Abstract:Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a disorder of unknown physiopathology with multisystemic repercussions, framed in ICD-11 under the heading of neurology (8E49). There is no specific test to support its clinical diagnosis. Our objective is to review the evidence in neuroimaging and dysautonomia evaluation in order to support the neurological involvement and to find biomarkers serving to identify and/or monitor the pathology. The symptoms typically appear acutely, although they can … Show more
“…In 2015 the Institute of Medicine (IOM) in the US (37) informed that ME/CFS is a medical illness and should not be considered a psychiatric condition. In support of IOM conclusions that ME/CFS has a biological basis numerous studies show neurologic (38), immune (39), and metabolic (40) disturbances in these patients. Still, ME/CFS biomarker validation remains an important challenge with many research groups identifying putative diagnostic markers which could help move forward our understanding of the affected pathways in the disease.…”
Section: Discussionsupporting
confidence: 54%
“…As described in a previous study (12), study participants were women with an average age of 46.8 (age range [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53] for the disease cohort and 45.2 (age range 18-52) years for the matched HC group. Median ages were 48 years and 47 for the ME/CFS and HC group, respectively.…”
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a chronic disease characterized by long-lasting persistent debilitating widespread fatigue and post-exertional malaise, remains diagnosed by clinical criteria. Our group and others have identified differentially expressed miRNA profiles in the blood of patients. However, their diagnostic power individually or in combinations seems limited. A Partial Least Squares-Discriminant Analysis (PLS-DA) model initially based on 817 variables: two demographic, 34 blood analytic, 136 PBMC miRNAs, 639 Extracellular Vesicle (EV) miRNAs, and six EV features, selected an optimal number of five components, and a subset of 32 regressors showing statistically significant discriminant power. The presence of four EV-features (size and z-values of EVs prepared with or without proteinase K treatment) among the 32 regressors, suggested that blood vesicles carry relevant disease information. To further explore the features of ME/CFS EVs, we subjected them to Raman micro-spectroscopic analysis, identifying carotenoid peaks as ME/CFS fingerprints, possibly due to erythrocyte deficiencies. Although PLS-DA analysis showed limited capacity of Raman fingerprints for diagnosis (AUC = 0.7067), Raman data served to refine the number of PBMC miRNAs from our previous model still ensuring a perfect classification of subjects (AUC=1). Further investigations to evaluate model performance in extended cohorts of patients, to identify the precise ME/CFS EV components detected by Raman and to reveal their functional significance in the disease are warranted.
“…In 2015 the Institute of Medicine (IOM) in the US (37) informed that ME/CFS is a medical illness and should not be considered a psychiatric condition. In support of IOM conclusions that ME/CFS has a biological basis numerous studies show neurologic (38), immune (39), and metabolic (40) disturbances in these patients. Still, ME/CFS biomarker validation remains an important challenge with many research groups identifying putative diagnostic markers which could help move forward our understanding of the affected pathways in the disease.…”
Section: Discussionsupporting
confidence: 54%
“…As described in a previous study (12), study participants were women with an average age of 46.8 (age range [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53] for the disease cohort and 45.2 (age range 18-52) years for the matched HC group. Median ages were 48 years and 47 for the ME/CFS and HC group, respectively.…”
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a chronic disease characterized by long-lasting persistent debilitating widespread fatigue and post-exertional malaise, remains diagnosed by clinical criteria. Our group and others have identified differentially expressed miRNA profiles in the blood of patients. However, their diagnostic power individually or in combinations seems limited. A Partial Least Squares-Discriminant Analysis (PLS-DA) model initially based on 817 variables: two demographic, 34 blood analytic, 136 PBMC miRNAs, 639 Extracellular Vesicle (EV) miRNAs, and six EV features, selected an optimal number of five components, and a subset of 32 regressors showing statistically significant discriminant power. The presence of four EV-features (size and z-values of EVs prepared with or without proteinase K treatment) among the 32 regressors, suggested that blood vesicles carry relevant disease information. To further explore the features of ME/CFS EVs, we subjected them to Raman micro-spectroscopic analysis, identifying carotenoid peaks as ME/CFS fingerprints, possibly due to erythrocyte deficiencies. Although PLS-DA analysis showed limited capacity of Raman fingerprints for diagnosis (AUC = 0.7067), Raman data served to refine the number of PBMC miRNAs from our previous model still ensuring a perfect classification of subjects (AUC=1). Further investigations to evaluate model performance in extended cohorts of patients, to identify the precise ME/CFS EV components detected by Raman and to reveal their functional significance in the disease are warranted.
