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Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are serious, debilitating conditions that affect millions of people in the United States and around the world. ME/CFS can cause significant impairment and disability. Despite substantial efforts by researchers to better understand ME/CFS, there is no known cause or effective treatment. Diagnosing the disease remains a challenge, and patients often struggle with their illness for years before an identification is made. Some health care providers have been skeptical about the serious physiological - rather than psychological - nature of the illness. Once diagnosed, patients often complain of receiving hostility from their health care provider as well as being subjected to treatment strategies that exacerbate their symptoms.
Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome proposes new diagnostic clinical criteria for ME/CFS and a new term for the illness - systemic exertion intolerance disease(SEID). According to this report, the term myalgic encephalomyelitis does not accurately describe this illness, and the term chronic fatigue syndrome can result in trivialization and stigmatization for patients afflicted with this illness. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome stresses that SEID is a medical - not a psychiatric or psychological - illness. This report lists the major symptoms of SEID and recommends a diagnostic process.One of the report's most important conclusions is that a thorough history, physical examination, and targeted work-up are necessary and often sufficient for diagnosis. The new criteria will allow a large percentage of undiagnosed patients to receive an accurate diagnosis and appropriate care.
Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome will be a valuable resource to promote the prompt diagnosis of patients with this complex, multisystem, and often devastating disorder; enhance public understanding; and provide a firm foundation for future improvements in diagnosis and treatment.
eBook
Immediate crossover fatigue after unilateral submaximal eccentric contractions of the knee flexors involves peripheral alterations and increased global perceived fatigue
After a unilateral muscle exercise, the performance of the non-exercised contralateral limb muscle can be also impaired. This crossover fatigue phenomenon is still debated in the literature and very few studies have investigated the influence of eccentric contractions. This study was designed to assess neuromuscular adaptations involved in the crossover fatigue of the non-exercised contralateral knee flexor muscles. Seventeen healthy young men performed a unilateral submaximal eccentric exercise of the right knee flexors until a 20% reduction in maximal voluntary isometric contraction torque was attained in the exercised limb. Before (PRE), immediately after exercise cessation (POST) and 24 hours later (POST24), neuromuscular function and perceived muscle soreness were measured in both the exercised limb and non-exercised limb. In addition, global perceived fatigue was assessed at each measurement time. At POST, significant reductions in maximal voluntary isometric contraction were observed in the exercised limb (-28.1%, p < 0.001) and in the non-exercised limb (-8.5%, p < 0.05), evidencing crossover fatigue. At POST, voluntary activation decreased in the exercised limb only (-6.0%, p < 0.001), while electrically evoked potentiated doublet torque was impaired in both the exercised limb and the non-exercised limb (-11.6%, p = 0.001). In addition, global perceived fatigue significantly increased at POST (p < 0.001). At POST24, all measured variables returned to PRE values, except for perceived muscle soreness scores exhibiting greater values than PRE (p < 0.05). A possible cumulative interaction between peripheral alterations and global perceived fatigue may account for the immediate crossover fatigue observed in the non-exercised limb.
Journal Article
0606 Fatigue or excessive daytime sleepiness, which is more related with depression?
Introduction Fatigue and excessive daytime sleepiness (EDS) were often regarded as having almost similar meaning in routine daily life. However, these two terms are strictly distinct concepts. The effect on depression between EDS and fatigue, which coexist depending on the situation or exist individually. We aimed to investigate both fatigue and EDS were classified in detail to determine which is more related to depression in the general population. Methods A total of 2,493 participants (female: 1,257) (47.90 ± 0.33 years old) were investigated nationwide, across 15 South Korean districts using face-to-face interviews survey. Fatigue, EDS, and depression were evaluated using the Fatigue Severity Scale (FSS), Epworth sleepiness scale (ESS), and Patient Health Questionnaire-9 (PHQ-9), respectively. The covariates such as sleep habits and socio-behavioral factors were included. Results The prevalence of depression (PHQ-9 ≥ 10) was 8.42% (n = 210). Fatigue (FSS ≥ 36) was 30.8% (n = 767). EDS (ESS ≥ 11) was 15.3% (n = 382). The prevalence of depression was following four categories; EDS with fatigue (E+F+) (n = 67, 31.9% vs. 7.3%) (P < 0.001), fatigue without EDS (E-F+) (n = 71, 33.8% vs. 20.3%) (P < 0.001), EDS without fatigue (E+F-) (n= 16, 7.6% vs. 5.8%) (P = 0.294), and absence of fatigue and EDS (E-F-) (n = 56, 26.7% vs. 66.6%) (P < 0.001). After adjusting for covariates, the presence of depression (E-F-, reference) was associated with E+F+ (OR 8.804, 95% CI 5.818-13.321), E-F+ (OR 3.942, 95% CI 2.704-5.747), and E+F- (OR 2.812, 95% CI 1.542-5.131). We additionally performed logistic regression according to two categories. There was no significant difference of prevalence of depression between E+F- (reference) and E-F+ (OR 1.399, 95% CI 0.760-2.575). Conclusion Although fatigue and EDS were associated with depression regardless of the presence of each other. But we did not find out which is more related with depression. Support (if any)
Journal Article
The Perrin technique : how to beat chronic fatigue syndrome/ME
After many years of careful study coupled with practical hands-on experience, Perrin has arrived at the firm conclusion that M.E. is a structural disorder with definite diagnosable physical signs. This technique gives you the chance to take charge of your own structural health and rid yourself of years of toxin build-up.
Book
095 Steering Wheel Angle Excursions as a Measure of Fatigue-Related Driver Performance Impairment
Introduction Fatigue from sleep loss and circadian misalignment causes automobile driving performance impairment. Metrics based on steering wheel angle, which is straightforward to measure, could be used to quantify this impairment. As the tail of the distribution of steering wheel angles (absolute magnitude of deviation from center) increases with fatigue, we investigated whether driving performance impairment could be quantified based on the prevalence of steering wheel excursions beyond a given angle threshold. We used data from two published laboratory studies of simulated shift work, in which fatigue remained low during day shifts but increased across time awake during night shifts. Methods N=37 healthy adults (ages 26.8±5.2y; 25 men) were assigned to a simulated night shift schedule (awake 20:00-10:00) or day shift schedule (awake 08:00-22:00; study 1 only). After an adaptation period, participants underwent two 5-day shift cycles with an intervening rest period. Driving performance was measured on a high-fidelity simulator during adaptation (data not used) and four times at 3h intervals during each shift day. Every drive involved 30min driving at 55mph, including ten 0.5mi uneventful straightaways being considered here. Steering wheel angle was measured at 72Hz (study 1) or 60Hz (study 2). A total of 1,471 drives (31,394,498 angle measurements) were available for analysis. Results We investigated angle thresholds across 0.01-0.25rad in 0.01rad intervals and counted the corresponding number of threshold excursions in each drive for each participant. For study 1, we applied mixed-effects ANOVA with fixed effects for condition and time awake, and their interaction, and determined the local effect size for interaction. A 0.03rad (1.7°) threshold yielded the greatest effect size, f²=0.031 (small). For this threshold, we repeated the analysis using the data from both studies, controlling for study. The interaction was significant (F[3,1428]=13.23, p<0.001), showing low driving impairment across time awake during day shifts but increasing impairment across time awake during night shifts. Conclusion The prevalence of steering wheel excursions beyond a 1.7° angle threshold yielded sensitivity to fatigue-related driving performance impairment during simulated night shifts. Further research will extend our results to driving through curves and with greater fatigue levels. Support (if any) FMCSA DTMC75-07-D-00006
Journal Article