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The label 'chronic fatigue syndrome' (CFS) has persisted for many years because of the lack of knowledge of the aetiological agents and the disease process. In view of more recent research and clinical experience that strongly point to widespread inflammation and multisystemic neuropathology, it is more appropriate and correct to use the term 'myal...
Citations
... On the day of the investigation, participants were asked to self-report on four different questionnaires targeting fatigue. Fulfillment of the Canadian Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a questionnaire facilitating the diagnostics of ME/CFS according to the international consensus criteria [22]. The Chalder fatigue scale, an 11-item questionnaire assessing physical and psychological fatigue with high reliability in ME/CFS studies and occupational research, a high score expresses high fatigue [23]. ...
Background/Objectives: A relevant subgroup of post-COVID-19 syndrome (PCS) patients suffers from post-exertional malaise (PEM) and cardiovascular or neurological symptoms, impairing daily functioning up to becoming even house-or bedbound. Recent data suggest that PCS summarizes different subgroups, one of them being characterized by an impaired microcirculation. Thus, the aim of the present study was to investigate local deoxygenation, measured with non-invasive near-infrared regional spectroscopy (NIRS), and its association with self-reported fatigue in patients with PCS compared to controls in light exercise. Methods: 150 participants (100 PCS patients and 50 controls) were recruited. PEM was assessed using FACIT, Chalder, and Bell scoring and Canadian Criteria. NIRS was used to measure local oxygenation while kneading a stress ball and during recovery. Results: PCS patients showed fatigue scores of 30 (Bell score), 20.6 (FACIT fatigue score), and 9.914 (Chalder fatigue score). Decreased deoxygenation peaks at the start of exercise were observed in patients with PCS, compared to controls (p = 0.0002). Multivariate analysis identified a subgroup, showing an association between strong fatigue and restricted oxygenation dynamics. Conclusions: NIRS could be a potential tool to assess deoxygenation deficits even in moderate to severely impaired PCS patients using light exercise protocols. Citation: Ladek, A.-M.; Lucio, M.; Weiß, A.; Knauer, T.; Sarmiento, H.; Ilgner, M.; Jakobi, M.; Barteczko, L.; Ganslmayer, M.; Rech, J.; et al. Deoxygenation Trends and Their Multivariate Association with Self-Reported Fatigue in Post-COVID Syndrome.
... Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic illness with key symptoms including (but not limited to) unrefreshing sleep, post-exertional malaise, and cognitive impairment [1][2][3]. Sleep difficulties are some of the most common symptoms experienced by patients with ME/CFS [4,5]. There are different subtypes of sleep disorders for those with ME/CFS [3,4,6], and suboptimal sleep quality is related to more frequent and severe ME/CFS symptoms [7]. ...
Background/Objectives: Impaired sleep is one of the core symptoms of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), yet the mechanisms and impact of sleep-related issues are poorly understood. Sleep dysfunctions for patients with ME/CFS include frequent napping, difficulties falling asleep, waking up early, and sleep reversal patterns (e.g., sleeping throughout the day and staying awake throughout the night). The current study focuses on sleep reversal for patients with ME/CFS. Methods: We explored the symptoms and functional impairment of those with and without sleep reversal by analyzing the responses of a large international sample (N = 2313) using the DePaul Symptom Questionnaire (DSQ) and Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). Results: We found that those in our Sleep Reversal group (N = 327) compared to those without sleep reversal (N = 1986) reported higher symptom burden for 53 out of 54 DSQ symptoms and greater impairments for all six SF-36 subscales. The most accurate predictors of sleep reversal included age (p < 0.05), body mass index (p < 0.05), eleven DSQ symptoms (p < 0.01), and two SF-36 subscales (p < 0.01). Conclusions: These features provide clues regarding some of the possible pathophysiological underpinnings of sleep reversal among those with ME/CFS.
... Patients were advised, when possible, to taper off and to stop drugs influencing HR or BP one week before the date of the tilt testing. During the first visit, we determined whether participants satisfied the criteria for ME and for CFS [22,23], taking the exclusion criteria into account. No other illnesses were present that explained symptomatology. ...
... No other illnesses were present that explained symptomatology. Disease severity in patients was scored according to the international consensus criteria (ICCs), with severity scored as mild, moderate, severe, and very severe [23]. Very severe patients (bedridden patients) were not studied here because they were not able to undergo a tilt test. ...
