Evidence browser

Fatigue secondary to chronic illness: postpolio syndrome, chronic fatigue syndrome, and multiple sclerosis.

Packer, T L, Sauriol, A, Brouwer, B·Archives of physical medicine and rehabilitation·1994

This study compared fatigue in people with three different chronic illnesses: postpolio syndrome, ME/CFS, and multiple sclerosis. Researchers found that people with all three conditions experienced much higher levels of fatigue than healthy people, and those with ME/CFS and MS also had greater difficulty doing everyday activities. The study highlights how serious and disabling fatigue can be across these different conditions.

A comparison of case definitions of chronic fatigue syndrome.

Bates, D W, Buchwald, D, Lee, J et al.·Clinical infectious diseases : an official publication of the Infectious Diseases Society of America·1994

This study tested whether three different sets of diagnostic criteria for ME/CFS identified the same patients. Researchers looked at 805 patients at two clinics and found that about 55-61% met each of the three definitions, though different patients sometimes qualified under different criteria. The study suggests that using broader, more flexible definitions might better capture people with ME/CFS.

[Chronic fatigue syndrome: immune dysfunction, role of pathogens and toxic agents and neurological and cardial changes].

Hilgers, A, Frank, J·Wiener medizinische Wochenschrift (1946)·1994

This study examined 375 patients with ME/CFS to understand what goes wrong with their immune systems and which infections might be involved. Researchers found that most patients had problems with immune cell function, signs of past viral infections (especially Epstein-Barr virus), and imbalances in immune chemicals. The study suggests ME/CFS may be connected to autoimmune problems and multiple infections.

Immune System

E2 ModerateBehavioralPEM not requiredLongitudinal

Use of dynamic tests of muscle function and histomorphometry of quadriceps muscle biopsies in the investigation of patients with chronic alcohol misuse and chronic fatigue syndrome.

Wassif, W S, Sherman, D, Salisbury, J R et al.·Annals of clinical biochemistry·1994

Researchers tested muscle function and examined muscle samples from people with ME/CFS and people with chronic alcohol problems to see if their muscle problems were similar or different. They found that while some people initially thought to have ME/CFS actually had other conditions (like a rare enzyme deficiency or inflammation), the muscle changes in alcohol misuse were quite distinct and recognizable through muscle biopsies.

Biomarkers

Longitudinal study of outcome of chronic fatigue syndrome.

Wilson, A, Hickie, I, Lloyd, A et al.·BMJ (Clinical research ed.)·1994

This study followed 103 ME/CFS patients for about 3 years to see who got better and why. Most patients improved somewhat over time, but only a small number felt completely well. The researchers found that how patients thought about their illness and coped with it mattered more for recovery than immune system tests or how old they were when they got sick.

E2 ModerateBehavioralPEM not requiredCross-Sectional

Chronic fatigue and chronic fatigue syndrome: clinical epidemiology and aetiological classification.

Manu, P, Lane, T J, Matthews, D A·Ciba Foundation symposium·1993

This study looked at 405 patients who came to a hospital complaining of chronic fatigue and tried to figure out what was causing it. Doctors found that most patients had psychiatric conditions like depression or anxiety rather than physical diseases. About 30% of patients met the definition for ME/CFS, and these patients were more likely to attribute their illness to a viral infection than other fatigued patients.

E2 ModerateCohortPEM unclearCross-Sectional

Human herpesvirus 6 and chronic fatigue syndrome.

Eymard, D, Lebel, F, Miller, M et al.·The Canadian journal of infectious diseases = Journal canadien des maladies infectieuses·1993

This study compared antibody levels against human herpesvirus 6 (HHV-6) in two groups: people with ME/CFS and people with chronic fatigue who didn't meet the official ME/CFS diagnosis. Researchers found that people with ME/CFS had significantly higher antibody levels against HHV-6, suggesting the virus might play a role in the condition. The study also found that sore throat, headache, and recurrent fatigue were more common in the ME/CFS group.

Immune System

The overdiagnosis of Lyme disease.

Steere, A C, Taylor, E, McHugh, G L et al.·JAMA·1993

This study looked at 788 people referred to a Lyme disease clinic who were thought to have Lyme disease. Researchers found that only 23% actually had active Lyme disease, while 57% did not have Lyme disease at all—many of these patients had chronic fatigue syndrome or fibromyalgia instead. The main problem was that patients were being incorrectly diagnosed with Lyme disease and given antibiotics that didn't help because they didn't actually have the infection.

Prevalence of fatigue and chronic fatigue syndrome in a primary care practice.

Bates, D W, Schmitt, W, Buchwald, D et al.·Archives of internal medicine·1993

This study looked at how common severe, long-lasting fatigue is in a primary care doctor's office and how often it is ME/CFS. Researchers found that while about 27% of patients had long-term fatigue affecting their daily life, most could be explained by other medical or mental health conditions. Only about 0.3% to 1% of patients actually had ME/CFS, depending on which diagnostic criteria were used.

E2 ModerateBehavioralPEM not requiredCross-Sectional

Chronic fatigue in primary care attenders.

