Tag: fatigue

The feeling of fatigue–fatigue severity by unidimensional versus composite questionnaires

Abstract:

The authors’ purpose in this study was to compare the perception of fatigue severity as measured by different fatigue questionnaires. The authors evaluated 3 groups of patients in a cross-sectional study: chronic fatigue syndrome (CFS, n = 20), non-CFS fatigue (n = 20), and familial Mediterranean fever (FMF n = 25). In addition, the authors tracked 7 patients with CFS longitudinally for severity of fatigue.

The severity of fatigue-related symptoms was assessed with 2 questionnaires: the unidimensional Chalder’s Fatigue Severity Scale (CH) and the composite Fatigue Impact Scale (FI) which has 3 subscales–cognitive, physical, and social–and a total score.

In the cross-sectional study, correlations between CH and FI cognitive scores were r = .78 (p < .0001), CH versus FI physical scores r = .603 (p < .0001), CH versus FI social scores r = .66 (p < .0001), and CH versus FI total scores r = .74 (p < .0001).

In the longitudinal survey of CFS patients, the authors compared 30 questionnaires revealing correlations of CH versus FI cognitive scores r = .64 (p = .0004), CH versus FI physical r = .68 (p = .0001), CH versus FI social r = .87 (p < .0001), and CH versus FI total r = .90 (p < .0001).

Fatigue severity as assessed by the unidimensional CH scale and the composite FI scale is comparable. The simple CH scale may be adequate for the assessment of the feeling of fatigue, in general, and for monitoring the severity of fatigue in CFS, in particular.

 

Source: Naschitz JE, Rozenbaum M, Shaviv N, Fields MC, Enis S, Babich JP, Manor H, Yeshurun D, Sabo E, Rosner I. The feeling of fatigue–fatigue severity by unidimensional versus composite questionnaires. Behav Med. 2004 Winter;29(4):167-72. http://www.ncbi.nlm.nih.gov/pubmed/15369197

 

Chronic fatigue syndrome – medical fact or artifact

Abstract:

Despite extensive investigation, the enigma of Chronic Fatigue Syndrome (CFS) continues to confound medical researchers. It is suggested that this may be due to two impediments inherent in their overall approach to the problem.

Firstly, although fatigue is central to CFS, medical scientists appear not to understand what fatigue itself really is, nor what is its purpose or mode of function. A functional definition of fatigue is suggested to help resolve this.

Secondly, physicians and other researchers – psychologists and alternative medicine practitioners – fail to observe an elementary and fundamental procedure of clinical medicine, namely, that of properly examining their patients before making a diagnosis or providing treatment. The notion of the ‘black hole’ of medicine is introduced. Recognizing the existence of these impediments is considered a self-evident precondition for further significant progress being made in this field.

 

Source: Eidelman D. Chronic fatigue syndrome – medical fact or artifact. Med Hypotheses. 2003 Jun;60(6):840-2. http://www.ncbi.nlm.nih.gov/pubmed/12699708

 

Relationship between musculoskeletal symptoms and blood markers of oxidative stress in patients with chronic fatigue syndrome

Abstract:

In 21 patients with chronic fatigue syndrome (CFS) versus 20 normal subjects, we investigated the oxidant/antioxidant balance and its correlation with muscle symptoms. Patients versus controls showed significantly: lower Lag Phase and Vitamin E (Vit E) concentrations in plasma and low-density lipoproteins (LDL), higher LDL thiobarbituric acid reactive substances (TBARS), higher fatigue and lower muscle pain thresholds to electrical stimulation.

A significant direct linear correlation was found between fatigue and TBARS, thresholds and Lag Phase, thresholds and Vit E in plasma and LDL. A significant inverse linear correlation was found between fatigue and Lag Phase, fatigue and Vit E, thresholds and TBARS. Increased oxidative stress and decreased antioxidant defenses are related to the extent of symptomatology in CFS, suggesting that antioxidant supplementation might relieve muscle symptoms in the syndrome.

 

Source: Vecchiet J, Cipollone F, Falasca K, Mezzetti A, Pizzigallo E, Bucciarelli T, De Laurentis S, Affaitati G, De Cesare D, Giamberardino MA. Relationship between musculoskeletal symptoms and blood markers of oxidative stress in patients with chronic fatigue syndrome. Neurosci Lett. 2003 Jan 2;335(3):151-4. http://www.ncbi.nlm.nih.gov/pubmed/12531455

 

Relationship between chronic fatigue and subjective symptoms of fatigue with performance status (P.S.) and subjective fatigue scale for young adults (SFS-Y)

Abstract:

OBJECTIVE: Today, fatigue complaints in adolescence are regarded as an issue for young adults as they may progress to the chronic fatigue syndrome. The purpose of this study was to examine the relationships between chronic fatigue based on self-reported performance states (P.S.) and subjective symptoms of fatigue assessed with a fatigue scale for young adults (SFS-Y).