... From our database, we selected ME/CFS patients who visited our clinic between November 2012 and June 2023, who fulfilled the criteria for both ME and CFS [22,23], and who had a tilt test because of the suspicion of orthostatic intolerance (n = 1320). In all patients, CBF measurements as well as suprasternal derived stroke volume were available. ...
Background/Objectives: Orthostatic intolerance is prevalent in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and is caused by an abnormal reduction in cerebral blood flow (CBF). In healthy controls (HCs), CBF is regulated complexly, and cardiac output (CO) is an important determinant of CBF. A review in HC showed that a 30% reduction in CO results in a 10% reduction in CBF. In contrast, we showed in ME/CFS patients with a normal HR (HR) and blood pressure response during a tilt test that CO and CBF decreased to a similar extent. The relation between CO and CBF in ME/CFS patients with postural orthostatic tachycardia syndrome (POTS) is unknown. Therefore, the aim of this study is to assess the relation between CBF and CO, in ME/CFS patients with POTS. The methods used in this retrospective study analyze this relation in a large group of patients. We also analyzed the influence of clinical data. A total of 260 ME/CFS patients with POTS underwent tilt testing with measurements of HR, BP, CBF, CO, and end-tidal PCO2. We measured CBF using extracranial Doppler flow velocity and vessel diameters obtained with a General Electric echo system, and suprasternal aortic flow velocities were measured using the same device. We recorded end-tidal PCO2 using a Nonin Lifesense device. Results: End-tilt HR and the HR increase were significantly higher in the patients with a %CO reduction ≥ −15% than in the other group. End-tilt CO was higher and the %CO reduction was lower in patients with %CO reduction ≥ −15% than in the other group. CBF data (supine, end-tilt and the %CBF reduction) were not different between the two patient groups. The use of HR increases and %SV reductions were not as discriminative as the %CO reduction. Conclusions: In ME/CFS patients with POTS during tilt testing with measurements of both the CO and the CBF, two different patterns were observed: (1) appr. two-thirds of patients had an almost 1:1 relation between the %CBF reduction and the %CO reduction. (2) Appr. one-third of patients showed a limited reduction in CO together with a substantial increase in HR. In these patients, there was no relation between the CO and CBF reduction. These data suggest the presence of a hyperadrenergic response.
... The Department of Veterans Affairs uses the term CMI not only to describe chronic unexplained heterogeneous symptoms in veterans of the 1991 Gulf War but also to designate a group of disorders with overlapping symptoms, including fatigue, mood and cognition disorders, and musculoskeletal pain. Under this umbrella, disorders such as ME/CFS and GWI have defined case definitions for research purposes [1,3,24,[30][31][32], while others are diagnosed primarily by exclusion. Despite considerable research, the causes of CMI modalities remain unclear, and effective treatment options are currently unavailable. ...
Chronic multi‐symptom illness (CMI) is a broad term utilized by the Department of Veterans Affairs to refer to complex conditions of unknown etiology where individuals experience symptoms that lack a clear medical diagnosis. In this study, we sought to determine if herpesvirus reactivation and the antiviral response could be involved in CMI. Longitudinal serology studies conducted in two military veteran cohorts diagnosed with CMI or Gulf War Illness (GWI) revealed an increased prevalence of IgG (55% and 83%, respectively) and IgM antibodies (80%–90% and 100%, respectively) to the deoxyuridine triphosphate nucleotidohydrolase (dUTPase) protein of multiple herpesviruses compared to age/gender‐matched healthy controls (5% and 7% for IgG and IgM respectively, p < 0.001) by ELISA. Despite the ongoing viral reactivation in CMI veterans, IFN‐γ levels surprisingly stayed mostly unchanged from healthy control levels, while in GWI were significantly upregulated. Interestingly, MCP‐1/CCL‐2 levels were significantly increased in some CMI veterans compared to GWI and healthy controls ( p = 0.0009). Our data provide evidence suggesting aberrant antiviral response and immune dysfunction in CMI veterans and supports the premise that decreased serum levels of IFN‐γ together with heightened MCP‐1 and dUTPase antibodies to multiple herpesviruses may be useful to identify CMI veterans with deficient antiviral response.
... Diagnosis criteria for ME/CFS rely on clinical symptoms [2][3][4], as no validated biomarker exists, with post-exertional malaise or PEM playing a significant role, including fatigue, pain, and cognitive, intestinal, and sleep disturbances, among others, limiting a patient's daily performance in mildly affected patients and driving bed confinement in ...