“…(2019) [ 11 ] n = 172 SOFI ( α = 0,86–0,93) COPSOQ-II ( α = 0,85) Fatigue ist assoziiert mit extremer Müdigkeit oder Schläfrigkeit und ist meist ein Zustand, der sich im Laufe der Zeit zu einer chronischen körperlichen und mentalen Beeinträchtigung ausweiten kann Frone and Blais (2019) [ 15 ] n = 1375 3D-WFI ( α = 0,97–0,99) Fatigue wird durch extreme Müdigkeit und eingeschränkte Funktionsfähigkeit beschrieben, die während und am Ende des (Arbeits‑)Tages subjektiv erlebt wird, und von Schläfrigkeit abgegrenzt werden muss Gandasegui et al. (2021) [ 16 ] – – Fatigue wird definiert als Gefühl der Müdigkeit, die nicht mir körperlicher Aktivität zusammenhängt, sich unverhältnismäßig verschlimmern kann und sich nicht durch Ruhe bessert Guest et al. (2021) [ 19 ] n = 386 OFER-15 ( α > 0,84) Anhaltende Fatigue entsteht, wenn Betroffene sich geringfügig von starker Müdigkeit erholen.…”
Section: Methodikunclassified
“…In den uns hier vorliegenden Arbeiten wird Fatigue charakterisiert durch einen Energiemangel mit extremem Ausmaß. Dies hängt jedoch nicht mit körperlicher Aktivität zusammen und kann sich zudem unproportional verschlimmern [ 16 , 32 , 55 ]. In Abgrenzung zur Müdigkeit nimmt die körperliche und mentale Einschränkung bei Fatigue trotz angemessener Erholung und Entspannung nicht ab [ 10 , 21 , 44 , 48 ].…”
Bedingt durch die COVID-19-Pandemie und das damit einhergehende Post-COVID-Syndrom, hat der Begriff der „Fatigue“ deutlich an Bedeutung gewonnen. Aber sowohl Definition wie auch Ursachen der Fatigue differieren in Abhängigkeit des jeweils betrachteten Krankheitsbildes. Zudem verwenden Betroffene, die ihre Symptomatik im alltäglichen Klinikalltag beschreiben, scheinbar nahezu durchgehend die Begriffe Müdigkeit, Fatigue und Erschöpfung synonym. Im Jahr 2007 beschrieb Olson, dass aus ihrer Sicht diese drei Begriffe als distinkte Zustände zu verstehen sind, diese aber auf einem Kontinuum in Relation zueinander gesetzt werden können. Diese Überlegung aufgreifend, wird ein Überblick über die aktuelle Forschung gegeben. Hierzu wurde die veröffentlichte Literatur der letzten zwei Jahre nach den Begriffen „Tiredness“, „Fatigue“ und „Exhaustion“ durchsucht. Es lassen sich einige gemeinsame Diagnoseinstrumente finden. Jedoch fällt die große Vielfalt der Instrumente auf, die zur Erfassung der drei Begriffe herangezogen werden. Trotz dieser unterschiedlichen Diagnose- und damit Definitionsmöglichkeiten lassen sich für die drei Symptome jeweils unterschiedliche therapeutische Maßnahmen ableiten. Es ist gerade vor dem Hintergrund der weiteren Therapie entscheidend, die drei Begriffe der Müdigkeit, der Fatigue und der Erschöpfung, voneinander zu trennen und jeweils einzeln auf dem gemeinsamen Kontinuum zu betrachten. Denn nur so ist sowohl eine zutreffende Diagnose als auch eine damit einhergehende erfolgreiche individuelle Therapie ableitbar.
“…Asthenia syndrome developed evolutionarily as a type of protective mechanism, signaling depletion of energy resources and the need for this to be corrected. It is therefore a characteristic feature of asthenic syndrome that it disappears after rest, as soon as the energy defi cit which operated as the initiating element in pathological fatigue is compensated [2]. Asthenia has a variety of causes, including stress, various infectious diseases, acute and chronic somatic and neurological pathologiesi.e., anything whose occurrence increases the "expenditure" of energy or requires signifi cant energy outlay for recovery will be accompanied by the development of this state.…”
Asthenia is a clinical syndrome that can be manifest in almost all somatic, infectious, and neurological diseases. Initially a protective mechanism indicating depletion of energy resources, asthenia can become a pathological and extremely disabling condition, and can even progress to an independent immune-mediated disease -chronic fatigue syndrome. Asthenia is often combined with affective and cognitive disorders, producing diagnostic diffi culties. The article addresses the complex interweaving of asthenia, chronic fatigue syndrome, and cognitive and affective disorders.
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