Considerations for the treatment of chronic fatigue syndrome

Abstract:

The etiology of chronic fatigue syndrome(CFS) is still unknown and under active discussion, but involvement of psychosocial factors appear to be essential for the onset and clinical course of CFS. As CFS patients complain of many stress-related physical and psychological symptom, it is important to understand the CFS from psychosomatic point of view. Not only for the pharmaceutical treatment, attentive consideration is required for treatment of exhaustion of body and mind of CFS patients. Use of anti-depressants or oriental herb medicine is often effective to relieve the anxiety and depressive condition. Furthermore to augment the self-healing potential, psychosomatic approach is important to modify the life style and behavioral characteristics.

 

Source: Murakami M. Considerations for the treatment of chronic fatigue syndrome. Nihon Rinsho. 2007 Jun;65(6):1089-92. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561702

 

Overview of psychiatric therapy for chronic fatigue syndrome

Abstract:

Chronic fatigue syndrome (CFS) is recognized as a special condition based on abnormality of psycho-neuro-endocrine-immunological system, which is caused by several cytokines and autoantibodies. For CFS diagnosis, it is required to exclude psychiatric diseases which could cause chronic fatigue. On the other hand, recent studies proved the effectiveness cognitive behavioral therapy(CBT) for CFS. Distorted cognition relevant to CFS includes the characteristics such as over adaptation, perfectionism, avoidance and so on. In the CBT for CFS, it is important to quit seeking physical causes, to accept the pathological state as it is, to monitor daily activity and recognize the cognitive and behavioral patterns which might prolong fatigue, to maintain a constant activity level and to make planned increases in activity.

 

Source: Yamadera W, Itoh H. Overview of psychiatric therapy for chronic fatigue syndrome. Nihon Rinsho. 2007 Jun;65(6):1082-6. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561701

 

Overview of medical treatment and management of chronic fatigue syndrome

Abstract:

A tailor-made management plan that includes various combinations of non-pharmacologic and pharmacologic therapy for patients withchronic fatigue syndrome (CFS) is important. We present an overview of four aspects of our medical treatment and management for CFS: introduction of our medical management system, summary of our management strategy, non-pharmacologic therapy, and pharmacologic therapy; according to foreign guidelines and the latest studies. The main non-pharmacologic therapies for CFS are rehabilitation and lifestyle guidance. Using a graded exercise therapy, we have constructed a broad management strategy for CFS. Herein we introduce our graded exercise therapy. If the symptoms continue despite careful management of the program by the physician, consultation with a psychiatrist or psychosomatic medicine specialist is necessary.

 

Source: Yoshihara K, Kubo C. Overview of medical treatment and management of chronic fatigue syndrome. Nihon Rinsho. 2007 Jun;65(6):1077-81. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561700

 

Chronic fatigue syndrome: biochemical examination of blood

Abstract:

Though patients with chronic fatigue syndrome (CFS) have lots of complaints, abnormal findings cannot be detected by biochemical screening tests. However, some specialized blood tests have revealed neuroendocrine immune axis abnormalities, which is closely associated with each other. Recent studies indicate that CFS can be understood as a special condition based on abnormality of the psycho-neuro-endocrino-immunological system, with the distinguishing feature of CFS seeming to be the secondary brain dysfunction caused by several cytokines and/or autoantibodies. In this paper, we summarize these abnormalities found in CFS and show the neuro-molecular mechanism leading to chronic fatigue.

 

Source: Hakariya Y, Kuratsune H. Chronic fatigue syndrome: biochemical examination of blood. Nihon Rinsho. 2007 Jun;65(6):1071-6. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561699

 

Antinuclear antibodies in patients with chronic fatigue syndrome

Abstract:

Significance of antinuclear antibodies (ANA) in the patients with chronic fatigue syndrome (CFS) was reviewed. When indirect immunofluorescence with the HEp-2 cells as the substrates was used, prevalence of the positive ANA was reportedly 15-25%. The ANA titers were low and the immunofluorescent staining patterns were heterogeneous.

One group in the USA reported that ‘nuclear envelope staining pattern’ was found in more than 50% of the patients with CFS. This results, however, have not been confirmed by any other research groups. Clinical significance of the positive ANA in the CFS patients resides in differential diagnoses of systemic lupus erythematosus and other diffuse connective tissue diseases. Recently, several ANAs specific to CFS have been described.

We reported anti-68/48kD protein antibodies utilizing SDS-PAGE/ immunoblot method. These autoantibodies were found in 13% of 114 CFS patients and 0% in healthy subjects (p < 0.05). Hypersomnia and difficulty in concentration were found more frequently in the CFS patients with this specific autoantibody.

 

Source: Nishikai M. Antinuclear antibodies in patients with chronic fatigue syndrome. Nihon Rinsho. 2007 Jun;65(6):1067-70. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561698

 

Estimation of fatigue state in patient with CFS using actigraph and R-R interval power spectrum analysis]

Abstract:

OBJECTIVES: In this study, we try to estimate the fatigue state using actigraphy and R-R interval power spectrum analysis.

