via e-mail at
email@example.com, or by phone in Canada at 403-685-4861.
Syncope: Evaluation and Management
Complaints of syncope are common among people with chronic
fatigue syndrome (CFS). An article in the April 2001 issue of Clinician Reviews offers advice
and managing the condition.
Syncope is, by definition, a transient condition that results from global decrease
in cerebral profusion.
Subtypes include cardiac syncope, often caused by arrhythmia; cough syncope; postural syncope, caused
by a defect or instability in vasomotor reflexes; and vasodepressor syncope, which accounts for half of
Diagnosis: Check for prescribed, OTC and recreational drug use. About nine percent
of syncope is caused
by drug reactions. Rule out other diagnoses, such as anxiety/hyperventilation, hypoglycemia and head trauma.
Management: Patients with diagnosed vasodepressor syncope could benefit from antihypertensives,
beta-blockers and calcium channel blockers. Those with chronic orthostatic intolerance could benefit from
Prevention: Counsel patients with postural hypotension to rise slowly from bed, after
spending a few
seconds lightly exercising their legs. Sleeping with the feet elevated eight to 12 inches may help, as
might wearing elastic stockings. High salt intake can increase fluid retention, but creates a long-term
risk of hypertension.
Education: Patients with recurring syncope should take precautions to avoid dangerous
such as driving an automobile or operating power tools. Cover sharp corners on furniture to lessen danger
of injury during falls. Cover bathroom floors and bathtub floors with rubber mats. When feeling lightheaded,
patients should lie on their backs with their legs elevated to improve blood flow to the head.