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Spring 2003 

Research News
The latest information on research, treatment and diagnosis of CFIDS and related disorders

(Terms in bold type appear in the CFIDS Glossary box.)

Blood flow normal in CFIDS patients
The amount of blood that flows to skeletal muscles in people with CFIDS appears to be normal, according to research published in the Feb. 13 issue of the British journal Clinical Science. The finding is important because some researchers have speculated that poor blood flow or poor delivery of oxygen to these muscles could cause CFIDS symptoms such as fatigue and post-exertional malaise.

This small study compared 19 people with CFIDS to a group of 11 normal, but sedentary, control subjects. The CFIDS patients showed similar scores to the controls in the amount of blood flowing to skeletal muscles, and in terms of how fast the muscles regained their normal oxygen levels after the blood was temporarily cut off to them.

Stimulating drug may show promise in CFIDS
The commonly prescribed drug dexamphetamine could be an effective treatment to improve the symptoms and quality of life in people with CFIDS (PWCs), according to a small pilot study from Australia.

Researchers conducted a small study of 20 PWCs, 10 of whom received treatment with the drug and 10 of whom received a fake drug called a placebo. After four weeks of treatment, the patients were asked to complete several evaluation tests to measure their progress.

The group that received dexamphetamine scored significantly better on a test called the Fatigue Severity Scale, which is commonly used to track changes in

PWC fatigue symptoms. The researchers report that nine of the 10 treated patients showed improvements on the scale, while only four of the 10 placebo patients improved.

The results, while promising, are considered preliminary. The authors say, however, that their study should justify a larger trial to better determine the effects of dexamphetamine. The drug, which is also known as the trademark name of Dexedrine, is often used to treat people with attention deficit and hyperactivity disorder (ADHD) as well as narcolepsy.

This study appeared in the January/February issue of the journal Psychosomatics.

Antioxidant supplements may help CFIDS symptoms
A new study from Italy suggests that supplements of antioxidants might help relieve some of the muscle-related symptoms of CFIDS.

The study looked at whether lower levels of antioxidants (specifically vitamin E) in the body — and higher levels of so-called “free radicals” and other markers — were linked to muscle fatigue and pain in people with CFIDS. Such altered levels lead to a phenomenon called oxidative stress, which has been implicated in a number of disease states, ranging from high blood pressure to Alzheimer’s disease.

The researchers looked at 21 patients with CFIDS and 20 control subjects. All participants were given blood tests to determine vitamin E levels and other related measures. Results showed that the CFIDS group as a whole had lower vitamin E concentrations in their blood plasma and low-density lipoproteins (LDL cholesterol). The CFIDS group also had lower pain thresholds in all muscle sites tested. The levels of vitamin E concentration were linked to the levels of muscle pain — the lower the vitamin E levels, the higher the pain levels.

Why people with CFIDS tended to have lower antioxidant levels remains unknown. The study authors suggest that the muscles themselves may be acting in ways that demand more vitamin E, thereby lowering the amount circulating in the bloodstream.

The study authors did not attempt to increase antioxidant levels through supplementation, so there’s no direct evidence that taking antioxidant vitamin pills will help relieve the muscle symptoms. But the authors said they believe their work provides a “first step” towards testing that theory. For now, patients with CFIDS are advised to seek their doctor’s opinion before taking antioxidant supplements.

The study appeared in the January 2003 issue of Neuroscience Letters. 

CFIDS patient registry in works
The U.S. Centers for Disease Control and Prevention (CDC) is taking steps to build the first-ever national registry of CFIDS patients. The registry, called for by Congress, will track CFIDS patients’ illness over time. Researchers will be able to use the registry to identify potential participants for CFS research studies. Records will be stored in a central data base that can only be accessed by qualified CFS researchers. Eventually, the registry might also allow patients to donate organs to CFIDS research, if they wish.

The CDC has launched a review of patient registries for various chronic medical conditions to determine the best format for the new CFIDS registry. The comparison registries are selected for their potential relevance to a CFIDS registry, including similar issues regarding recruitment mechanisms, inclusion criteria, data and specimen collection, cost, management and purpose.

CDC has contracted with former CFIDS Association staffer Vicki Walker to conduct this research and develop a plan for a successful CFS registry. Walker stated, “I am excited to be playing a central role in developing the CFS registry. I believe a CFS registry is a crucial step toward understanding the illness. Patient registries have provided important answers for a multitude of medical conditions and I am optimistic that CDC’s registry will do the same for CFS.”

AACFS conference held
The American Association for Chronic Fatigue Syndrome (AACFS) held its 6th International Conference on CFIDS and related syndromes in February near Washington, D.C. The four-day conference attracted dozens of the top researchers in the field for discussion on clinical treatment of CFIDS and presentations about new research.

For highlights of the proceedings, be sure to check the accompanying spring issue of The CFS Research Review.

CFIDS Glossary: Terms you need to know

Antioxidants: By definition, any agent that inhibits the oxidation of other compounds. In humans, certain vitamins (notably A, C and E) and other substances block the work of “free radicals” that oxidate and damage cell membranes. Such damage may be linked to heart disease, cancer and other conditions.

Control subjects: Participants in research studies who have not been exposed to the treatment or illness being tested. They are used to help measure the effect of a treatment or procedure on the other patients in the study.

For example: To study a new allergy drug, researchers will treat a group of patients with the medicine and give the control subjects a fake drug called a placebo. The researchers will then measure the change in allergy symptoms in both groups to see if the drug had any effect.

Typically, researchers will attempt to match control subjects to the patients in terms of age, gender, race and other relevant categories. (Controls are also commonly referred to as “healthy controls.”)

Pilot study: A small, preliminary version of a proposed research study. Pilot studies are used to help refine the methods researchers will use in the full study — and to see if the proposal shows any merit in a small sample.

Post-exertional malaise: One of the hallmark symptoms of CFIDS. Most people with CFIDS experience unusual levels of fatigue, cognitive problems and other symptoms after physical or mental activity. This “malaise” often does not begin immediately and can last for days following the activity. Such a degree of post-exertional malaise is rare in other illnesses.

If you have suggestions for terms to include in future editions of the glossary, please send them to chronicle@cfids.org, or to The CFIDS Association of America, PO Box 220398, Charlotte, NC28222-0398, Attention: Chronicle glossary.