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Understanding Muscle Fatigue in Chronic Fatigue Syndrome

Discussion in 'Latest ME/CFS Research' started by JaimeS, Jan 19, 2016.

  1. JaimeS

    JaimeS Senior Member

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    Hey, guys, I found this Julie Newton study... haven't taken a close look at it yet. :)

    Here is the link to the full text.

    Understanding Muscle Fatigue in Chronic Fatigue Syndrome

    Gina Rutherford1 MSc , Philip Manning1 PhD, Julia L Newton MD, PhD 1,2
    1Institute of cellular medicine, Newcastle University, Newcastle UK.
    2 Newcastle hospitals NHS foundation trust, UK NIHR biomedical research centre in ageing and age related disease, Newcastle University, Newcastle UK


    Introduction:

    Chronic fatigue syndrome/ Myalgic Encephalomyelitis (CFS/ME) is a debilitating disorder of unknown aetiology and is characterised by severe disabling fatigue in the absence of an alternative diagnosis. Historically, there has been a tendency to draw psychological explanations for the origin of fatigue, however this model is at odds with findings that fatigue and accompanying symptoms may be explained by central and peripheral pathophysiological mechanisms, including effects of the immune, oxidative, mitochondrial and neuronal pathways. For example, patient descriptions of their fatigue regularly cite difficulty in maintaining muscle activity due to perceived lack of energy. This narrative review examines the literature for evidence of biochemical dysfunction in CFS/ME at the skeletal muscle level.

    Looks like a rough draft with markups. I have no idea where it's posted, but Google Scholar alerted me... so it's posted somewhere. ;)

    -J
     
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  2. John Mac

    John Mac Senior Member

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    "All papers published up until August 2015 were eligible for inclusion in this review."

    Looks as though it is very recent.

    Nice to see Professor Newton is still working on our behalf
     
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  3. Dolphin

    Dolphin Senior Member

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    http://www.hindawi.com/journals/jar/aip/328971/

     
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  4. jimells

    jimells Senior Member

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    I couldn't find it on PubMed. Maybe it's on an internal server that wasn't supposed to be searched by Google bots?
     
  5. John Mac

    John Mac Senior Member

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    Could we be doing some harm by having it online here?
     
  6. jimells

    jimells Senior Member

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    I don't think so - it's available open access at the link @Dolphin found, and the journal's version seems to be identical to the Google version, right down to the strange highlighting.
     
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  7. dannybex

    dannybex Senior Member

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    Yes, very strange highlighting. Didn't (and couldn't) read the whole thing at all, but here's the conclusion from the 'provisional' PDF:

    Conclusion

    CFS/ME patient perceptions of the nature of their condition frequently cite ‘peripheral’ as opposed to a central origin, with many descriptions of their fatigue regularly referring to difficulty in maintaining muscle activity due to perceived lack of energy, or through muscle fatigue [15,17]. There is increasing evidence to suggest muscular bio-chemical abnormality may play a major role in CFS/ME associated fatigue. The literature suggests patients to exhibit profound intramuscular dysfunction regarding acid generation and clearance, with a tendency towards an over-utilisation of the lactate dehydrogenase pathway following relatively low-level activity. However, the precise mechanisms underlying the dysfunction are yet to be fully elucidated. There is a real need for adequately powered studies to examine PDC function in vitro, to determine the mechanisms responsible for bio-energetic dysfunction and peripheral fatigue.
     
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  8. jimells

    jimells Senior Member

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    I wish researchers were more careful about using the word "fatigue". I assume that the conclusion's phrase "muscle fatigue" means "muscle failure", as in "the muscles won't contract anymore". Meanwhile "descriptions of their fatigue" seems to suggest that "fatigue" means "I feel like I need to rest". As for "peripheral fatigue" - I have no idea what that might mean.

    And of course "fatigue" is largely a distraction anyway. I don't care about "fatigue" - I just want to get my own groceries without triggering a three-day migraine, etc.

    Now this looks really interesting...
     
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  9. JaimeS

    JaimeS Senior Member

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    Started reading through this. It's a giant, honking review article of all info available on muscle abnormalities in CFS/ME (their words). A great jumping-off point for anyone who intends to pursue that line of inquiry.

    -J
     
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  10. msf

    msf Senior Member

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  11. Keela Too

    Keela Too Sally Burch

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    Not much impressed with the last line:
    "Potentially, these abnormalities may lead to the perception of severe fatigue in CFS/ME."

    Bold is mine.
     
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  12. msf

    msf Senior Member

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    Yes, I thought someone would highlight that, but they had already clearly stated that this is a physical, not a psychological phenomenon.

    ´Perception´ could be a sop to Wessely and co., it could just be unfortunate phrasing, or it could be deliberate to point out that fatigue can have different physical causes, all of which lead to the perception of fatigue, just as different physical insults lead to the perception of pain.
     
  13. duncan

    duncan Senior Member

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    "Perception of" is a bit too PC for me.

    It smacks of someone trying too hard to fit into current idiomatic or jargon fads. Like evidenced based medicine.

    Fatigue is fatigue. Pain is pain. If researchers want to talk degrees, alright. But "perception of" whatever is one unnecessary degree removed form the subject, and therefore potentially one degree removed from truth. We have enough intermediators in the medical field without introducing them into our copy.
     
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  14. lnester7

    lnester7 Seven

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    I don't understand why is "perceived" if EVERYBODY around me noticed when I feel so tired, My muscles in the face relaxed or drag down (I look like 10 years older) and my dark circles become Shiny Blue and My eye swell a bit (not counting the unstoppable yawning).. My husband, my kid, coworkers say "hey sit down you look tired" So before I say anything everybody around me can tell I am tired, so I don't think is me perceiving being tired.

    Edit I forgot to say I get pale as a ghost (VERY OBVIOUS)
     
    Last edited: Mar 22, 2016
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  15. Marco

    Marco Grrrrrrr!

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    I'm looking forward to reading this one.

    I don't have a problem with 'perception'. If we didn't 'perceive' pain or fatigue or whatever it wouldn't be much use as signal to change behaviour.
     
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  16. Sasha

    Sasha Fine, thank you

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    I think the use of the word "perception" could suggest it's all perception and no actual fatigue - or at least that there's a mismatch between the amount of fatigue perceived and the amount that's actually going on at a biochemical level.

    I don't know if this reflects a poor understanding of fatigue generally or if it's just ME/CFS where this sort of comment would be seen as appropriate.
     
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  17. Cheshire

    Cheshire Senior Member

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    How do you check for actual fatigue, if not by the perception of the fatigued person?
    There's no "actual fatigue" vs "not real fatigue", perceived or not, all fatigue felt is actual and perceived.
     
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  18. Marco

    Marco Grrrrrrr!

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    It could well be all or mostly perception which would suggest a disorder of signalling. That doesn't make it any less real in the same way that neuropathic pain is still pain.
     
  19. Sasha

    Sasha Fine, thank you

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    But the results of the review didn't seem to indicate a signalling issue:

     
  20. Cheshire

    Cheshire Senior Member

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    If it were just "perceived", because signalling is broken, then how do you explain PEM? Our "fatigue" and other symptoms are signalling us we're doing too much, if we don't listen we'll get PEM. If it were just a signaling problem, we'd just ignore fatigue and lead a normal life. We'd be fatigued but functioning.
     
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