Capturing the post-exertional exacerbation of fatigue following physical and cognitive challenge in patients with chronic fatigue syndrome

Keech, Andrew; Sandler, Carolina X.; Vollmer‐Conna, Ute; Cvejic, Erin; Lloyd, Andrew R.; Barry, Benjamin K.

doi:10.1016/j.jpsychores.2015.08.008

Cited by 35 publications

(35 citation statements)

References 42 publications

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“…This is also in line with previous research in ME/CFS (e.g. [35,45]). Considering that no only physical, but also is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint…”

Section: Content Analysis Of Open-ended Questionnaires Delivered 96 Hsupporting

confidence: 93%

“…To gain a comprehensive understanding of the participant experience, an open-ended questionnaire was provided (hard copy or via email, participant preference), and participants were instructed to complete this 96 h after the exercise test. This accounted for the potential for prolonged adverse responses as reported in people with ME/CFS [34][35][36], while also limiting the requirement for…”

Section: Measurement Of Post-exertional Malaisementioning

confidence: 99%

“…A number of previous studies have used maximal exercise tests to investigate the effects of physical exertion on ME/CFS symptoms (e.g. [34][35][36]). For example, prolonged adverse responses to maximal exercise tests are common in women with CFS (96% took >2 days to recover) and largely absent in a sedentary control group (where 87% indicated full recovery within 24 h and 100% by 2 days) [34].…”

Section: Content Analysis Of Open-ended Questionnaires Delivered 96 Hmentioning

confidence: 99%

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Post-Exertional Malaise in People with Chronic Cancer-Related Fatigue

Twomey

Yeung

Wrightson³

et al. 2019

Preprint

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Context: Cancer-related fatigue (CRF) is a distressing and persistent sense of tiredness or exhaustion that interferes with usual functioning. Chronic CRF continues for months after curative cancer treatment is complete. Post-exertional malaise (PEM) is a worsening of symptoms after physical or mental activity, with limited investigations in people with chronic CRF. Objectives: The purpose of this study was to identify and describe self-reported incidences of PEM in people with chronic CRF. Methods: Participants (n=18) were eligible if they scored ≤34 on the Functional Assessment of Chronic Illness Therapy-Fatigue scale and had a cancer-related onset of fatigue. Participants completed a brief questionnaire to assess PEM over a 6-month time-frame (the DePaul Symptom Questionnaire - Post-Exertional Malaise; DSQ-PEM). In addition, a maximal exercise test was used to investigate self-reported symptom exacerbation (via an open-ended questionnaire) after strenuous physical exertion. Results: On the DSQ-PEM, three participants met previously defined scoring criteria, which included experiencing moderate to very severe symptoms at least half of the time, worsening of fatigue after minimal effort, plus a recovery duration of >24 h. Content analysis of responses to open-ended questionnaires identified five people who experienced a delayed recovery and symptoms of PEM after maximal exercise. Conclusion: A subset of people with chronic CRF (up to 33% in this sample) may experience PEM. Exercise specialists and health care professionals working with people with chronic CRF must be aware that PEM may be an issue. Symptom exacerbation after exercise should be monitored, and exercise should be tailored and adapted to limit the potential for harm.

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Section: Content Analysis Of Open-ended Questionnaires Delivered 96 Hsupporting

confidence: 93%

Section: Measurement Of Post-exertional Malaisementioning

confidence: 99%

Section: Content Analysis Of Open-ended Questionnaires Delivered 96 Hmentioning

confidence: 99%

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Post-Exertional Malaise in People with Chronic Cancer-Related Fatigue

Twomey

Yeung

Wrightson³

et al. 2019

Preprint

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“…For example, Barry and colleagues devised a Fatigue and Energy Scale to measure the state level of fatigue after performing a bout of physical activity in individuals with chronic fatigue syndrome (32). One of the characteristics of the syndrome is the prolonged exacerbation of symptoms after performing physical activity.…”

