Orthostatic Intolerance & neurocognitive impairment overlap in ME/CFS
Prof Jason Leonard and US colleagues investigated the relationship between Orthostatic Intolerance and neurocognitive impairment in ME/CFS
Orthostatic intolerance (OI) is the development of symptoms when standing upright that are relieved when reclining (Wikipedia)
Conclusions
Neurocognitive symptoms and OI overlap in ME/CFS, and our results do not support the IOM’s inclusion of neurocognitive impairment and OI as interchangeable symptoms. Furthermore, our findings highlight the need for a uniform method of defining and measuring OI via self-report in order to accurately study OI as a symptom of ME/CFS.
Neurocognitive domains. The DSM-5 defines 6 key domains of cognitive function – Sachdev et al
Orthostatic intolerance and neurocognitive impairment in Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS), by Caroline L Gaglio, Mohammed F Islam, Joseph Cotler and Leonard A Jason in Epidemiologic Methods October 10, 2022 [doi.org/10.1515/em-2021-0033]
Research abstract
Objectives
The Institute of Medicine (IOM 2015. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness. Washington: The National Academies Press) suggested new criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), which requires an endorsement of either neurocognitive impairment or orthostatic intolerance (OI) in addition to other core symptoms.
While some research supports the inclusion of OI as a core symptom, others argue that overlap with neurocognitive impairment does not justify the either/or option. The current study assessed methods of operationalizing OI using items from the DePaul Symptom Questionnaire (DSQ-1 and -2) as a part of the IOM criteria. Evaluating the relationship between OI and neurocognitive symptoms may lead to a better understanding of diagnostic criteria for ME/CFS.
Methods
Two-hundred and forty-two participants completed the DSQ. We examined how many participants met the IOM criteria while endorsing different frequencies and severities of various OI symptoms.
Results
Neurocognitive impairment was reported by 93.4% of respondents. OI without concurrent neurocognitive symptoms only allowed for an additional 1.7–4.5% of participants to meet IOM criteria.
Conclusions
Neurocognitive symptoms and OI overlap in ME/CFS, and our results do not support the IOM’s inclusion of neurocognitive impairment and OI as interchangeable symptoms.
Furthermore, our findings highlight the need for a uniform method of defining and measuring OI via self-report in order to accurately study OI as a symptom of ME/CFS.
The full paper is behind a paywall