McDonald, E, David, A S, Pelosi, A J et al.·Psychological medicine·1993

Researchers studied 77 primary care patients with chronic fatigue and found that 26% met criteria for chronic fatigue syndrome (CFS). Most patients received other diagnoses, including depression and a condition called neurasthenia. Interestingly, patients seen in general practice were more likely to recognize that stress and emotional factors played a role in their fatigue, unlike hospital patients who often blamed purely physical causes like viruses.

E2 ModerateCohortPEM not requiredObservational

Epidemiology of chronic fatigue syndrome: the Centers for Disease Control Study.

Gunn, W J, Connell, D B, Randall, B·Ciba Foundation symposium·1993

Between 1989 and 1991, the CDC tracked patients with chronic fatigue syndrome across four U.S. cities to understand how common the illness is and who gets it. Researchers found that only about 1 in 4 patients referred to them actually met the strict diagnostic criteria for CFS, while others had different medical conditions or psychiatric histories that might explain their fatigue. The study estimated that CFS affects roughly 2–11 people per 100,000 in the general population, and it most commonly affected women in their 30s.

E2 ModerateCohortPEM unclearCross-Sectional

Repetitively negative changing T waves at 24-h electrocardiographic monitors in patients with the chronic fatigue syndrome. Left ventricular dysfunction in a cohort.

Lerner, A M, Lawrie, C, Dworkin, H S·Chest·1993

This study looked at heart activity recorded over 24 hours in ME/CFS patients compared to others. All 24 ME/CFS patients showed unusual patterns on their heart monitors (abnormal T waves), compared to only 22% of people without ME/CFS. Further testing found that 8 out of 60 ME/CFS patients had mild heart pumping problems that only showed up during exercise, even though their resting heart function appeared normal. The researchers suggest ME/CFS fatigue might be related to the heart not working well during normal daily activities.

Post-Exertional Malaise

Quality of attention in chronic fatigue syndrome: subjective reports of everyday attention and cognitive difficulty, and performance on tasks of focused attention.

Ray, C, Phillips, L, Weir, W R·The British journal of clinical psychology·1993

Many people with ME/CFS report problems with attention and concentration in daily life. This study compared ME/CFS patients with healthy people using questionnaires about attention problems and computer-based attention tests. Patients reported significantly more attention difficulties than controls, though standard attention tests didn't show clear differences. Interestingly, patients were slower at processing tasks like reading words and naming colors, suggesting their thinking speed may be affected rather than their ability to focus.

Cognitive Impairment

Fatigue, depression, and social adjustment in chronic fatigue syndrome.

Walford, G A, Nelson, W M, McCluskey, D R·Archives of disease in childhood·1993

This study looked at 12 children with ME/CFS and compared them to children with cystic fibrosis and healthy children. Children with ME/CFS reported much higher levels of tiredness affecting both body and mind, and many showed signs of depression. Their schooling and social lives were seriously disrupted by the illness.

Cognitive Impairment

Japanese patients with chronic fatigue syndrome are negative for known retrovirus infections.

Honda, M, Kitamura, K, Nakasone, T et al.·Microbiology and immunology·1993

This study tested 30 Japanese patients with ME/CFS to see if they had been infected with certain viruses called retroviruses, which some researchers thought might cause the illness. Using multiple testing methods, the researchers found that none of the patients had these viral infections. This suggests that these particular known viruses are not responsible for causing ME/CFS in this Japanese patient population.

A controlled study of brain magnetic resonance imaging in patients with the chronic fatigue syndrome.

Natelson, B H, Cohen, J M, Brassloff, I et al.·Journal of the neurological sciences·1993

Researchers compared brain scans (MRIs) of 52 people with ME/CFS to 52 similar healthy people. They found that ME/CFS patients were much more likely to have abnormal brain scans—27% compared to only 2% in the control group. The abnormalities included areas of white matter changes and some brain tissue enlargement, though the researchers noted that some of these findings might actually indicate other medical conditions rather than ME/CFS itself.

Abnormalities of sleep in patients with the chronic fatigue syndrome.

Morriss, R, Sharpe, M, Sharpley, A L et al.·BMJ (Clinical research ed.)·1993

This study compared sleep patterns between 12 people with ME/CFS and 12 healthy volunteers using both sleep diaries and objective monitoring devices. People with ME/CFS spent more time in bed but slept less efficiently, woke up more after falling asleep, and were more likely to have sleep disorders. The researchers concluded that sleep problems are common in ME/CFS and may contribute to daytime fatigue.

Serum folate and chronic fatigue syndrome.

Jacobson, W, Saich, T, Borysiewicz, L K et al.·Neurology·1993

Researchers measured folic acid levels in the blood of 60 ME/CFS patients and found that about half had lower-than-normal amounts. This suggests that some people with ME/CFS may not have enough folic acid in their body, which is a B vitamin important for many body functions.

Assessment of a retrovirus sequence and other possible risk factors for the chronic fatigue syndrome in adults.

Khan, A S, Heneine, W M, Chapman, L E et al.·Annals of internal medicine·1993

Researchers tested whether a virus called HTLV-II might be a cause of ME/CFS by comparing blood samples from 21 people with CFS to 21 healthy controls. They found no trace of the HTLV-II virus in any of the participants, and found no differences between the two groups in exposure to activities that spread viruses. This study argues against the idea that HTLV-II is linked to ME/CFS.