Female patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome or Idiopathic Chronic Fatigue: comparison of responses to a Two-Day Cardiopulmonary Exercise Testing protocol, by C Linda M C van Campen, Frans C Visser in Healthcare (Basel) 2021 Jun 5;9(6):682 [doi: 10.3390/healthcare9060682] This article belongs to the Special Issue Sport and Exercise Medicine
Research abstract
Introduction:
Multiple studies have shown that peak oxygen consumption is reduced in the majority of ME/CFS patients, using the golden standard for measuring exercise intolerance: cardiopulmonary exercise testing (CPET). A 2-day CPET protocol has shown different results on day 2 in ME/CFS patients compared to sedentary controls. No comparison is known between ME/CFS and idiopathic chronic fatigue (ICF) for 2-day CPET protocols. We compared ME/CFS patients with patients with chronic fatigue who did not fulfil the ME/CFS criteria in a female population and hypothesized a different pattern of response would be present during the 2nd day CPET.
Methods:
Fifty-one female patients with ICF completed a 2-day CPET protocol and were compared to an age/sex-matched group of 50 female ME/CFS patients. Measures of oxygen consumption (VO2), heart rate (HR), systolic and diastolic blood pressure, workload (Work), and respiratory exchange ratio (RER) were collected at maximal (peak) and ventilatory threshold (VT) intensities.
Results:
Baseline characteristics for both groups were similar for age, BMI, BSA, and disease duration. A significance difference was present in the number of patients with fibromyalgia (seven ME/CFS patients vs zero ICF patients). Heart rate at rest and the RER did not differ significantly between CPET 1 and CPET 2. All other CPET parameters at the ventilatory threshold and maximum exercise differed significantly (p-value between 0.002 and <0.0001). ME/CFS patients showed a deterioration of performance on CPET2 as reflected by VO2 and workload at peak exercise and ventilatory threshold, whereas ICF patients showed improved performance on CPET2 with no significant change in peak workload.
Conclusion: This study confirms that female ME/CFS patients have a reduction in exercise capacity in response to a second day CPET. These results are similar to published results in female ME/CFS populations.
Patients diagnosed with ICF show a different response on day 2, more similar to sedentary and healthy controls, [suggesting that despite fatigue complaints of similar severity, a different disease is present and ICF might be trainable, whereas ME/CFS is not. – comment from full paper]
Currently, no biomarkers or established diagnostic tests for ME/CFS exist. In Germany, it is estimated that over 300,000 people are affected by ME/CFS. Research from the United States and the UK shows that patients with ME/CFS are medically underserved, as they face barriers to medical care access and are dissatisfied with medical care.
Multiple studies have shown that peak oxygen consumption is reduced in the majority of myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS) patients, using the gold standard for measuring exercise intolerance: cardiopulmonary exercise testing (CPET). A 
12 out of 382 retrieved references were included. Seven studies were randomized controlled trials (RCTs) with one including three reports (1 RCT, 2 single-arms); others were single-arm trials. Interventions included mindfulness-based stress reduction, mindfulness-based cognitive therapy, relaxation, Qigong, cognitive-behavioral stress management, acceptance and commitment therapy and isometric yoga.
Exact low-resolution electromagnetic tomography (
significant differences occurred immediately post-test, which were most pronounced after 24 hours, particularly in the low alpha (8-10 Hz) and low beta (13-18 Hz) frequency sub-bands. Together, the present findings offer support for EEG source localization techniques to investigate PEM. If confirmed, this study could provide a useful instrument for functional diagnosis and evaluation of treatment outcomes.
Recently launched is the global professional association for medical practitioners, scientists and researchers with myalgic encephalomyelitis.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause chronic and acute disease. Postacute sequelae of SARS-CoV-2 infection (PASC) include injury to the lungs, heart, kidneys, and brain that may produce a variety of symptoms. PASC also includes a post–coronavirus disease 2019 (COVID-19) syndrome (‘long COVID’) with features that can follow other acute infectious diseases and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
I am the volunteer in charge of the newly created WAMES Instagram account. I joined WAMES as a volunteer because I liked the idea of being able to help others that are in my situation, especially young people like me. Running the Instagram account allows me post about things I wish I would have been able to see when I had ME!
After 2 years of suffering with ME, I made a full recovery and 5 years on from my diagnosis, my life is back to normal (if it was ever normal to begin with!) I am on my way to university to study Biomedical Science and I have started swimming again.
This paper aims to demonstrate the additional benefit of ultrasound in the diagnosis of chronic osteolysis and osteonecrosis (bone marrow defects) of the jaw shown in a clinical case report.
