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Brain imaging reveals clues about chronic fatigue syndrome

Discussion in 'General ME/CFS News' started by Firestormm, May 23, 2014.

  1. Simon

    Simon

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    It would be easy to get the impression that they effectively used Fukuda, but they didn't. Ref 23 is the Reeves 'Empiric' criteria. The Empiric criteria is, in fact, based on Fukuda - hence the same exclusions, medical history etc - but the 'empiric' bit refers to thresholds for fatigue, physical function etc - and that's where the empiric gets it wrong.
    See above re PACE - the PACE figures are in line with other outpatient studies as far as I recall - maybe a bit higher.

    The as yet unpublished muscle culture work done by Newton's group, using muscle biopsy samples from the same patients found similar problems and acidosis - oxygenation would be the same in both controls and patients in muscle culture, suggesting the problem is not oxygenation itself (They think it's a problem with the cell metabolism, which means not enough glucose gets burned in mitochondria).
    aimossy, WillowJ, Firestormm and 2 others like this.
  2. N.A.Wright

    N.A.Wright Guest

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    Right. I’d confused Georgia with Witchita, the Georgia study using Empirical at the outset and giving the absurd 2.54% prevalence - but I’m still puzzled by the follow up process that Miller used – if the 751 participants had already been classified as CFS, non fatigued, or ISF, what did the process : Following clinical and laboratory assessments, 71 persons met criteria for CFS, and 212 were determined to be controls involve ?

    There certainly seems to have been a major sorting exercise which reduced the CFS cohort to just 10% of the study population, and it seems unlikely that could be soley down to use of the Empircal criteria.
    Firestormm likes this.
  3. Simon

    Simon

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    The 751 figure is those assessed in the Clinic, not CFS cases. The original Georgia study identified 113 CFS cases in the clinic (most of the cases assessed in the Clinic then were not CFS either). Presumably a good chunk of the original sample would have been lost to follow up 3-4 years later in any case. So they didn't reduce the CFS cases to 10% of the original.

    Edit: I think the original classification was based on questionnaire answers, a crude screen before diagnosis by lab tests and clinical assessment, inc psych screen.

    Edit 2: dull stuff, mainly for my notes, but further reason to assume this isn't a representative CFS sample:
    As I'd pointed out earlier, the SF36 physical function score of 64 indicates are surprisingly able-bodied group. I've no checked out the fatigue score and the results are the same.

    They measured fatigue with the MFI-20 (Multi-Dimensional Fatigue Inventory) scale. I'll just look at the Mental Fatigue subscale here, as that was what correlated so strongly with the fMRI results: those with more fatigue showed less basal ganglia response to the gambling test.

    The mental fatigue scale scores between 4 (no problems) to 20 (worst problems)
    This study mean score: Controls=5.8, CFS=12.7

    So what's 12.7/20 like?

    Well, here's another study using the MFI in, as it happens, the same original Georgia study. This study found a Mental Fatigue score of:
    CFS-like=11.0
    So here, CFS-like wasn't quite as bad as CFS for mental fatigue, but it wasn't so far off either; 56% of CFS-like cases were evaluated as full CFS cases in the clinic.

    Here's the killer stats though, for that CFS-like group with similar mental fatigue scores (though a bit lower) to the CFS patients in the new study:
    Full time working (>30 hours a week)=55%
    Part time=11%
    So two-thirds of a group of patients with similar mental fatigue scores to the basal ganglia study patients were working. That does not look like any group of CFS patients I've seen - apart from those selected with the empiric criteria.
    Last edited: May 29, 2014
    aimossy, Valentijn and Firestormm like this.

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