RESULTS: Actigraphy analysis showed that mean awake activity was decreased and duration of sleep was prolonged in patients with chronic fatigue syndrome (CFS), significantly (p < 0.001). Both of sleep episodes in wake period and wake episodes in sleep period were significantly increased in CFS patients in comparison with healthy volunteers (p < 0.001) In autonomic nerve analysis, sleep/awake ratio of high frequency component was significantly decreased in patients with CFS (p < 0.05).

CONCLUSION: The quality of sleep in patients with CFS was decreased because of increase of wake episodes in sleep period. Also the lack of parasympathetic activation during sleep period might be associated with the deterioration of sleep quality in patients with CFS.

 

Source: Tajima S, Kuratsune H, Yamaguti K, Takahashi A, Takashima S, Watanabe Y, Nishizawa Y. Estimation of fatigue state in patient with CFS using actigraph and R-R interval power spectrum analysis. Nihon Rinsho. 2007 Jun;65(6):1057-64. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561697

 

Spectroscopic diagnosis of chronic fatigue syndrome by multivariate analysis of visible and near-infrared spectra

Abstract:

We have recently evaluated the possibility of visible and near-infrared (Vis-NIR) spectroscopy for diagnosis of chronic fatigue syndrome(CFS). Vis-NIR spectra in the 600-1,100 nm region for sera from CFS patients and healthy donors were subjected to principal component analysis (PCA) and soft independent modeling of class analogy (SIMCA) to develop multivariate models to discriminate between CFS patients and healthy donors. The PCA and SIMCA model predicted successful prediction of the masked samples. Furthermore, taking advantage of Vis-NIR spectroscopy to enable noninvasive analysis, our preliminary results have shown that SIMCA model from Vis-NIR spectra of thumb has achieved 70-80% correct determinations. In this review, we will introduce the potential of the Vis-NIR spectroscopy for CFS diagnosis.

 

Source: Sakudo A, Kuratsune H, Hakariya Y, Kobayashi T, Ikuta K. Spectroscopic diagnosis of chronic fatigue syndrome by multivariate analysis of visible and near-infrared spectra. Nihon Rinsho. 2007 Jun;65(6):1051-6. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561696

 

Chronic fatigue syndrome and herpesvirus reactivation

Abstract:

Human herpesvirus 6(HHV-6) and human herpesvirus 7(HHV-7) establish life-long latency, reactivate frequently, and are shed in saliva. To identify the factor(s) of their reactivation, we have studied the association with the reactivation and fatigue. Reactivation was examined for viral DNA by real-time PCR method. As a result, healthy adults shed the reactivated HHV-6 in the saliva during work -induced fatigue, and the copy number of HHV-6 DNA was reduced after holidays. However, no significant HHV-6 DNA increase was observed in chronic fatigue syndrome (CFS) patients. In contrast, increase of HHV-7 reactivation was observed both in the case of work-induced fatigue and CFS. These findings suggest that the amount of HHV-6 and HHV-7 reactivation can be an objective biomarker for fatigue.

 

Source: Kondo K. Chronic fatigue syndrome and herpesvirus reactivation. Nihon Rinsho. 2007 Jun;65(6):1043-8. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561695

 

Evaluation of fatigue by using acceleration plethysmography

Abstract:

We evaluated the fatigue of patients with chronic fatigue syndrome by using acceleration plethysmography. The changes in the acceleration plethysmography were relatively dominant in the sympathetic nervous system from the viewpoint of the autonomic nervous system, and the fluctuation in the time-series data of the acceleration plethysmography was decreased from the viewpoint of chaos or complexity system. We found the relation between the level of fatigue and the changes in acceleration plethysmography. Therefore, the acceleration plethysmography might be useful for the evaluation of fatigue.

 

Source: Yamaguti K. Evaluation of fatigue by using acceleration plethysmography. Nihon Rinsho. 2007 Jun;65(6):1034-42. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561694

 

Identification and application of marker genes for differential diagnosis of chronic fatigue syndrome

Abstract:

Chronic fatigue syndrome (CFS) is a complex disease and has no laboratory biomarkers, which makes diagnosis of CFS difficult. Several research groups challenged to identify genes specific for CFS; however, there are no overlaps between studies. The U.S. Centers for Disease Control and Prevention reported remarkable gene expression profiles of a large scale cohort study recruited 227 people. Reported genes were mostly different from the previously reported genes, again featuring the complexity of CFS. Separately, we identified 9 genes that were significantly and differentially expressed between CFS patients and healthy subjects using an original microarray. The changes in expression of 9 genes were confirmed by quantitative PCR. We also demonstrated the usefulness of 9 genes for differential diagnosis of CFS.

 

Source: Kawai T, Rokutan K. Identification and application of marker genes for differential diagnosis of chronic fatigue syndrome. Nihon Rinsho. 2007 Jun;65(6):1029-33. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561693