... Magnetic resonance imaging (MRI) in 2016, at age 26, revealed a small demyelinating juxtacortical lesion in the left temporal pole, but other investigations were unremarkable, leading to a diagnosis of ME/CFS. The patient met the 2011 International Consensus Criteria [2], as well as Canadian [3] and IOM (Institute of Medicine) 2015 criteria [4]. Prescribed supplements, including magnesium, NADH, D-ribose, L-carnitine, ubiquinol, melatonin, vitamin B1, alpha-lipoic acid, vitamin D, and LDN (Low-Dose Naltrexone), failed to improve his symptoms. ...
This article summarizes the case of 30-year-old male diagnosed with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and its longitudinal follow-up, which provided a secondary diagnosis of Multiple Sclerosis (MS) eight years later. The most impactful result was his response to rituximab treatment after the systematic failure of prior treatments. Although the expression of endogenous retroviral proteins has been associated with autoimmunity, the patient did not show increased expression of the toxic protein HERV (human endogenous retrovirus)-W ENV, a target of the ongoing clinical trials with temelimab in MS and long COVID-19 cases. However, genome-wide HERV transcriptome analysis by high density microarrays clearly revealed a distinct profile in the patient’s blood supportive of an altered immune system. Limitations of the study include sub-optimal frequency of magnetic resonance imaging to monitor lesion progression, and similarly for reassessment of HERV profiles after rituximab. Overall, the coincidence of HERV alterations and the impactful response to rituximab presents the possibility of additional, more specific, therapeutic targets encoded by other HERV elements yet to be discovered.
... Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), classified by the WHO with the ICD-11 8E49 code as a postviral fatigue syndrome, and fibromyalgia (FM) (ICD-11 MG30.0 for chronic primary pain) (Harrison et al., 2021), are chronic, disabling, acquired diseases, characterized by complex symptomatology that affects multiple organs (Bateman et al., 2021;Wolfe et al., 2010). Diagnosis of ME/CFS and FM continues to be based on the clinical assessment of unspecific symptoms, such as debilitating fatigue, generalized pain, cognitive impairment or intestinal, sleep, and immune disturbances (Carruthers et al., 2011;Carruthers et al., 2003;Wolfe et al., 2016;Wolfe et al., 2010;Wolfe et al., 1990). Their frequent co-diagnosis drove the hypothesis of a single syndrome and promoted the search for common or differentiating factors (Abbi and Natelson, 2013;Natelson, 2019;Wessely et al., 1999). ...
... In this study, we elevated these analyses to obtain genome-wide HERV profiles (HERV expression profiles) of patients having received ME/CFS, FM diagnosis, or both, hypothesizing that HERV expression profiles may reveal distinct underlying pathomechanisms that justify their classification as separate diseases, and/or common fingerprints explaining their joint high prevalence. To test our hypothesis, we scrutinized HERV and gene transcriptomes by using high-density microarray technology in a selected cohort of female patients carefully phenotyped by a single expert clinician into three defined groups of patients: patients fulfilling Canadian and International ME/CFS diagnosis criteria (Carruthers et al., 2011;Carruthers et al., 2003), patients fulfilling FM diagnosis ACR (American College of Rheumatology) criteria (Wolfe et al., 2016;Wolfe et al., 2010;Wolfe et al., 1990), or patients complying with both, ME/CFS and FM diagnosis criteria, being called co-diagnosed from now on. The results of comparing HERV profiles within PBMCs across these three patient groups as well as to HERV profiles of matched healthy subjects allowed, not only for the separation of patients from healthy individuals but also for perfect discrimination of patients into three distinct disease groups, suggesting distinct subjacent pathomechanisms. ...
... With no biomarkers available and unclear pathophysiology, ME/CFS and FM are often misdiagnosed, further complicating the identification of effective treatments. In this study, we tried to overcome patient heterogeneity by studying a very finely phenotyped cohort diagnosed by a single expert clinician, representing one of the few studies (Nepotchatykh et al., 2023) including samples of patients diagnosed with either ME/ CFS, FM, or both (co-diagnosed group) by two different clinical criteria (Canadian (Carruthers et al., 2003) and International Consensus (Carruthers et al., 2011) criteria, and the 1990 (Wolfe et al., 1990) and 2011 (Wolfe et al., 2016;Wolfe et al., 2010) ACR criteria, respectively). Due to previously reported sex-associated differences in these diseases, only female patients were included, limiting the external validity of the results in the male population while minimizing potential sex-associated bias. ...