METHOD: The SFS-Y consisted of 24 item questions represonting 6 sub-scales, for difficulty in concentrated thinking, languor, reduced activation, reduced motivation, drowsiness and feeling of physical disintegration. The SFS-Y and for assessing fatigue symptoms and P.S. for chronic fatigue were administered to 548 male and female students aged 15-18 yr and to 608 male students aged 16-18 yr, respectively. Discriminant analysis and a logistic analysis model were employed to define the relevance of subjective symptoms of fatigue to chronic fatigue.

RESULTS: It was determined that the SFS-Y can discliminate P.S. with high probability (74.0-81.4%), with accuracy beyond a fixed level. In particular, the correlation with “difficulty in concentrated thinking” was high.

CONCLUSION: It was judged that the SFS-Y is effective as an index for discrimination of chronic fatigue in young adults with a particularly high relationship between “difficulty in centrated thinking” and chronic fatigue.

 

Source: Kobayashi H, Demura S. Relationship between chronic fatigue and subjective symptoms of fatigue with performance status (P.S.) and subjective fatigue scale for young adults (SFS-Y). Nihon Koshu Eisei Zasshi. 2002 Oct;49(10):1062-9. [Article in Japanese] http://www.ncbi.nlm.nih.gov/pubmed/12462040

 

Fatigue in chronic migraine patients

Abstract:

Fatigue is a common symptom frequently reported in many disorders including headaches, but little is known about its nature. The objective was to determine the prevalence of fatigue in chronic migraine (CM) patients, to define its subtypes and its relationship with other conditions comorbid with CM. Sixty-three CM patients were analysed. The Fatigue Severity Scale (FSS), the Chalder fatigue scale and the CDC diagnostic criteria for chronic fatigue syndrome (CFS) were used. Fifty-three (84.1%) patients had FSS scores greater than 27. Forty-two (66.7%) patients met the CDC criteria for CFS. Thirty-two patients (50.8%) met the modified CDC criteria (without headache). Beck depression scores correlated with FSS, mental and physical fatigue scores. Trait anxiety scores also correlated with fatigue scales. Women had higher FSS scores than men, P < 0.05. Physical fatigue was associated with fibromyalgia, P < 0.05. Fatigue as a symptom and CFS as a disorder are both common in CM patients. Therapeutic interventions include a graded aerobic exercise program, cognitive behavioural therapy and antidepressants. Identification of fatigue and its subtypes in headache disorders and recognition of headaches in CFS patients has implications for the pathophysiology, diagnosis and treatment of these disorders.

 

Source: Peres MF, Zukerman E, Young WB, Silberstein SD. Fatigue in chronic migraine patients. Cephalalgia. 2002 Nov;22(9):720-4. http://www.ncbi.nlm.nih.gov/pubmed/12421157

 

Brain regions involved in fatigue sensation: reduced acetylcarnitine uptake into the brain

Abstract:

Fatigue is an indispensable sense for ordering rest. However, the neuronal and molecular mechanisms of fatigue remain unclear. Chronic fatigue syndrome (CFS) with long-lasting fatigue sensation seems to be a good model for studying these mechanisms underlying fatigue sensation.

Recently, we found that most patients with CFS showed a low level of serum acetylcarnitine, which well correlated with the rating score of fatigue, and that a considerable amount of acetyl moiety of serum acetylcarnitine is taken up into the brain. Here we show by metabolite analysis of the mouse brain that an acetyl moiety taken up into the brain through acetylcarnitine is mainly utilized for the biosynthesis of glutamate.

When we studied the cerebral uptake of acetylcarnitine by using [2-(11)C]acetyl-L-carnitine in 8 patients with CFS and in 8 normal age- and sex-matched controls, a significant decrease was found in several regions of the brains of the patient group, namely, in the prefrontal (Brodmann’s area 9/46d) and temporal (BA21 and 41) cortices, anterior cingulate (BA24 and 33), and cerebellum.

These findings suggest that the levels of biosynthesis of neurotransmitters through acetylcarnitine might be reduced in some brain regions of chronic fatigue patients and that this abnormality might be one of the keys to unveiling the mechanisms of the chronic fatigue sensation.