Section: Translating Fatigue To Performancementioning

confidence: 99%

Translating Fatigue to Human Performance

Enoka

Duchateau

2016

Medicine &Amp; Science in Sports &Amp; Exercise

606

582

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Despite flourishing interest in the topic of fatigue—as indicated by the many presentations on fatigue at the 2015 annual meeting of the American College of Sports Medicine—surprisingly little is known about its impact on human performance. There are two main reasons for this dilemma: (1) the inability of current terminology to accommodate the scope of the conditions ascribed to fatigue, and (2) a paucity of validated experimental models. In contrast to current practice, a case is made for a unified definition of fatigue to facilitate its management in health and disease. Based on the classic two-domain concept of Mosso, fatigue is defined as a disabling symptom in which physical and cognitive function is limited by interactions between performance fatigability and perceived fatigability. As a symptom, fatigue can only be measured by self-report, quantified as either a trait characteristic or a state variable. One consequence of such a definition is that the word fatigue should not be preceded by an adjective (e.g., central, mental, muscle, peripheral, and supraspinal) to suggest the locus of the changes responsible for an observed level of fatigue. Rather, mechanistic studies should be performed with validated experimental models to identify the changes responsible for the reported fatigue. As indicated by three examples (walking endurance in old adults, time trials by endurance athletes, and fatigue in persons with multiple sclerosis) discussed in the review, however, it has proven challenging to develop valid experimental models of fatigue. The proposed framework provides a foundation to address the many gaps in knowledge of how laboratory measures of fatigue and fatigability impact real-world performance.

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“…6,7 During the relief stage in patients with CFS, symptoms of fatigue and pain, as well as functional capacity, often take hours to days to return to baseline levels. [8][9][10][11][12][13] In adolescents, CFS is a well-known condition, with an estimated prevalence of 0.1 to 1.0%. CFS is still poorly understood, and there is no consensus on a reference standard for diagnosis of CFS.…”

Section: And Abstractmentioning

confidence: 99%

MicroRNAs as Biomarkers of Pain Intensity in Patients With Chronic Fatigue Syndrome

2019

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Background Numerous experimental models have shown that microRNAs (miRNAs)play an important role in regulating pain processing in clinical pain disorders. In this study, we evaluated a set of miRNAs as diagnostic biomarkers of pain intensity in adolescents with chronic fatigue syndrome (CFS). We then correlated the expression of these miRNAs with the levels of inflammatory markers and pain‐related comorbidities in adolescents with CFS and healthy controls (HCs). Methods A total of 150 adolescents, 12 to 18 years of age, participated in this study between April 2016 and April 2017. The participants were classified into 2 groups: adolescents with CFS (n = 100) and HCs (n = 50). Reverse‐transcription polymerase chain reaction was used to evaluate the expression of miR‐558, miR‐146a, miR‐150, miR‐124, and miR‐143. Immunoassay analysis was used to assess the levels of immune inflammatory markers interleukin‐6 (IL‐6), tumor necrosis factor‐α (TNF‐α), and cyclooxygenase‐2 (COX‐2). Results Adolescents with CFS showed significantly higher pain thresholds than comparable nonfatigued HCs. Ability to enjoy life and relations with others were the parameters least influenced by pain in CFS patients. Differential expression of miR‐558, miR‐146a, miR‐150, miR‐124, and miR‐143 was significantly downregulated and notably interfered with pain intensity and frequency in patients with CFS. Also, the expression of these miRNAs was significantly correlated with that of IL‐6, TNF‐α, and COX‐2, which have been shown to mediate pain intensity in patients with CFS. Girls with CFS showed significantly decreased expression levels of these miRNAs compared with the levels of boys with CFS. Girls with CFS also showed increased expression of the inflammatory pain–related markers IL‐6, TNF‐α, and COX‐2 compared with the levels of boys with CFS. Conclusions The intensity and consequences of pain were influenced by differential expression of miR‐558, miR‐146a, miR‐150, miR‐124, and miR‐143, which was directly associated with higher expression of the immune inflammatory‐related genes TNFα, IL‐6, and COX‐2 in adolescents with CFS. Further studies of larger patient cohorts will help clarify the role of miRNAs in the pathogenesis of CFS.

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Capturing the post-exertional exacerbation of fatigue following physical and cognitive challenge in patients with chronic fatigue syndrome

Cited by 35 publications

References 42 publications

Post-Exertional Malaise in People with Chronic Cancer-Related Fatigue

Post-Exertional Malaise in People with Chronic Cancer-Related Fatigue

Translating Fatigue to Human Performance

MicroRNAs as Biomarkers of Pain Intensity in Patients With Chronic Fatigue Syndrome

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