Research of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM), two acquired chronic illnesses affecting mainly females, has failed to ascertain their frequent co-appearance and etiology. Despite prior detection of human endogenous retrovirus (HERV) activation in these diseases, the potential biomarker value of HERV expression profiles for their diagnosis, and the relationship of HERV expression profiles with patient immune systems and symptoms had remained unexplored. By using HERV-V3 high-density microarrays (including over 350k HERV elements and more than 1500 immune-related genes) to interrogate the transcriptomes of peripheral blood mononuclear cells from female patients diagnosed with ME/CFS, FM, or both, and matched healthy controls ( n = 43), this study fills this gap of knowledge. Hierarchical clustering of HERV expression profiles strikingly allowed perfect participant assignment into four distinct groups: ME/CFS, FM, co-diagnosed, or healthy, pointing at a potent biomarker value of HERV expression profiles to differentiate between these hard-to-diagnose chronic syndromes. Differentially expressed HERV–immune–gene modules revealed unique profiles for each of the four study groups and highlighting decreased γδ T cells, and increased plasma and resting CD4 memory T cells, correlating with patient symptom severity in ME/CFS. Moreover, activation of HERV sequences coincided with enrichment of binding sequences targeted by transcription factors which recruit SETDB1 and TRIM28, two known epigenetic silencers of HERV, in ME/CFS, offering a mechanistic explanation for the findings. Unexpectedly, HERV expression profiles appeared minimally affected in co-diagnosed patients denoting a new nosological entity with low epigenetic impact, a seemingly relevant aspect for the diagnosis and treatment of this prevalent group of patients.
... The aetiology of ME/CFS is unknown, and some hypotheses suggest that certain immunological, neurological, intestinal and mitochondrial abnormalities may play a role in its emergence and permanence (Muller et al. 2020). Diagnosis is currently based on detailed clinical records, physical examinations and supplementary tests, with the clinical case definition from the International Consensus Criteria being one of the most widely used (Carruthers et al. 2011). The cardinal symptom is post-exertional neuroimmune exhaustion (PENE), characterised by a worsening of symptoms following physical and/or mental exertion, which may be minimal and which, before the onset of the disease, was well tolerated. ...
... Individuals experience a significant reduction in their previous activity levels, along with a low threshold for physical and/or mental fatigability. Furthermore, neurological, immune, gastrointestinal and genitourinary impairments, as well as disruptions in energy metabolism and transportation, are commonly observed (Carruthers et al. 2011). ME/CFS often occurs alongside other comorbid conditions, such as fibromyalgia, myofascial pain syndrome, and sicca syndrome, among others, with more than 80% of individuals affected in some cohorts (Castro-Marrero et al. 2017). ...
Aim
To describe the prevalence of psychosocial nursing diagnostic labels and their relationship with sociodemographic characteristics in adults with myalgic encephalomyelitis‐chronic fatigue syndrome (ME/CFS).
Design
This is a cross‐sectional descriptive study.
Methods
Population: Adults with ME/CFS. Inclusion criteria: Being 18 years of age or older, having a medical diagnosis of ME/CFS and being an active member of a patient association. Data collection took place between May and July 2022 using an online and paper‐based ad hoc form that included sociodemographic and clinical data. Psychosocial diagnostic labels were obtained using the Questionnaire for Psychosocial Nursing Diagnosis (QPSND). In addition to a descriptive analysis, the relationships between the diagnostic labels obtained were explored through a multiple correspondence analysis, which was supplemented by a hierarchical cluster analysis of the results of the latter.
Results
Forty‐eight participants completed the form. Their mean age was 52.5 years (SD = 6.81), 95.83% were female, 70.83% had a university education, and 35.42% were actively working. Sixty‐six percent had some degree of officially recognised disability, and 16.67% had an officially recognised degree of dependency. The most prevalent diagnostic labels were Powerlessness (79.17%), Ineffective Coping (62.5%), and Fear (62.5%). The multiple correspondence analysis and subsequent cluster analysis identified profiles of individuals with ME/CFS: one profile (cluster 3) had greater psychosocial involvement based on the diagnostic labels assigned, as well as a lower educational level and higher symptom intensity. The other two profiles appear to bring together mainly employed or retired individuals with lower severity and frequency of symptoms, and who are at risk of developing psychosocial human responses.
Conclusions
Participants have a high prevalence of psychosocial diagnostic labels, suggestive of the psychosocial distress concomitant with ME/CFS. Nursing diagnoses allow subgroups of affected individuals to be differentiated and aligned based on differences in sociodemographic and clinical characteristics.