 

Source: Kuratsune H, Yamaguti K, Lindh G, Evengård B, Hagberg G, Matsumura K, Iwase M, Onoe H, Takahashi M, Machii T, Kanakura Y, Kitani T, Långström B, Watanabe Y. Brain regions involved in fatigue sensation: reduced acetylcarnitine uptake into the brain. Neuroimage. 2002 Nov;17(3):1256-65. http://www.ncbi.nlm.nih.gov/pubmed/12414265

 

Role of fatigue in limiting physical activities in humans with neuromuscular diseases

Abstract:

New methods of examining both central and peripheral fatigue are now available. A broader understanding of the mechanisms of fatigue in healthy human subjects has begun to emerge. The mechanisms of fatigue in patients with various neuromuscular diseases are even more complex than in healthy persons. Examples of both central and peripheral fatigue in various neuromuscular diseases and other disorders are presented, including metabolic myopathy, chronic fatigue syndrome, postpolio syndrome, and amyotrophic lateral sclerosis.

 

Source: Miller RG. Role of fatigue in limiting physical activities in humans with neuromuscular diseases. Am J Phys Med Rehabil. 2002 Nov;81(11 Suppl):S99-107. http://www.ncbi.nlm.nih.gov/pubmed/12409815

 

Asthenia in adolescents

Abstract:

Fatigue is defined as a subjective sensation of tiredness or weariness that occurs at rest. The perception of fatigue among 12-15 years-old Italian adolescents in a school survey was about 70%. Generally the symptoms are reported after a viral illness or an infection. In adolescents with persistent or severe fatigue a selected screening evaluation to look for an underlying organic disorder is warranted. A practical diagnostic approach is given and a brief description of chronic fatigue syndrome is reported according to CDC revised diagnostic criteria published in 1997.

 

Source: De Sanctis V, Mangiagli A, Campisi S, Raiola G. Asthenia in adolescents. Minerva Pediatr. 2002 Dec;54(6):631-7. [Article in Italian] http://www.ncbi.nlm.nih.gov/pubmed/12388954

 

Chronic fatigue and chronic fatigue syndrome: a co-twin control study of functional status

Abstract:

Chronic fatigue syndrome (CFS) and the symptom of chronic fatigue may be accompanied by substantial functional disability. A volunteer sample of twins discordant for fatigue was identified from throughout the US. Fatigued twins were classified using three increasingly stringent definitions: (1) > or = 6 months of fatigue (119 pairs); (2) CFS-like illness based on self-report of the Centers for Disease Control and Prevention CFS research definition criteria (74 pairs); and (3) CFS assessed by clinical examination (22 pairs). Twins with chronic fatigue were compared with their unaffected co-twins on the eight standard scales and two physical and mental component summary scales from the medical outcomes study short-form health survey (SF-36). Substantial impairment was observed for fatigued twins across all levels of fatigue, while scores in the healthy twins were similar to US population values. Mean scores among fatigued twins on the physical and mental component summary scales were below 97 and 77%, respectively, of the US population scores. Diminished functional status was found across increasingly stringent classifications of fatigue and was associated with a dramatic decrement in physical functioning. The symptom of fatigue has a pronounced impact on functional status, especially in the domain of physical functioning.

 

Source: Herrell R, Goldberg J, Hartman S, Belcourt M, Schmaling K, Buchwald D. Chronic fatigue and chronic fatigue syndrome: a co-twin control study of functional status. Qual Life Res. 2002 Aug;11(5):463-71. http://www.ncbi.nlm.nih.gov/pubmed/12113393

 

Fatigue after breast cancer and in chronic fatigue syndrome: similarities and differences

Abstract:

OBJECTIVE: Fatigue is investigated in 57 severely fatigued disease-free breast cancer patients and in 57 gender- and age-matched patients with chronic fatigue syndrome (CFS) using multidimensional and multimethod assessment. A comparison between these groups of patients is important to determine whether a cognitive behavioural intervention to reduce fatigue in CFS patients would be appropriate as well for severely fatigued disease-free breast cancer patients.

METHODS: Measurement included computerised questionnaires and a standardised neuropsychological test. Furthermore, patients filled out a daily Self-Observation List (SOL) and wore an actometer during a period of 12 days.

RESULTS: In comparison to severely fatigued disease-free breast cancer patients, CFS patients score more problematic with regard to the level of fatigue, functional impairment, physical activity, pain and self-efficacy. However, a subgroup of severely fatigued disease-free breast cancer patients reports the same amount of problems as CFS patients with regard to psychological well-being, sleep and concentration. Finally, CFS patients and severely fatigued breast cancer patients score equal on measures of social support.

CONCLUSION: There seem to be some similarities but also many differences between severely fatigued breast cancer survivors and females with CFS. Therefore, cognitive behaviour therapy (CBT) to reduce fatigue after treatment for cancer should also differ in certain aspects from cognitive behaviour therapy as it has been developed for patients with CFS.

 

Source: Servaes P, Prins J, Verhagen S, Bleijenberg G. Fatigue after breast cancer and in chronic fatigue syndrome: similarities and differences. J Psychosom Res. 2002 Jun;52(6):453-9. http://www.ncbi.nlm.nih.gov/pubmed/12069869