Implications for the Profession and/or Patient Care
We believe that this is a pioneering study in the identification of psychosocial nursing diagnostic labels of individuals with ME/CFS. Having profiles of people with ME/CFS associated with psychosocial nursing diagnoses facilitates their identification in healthcare practice and makes it possible to anticipate recommended interventions.
Impact
What problem did the study address? ○This study aims to ascertain the prevalence of psychosocial nursing diagnostic labels in individuals with ME/CFS. It also aims to identify more sociodemographic and clinical characteristics associated with these psychosocial problems.
What were the main findings? ○Individuals with ME/CFS had a high prevalence of psychosocial nursing diagnostic labels. Three subgroups of participants with ME/CFS were identified based on their diagnostic labels. Characteristics such as lower educational level, higher symptom intensity, and a diagnosis of fibromyalgia and Sjögren's syndrome, in addition to ME/CFS, were associated with the subgroup that had the most adverse psychosocial diagnostic profile. The other two subgroups appear to bring together mainly employed or retired individuals with lower severity and frequency of symptoms and who are at risk of developing certain psychosocial human responses.
Where and on whom will the research have an impact? ○This study may have an impact on both nursing management and clinical practice by informing the design of care plans for patients with ME/CFS.
Reporting Method
STROBE.
Patient or Public Contribution
Contributions from individuals with ME/CFS were taken into consideration for the study design, especially regarding the sampling and data collection procedures. The results of the study were presented publicly at research conferences attended by health professionals and members of associations of people living with ME/CFS.
... persistence of chronic fatigue [3,37,38]. Fatigue, observed in half of our patients, shares several similarities with myalgic encephalomyelitis [39], a condition that follows several infections, defined by chronic fatigue that lasts at least six months and is associated with brain fog, sleep disorders, post-exertional malaise and orthostatic intolerance [40,41]. Similar to PCC, the diagnosis of myalgic encephalomyelitis is primarily clinical and requires the exclusion of differential diagnoses. ...
Background
Post COVID-19 condition (PCC) affects 10–40% of patients and is characterized by persisting symptoms at ≥ 4 weeks after SARS-CoV-2 infection. Symptoms can last 7 or even more months. How long PCC persists and any changes in its clinical phenotypes over time require further investigation. We investigated PCC trajectories and factors associated with PCC persistence.
Material and methods
We included both hospitalized COVID-19 patients and outpatients from February 2020 to June 2023, who underwent at least one follow-up visit after acute infection at San Paolo Hospital, University of Milan. Follow-up visits were conducted at the post COVID-19 clinic or via telemedicine. During each follow-up examination, patients completed a short version of the World Health Organization (WHO) Case Report Form (CRF) for ongoing symptoms, the Hospital Anxiety and Depression Scale (HADS), and a screening tool for Post-Traumatic Stress Disorder (PTSD). Statistical analyses involved Chi-square, Mann–Whitney, Kruskal–Wallis tests, and logistic regression analysis.
Results
We enrolled 853 patients (median age 62, IQR 52–73; 41% females). 551/853 (64.6%), 152/418 (36.4%) and 21/69 (30.4%) presented PCC at median follow up of 3 (IQR 2–3), 7 (IQR 6–10) and 26 (IQR 20–33) months, respectively (p < 0.001). The main clinical phenotypes were fatigue, respiratory sequelae, brain fog and chronic pain; anosmia/dysgeusia was observed mostly in the first post-acute period. Female sex, acute disease in 2020, a longer hospital stay and no COVID-19 vaccination were associated with persistence or resolution of PCC compared to never having had PCC. Anxiety, depression and PTSD were more common in PCC patients. By fitting a logistic regression analysis, acute infection in 2020 remained independently associated with persistent PCC, adjusting for age, sex, preexisting comorbidities and disease severity (AOR 0.479 for 2021 vs 2020, 95%CI 0.253–0.908, p = 0.024; AOR 0.771 for 2022 vs 2020, 95%CI 0.259–2.297, p = 0.641; AOR 0.086 for 2023 vs 2020, 95%CI 0.086–3.830, p = 0.565).
Conclusions
There was a reduction in the PCC burden 7 months following the acute phase; still, one third of patients experienced long-lasting symptoms. The main clinical presentations of PCC remain fatigue, respiratory symptoms, brain fog, and chronic pain. Having had SARS-CoV-2 infection during the first pandemic phases appears to be associated with persistent PCC.
... Despite the public health burden of this disease, effective treatment and prevention strategies are still not available. Recent research and clinical experience strongly point to widespread inflammation and multisystemic neuropathology in CFS [2]. In 2011 it was therefore accepted as more appropriate and correct to use the term myalgic encephalomyelitis (ME) for this condition [2]. ...
... Recent research and clinical experience strongly point to widespread inflammation and multisystemic neuropathology in CFS [2]. In 2011 it was therefore accepted as more appropriate and correct to use the term myalgic encephalomyelitis (ME) for this condition [2]. ...
... Orthostatic intolerance is known to be associated with daily functional capacity in patients with ME/CFS [3][4][5]8]. Most orthostatic intolerance symptoms are related to cardiovascular and cerebral blood flow reduction, and to exaggerated sympathetic nervous system activation, which are frequently associated with postural orthostatic tachycardia [2,9]. Central vestibular dysfunction-related disequilibrium was recently implicated in the pathogenesis of orthostatic intolerance [3][4][5]. ...
Background
Chronic fatigue syndrome is primarily caused by myalgic encephalomyelitis (ME)-associated dysfunction of the central nervous system. Postural instability or disequilibrium is a typical neural sign and is classified as static or kinetic.
Methods
A total of 160 ME patients (53 males and 107 females) with a mean age of 37 ± 12 years were enrolled in this study. They underwent both the Romberg test for static disequilibrium and the tandem gait test with turn and return for kinetic disequilibrium.
Results
Static disequilibrium was found in 40 (25%) patients who showed instability when standing with both feet together and eyes either open (n = 7, 4%) or closed (n = 33, 21%). Kinetic disequilibrium was found in 71 (44%) patients, with 57 (36%) being positive for the straight tandem gait test. Fourteen (9%) patients were negative for the straight tandem gait test, but showed a positive result after turning and returning. Almost all patients with static disequilibrium also had kinetic disequilibrium (39/40, 98%). Patients with static and/or kinetic disequilibrium had a significantly higher prevalence of orthostatic intolerance, diagnosed as failure to complete the 10-min standing test, compared with patients without disequilibrium. They also had a significantly higher median performance status score (0–9) for restricted activities of daily living. Both types of disequilibria were recovered in 11 (85%) of 13 patients treated with repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex and primary motor area in the brain, suggesting a central vestibular origin.
Conclusions
Static disequilibrium related to orthostatic intolerance, and kinetic disequilibrium related to gait disturbance are both prevalent in patients with ME and are important central neural signs that restrict activities of daily living. rTMS treatment effectively alleviated these disequilibria.
Clinical Trial registration
The study has been registered on https://jrct.mhlw.go.jp/ (registration number: jRCT1042240065; registration date: July 30, 2024).
... Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating illness of unknown etiology involving complex dysregulation of the central nervous, immune, and endocrine systems. [1][2][3] ME/CFS is characterized by the primary symptom of chronic fatigue. The rapid and sustained fatigability in response to low-level physical and mental exertion distinguishes ME/CFS from fatigue experienced from other conditions, particularly with the low threshold of onset and prolonged recovery unique to ME/CFS. ...
... The rapid and sustained fatigability in response to low-level physical and mental exertion distinguishes ME/CFS from fatigue experienced from other conditions, particularly with the low threshold of onset and prolonged recovery unique to ME/CFS. [2,3] The unexplained fatigue may be accompanied by impaired neurological, immune, gastrointestinal, urogenital, cardiovascular, and autonomic functioning. [1,2] ME/CFS is a long-term illness that ubiquitously affects all racial, ethnic, and socioeconomic groups. ...
... [2,3] The unexplained fatigue may be accompanied by impaired neurological, immune, gastrointestinal, urogenital, cardiovascular, and autonomic functioning. [1,2] ME/CFS is a long-term illness that ubiquitously affects all racial, ethnic, and socioeconomic groups. [3] Its prognosis is generally considered poor, with reported recovery rates of 0-8% and improvement rates ranging between 17% and 64%. ...
This study was a phase 4, double-blind, randomized, placebo-controlled trial of solriamfetol in adults with ME/CFS. Eligible participants were randomly assigned to receive 75mg (titrated to 150mg as needed) solriamfetol or placebo. Solriamfetol demonstrated good safety and efficacy in improving fatigue and executive functioning in patients with ME/CFS. As a dual norepinephrine-dopamine reuptake inhibitor and wakefulness-promotion, solriamfetol has the potential to improve fatigue symptoms of ME/CFS.
