Let's get started on a brief pathophysiology of CFS. I found a great You Tube Video that covers the basics of CFS and I have included the link for your viewing.
"CFS is defined as at least 6 months of severe fatigue and disabling musculoskeletal and cognitive symptoms (impairment in short-term memory or concentration, headache, tender lymphadenopathy, muscle or joint pain, unrefreshed sleep, and post-exertional malaise lasting > 24 h) without another explanation" (Katz & Jason, 2013).
In a study by Cho, Skowera, Cleare, & Wessely, 2006, CFS is defined as a functional somatic syndrome possibly involving the central nervous syndrome, serotonergic system, hypothalamic-pituitary-adrenal (HPA) axis, immune system, genetics and psychological factors. Sounds like a lot, but do not worry I will break this down into understandable bite size pieces next week.
References
Cho, H., Skowera, A., Cleare, A., & Wessely, S. (2006). Chronic fatigue syndrome: an update focusing on phenomenology and pathophysiology. Current Opinion in Psychiatry, 19(1), 67-73.
Katz, B., & Jason, L. (2013). Chronic fatigue syndrome following infections in adolescents. Current Opinion In Pediatrics,25(1), 95-102. doi:10.1097/MOP.0b013e32835c1108
The Physiology of Pathophysiology
Trying to write about the pathophysiology when experts in the field can not agree on a true pathophysiology or etiology of CFS is a daunting task. There really is no definitive pathophysiological explanation for Chronic Fatigue Syndrome. There is a differentiation of trigger between adolescents versus adults. According to a study by Katz and Jason (2013) 10% of adults and up to 90% of adolescents can relate a trigger to development of CFS. Presence of pathogens or a biological cause have been cited as a cause of CFS by some, others claim a psychological component. Either way it is real. In adults, 75% have symptoms indicative of autonomic dysfunction (Katz, and Jason 2013). Adolescence tend to have orthostatic intolerance. It is questionable if the hypothalamic-pituitary-adrenal axis abnormality is an issue which may cause CFS.
"CFS is identified by symptoms and has no confirmatory physical signs or laboratory abnormalities. The etiology and pathophysiology remain unknown and there is an amazing lack of consensus in the findings of many well-conducted studies" (CDC 2010). Even though there is no confirmatory, Van Houdenhove et al, (2007) hypothesized the CFS decrease in motor performance involved physical deconditioning, perceptional disturbance, and the neurobiological stress system. In other words, CFS is frequently misdiagnosed and put off as basically just being tired.
Basically what's not working are the neurotransmitters in the brain, immunological issues, and possibly neuroendocrine dysfunction (Van Houdenhove et al 2007). Patients who do not have CFS do not exhibit decreased motor function or exercise intolerance, two common signs of CFS.
References
Carlisle, S., & Thompson, J., (2014). Image: Chronic Fatigue Syndrome. Retrieved from http://www.bing.com/images/searchq=images+of+chronic+fatigue+syndrome&id=0BDA08CF9CC7003F0BBDC1124066E3D8A5998A84&FORM=IQFRBA#view=detail&id=0BDA08CF9CC7003F0BBDC1124066E3D8A5998A84&selectedIndex=0
Centers for Disease Control and Prevention. (2010) Chronic Fatigue Syndrome. Retrieved from http://www.cdc.gov/cfs/programs/cdc_research/program_update_2002-2003.html
Katz, B., & Jason, L. (2013). Chronic fatigue syndrome following infections in adolescents. Current Opinion In Pediatrics,25(1), 95-102. doi:10.1097/MOP.0b013e32835c1108
Van Houdenhove, B., Verheyen, L., Pardaens, K., Luyten, P., & Van Wambeke, P. (2007). Rehabilitation of decreased motor performance in patients with chronic fatigue syndrome; should we treat low effort capacity or reduced effort tolerance?. Clinical Rehabilitation, 21(12), 1121-1142.
Wow, this condition is so much more than the name implies. The symptoms of this disease sound like it would make it difficult for an individual even to know definitively that something is wrong. I wonder how many individuals are suffering from CFS and don't even know it?
ReplyDeleteThere are more than one million people suffering from Chronic Fatigue Syndrome in the US. Women being four times more likely to develop CFS than men. It's not only hard to identify but also hard to diagnose and treat. In the past, patients with CFS had to "deal with it" but due to new research, they are now able to receive treatment.
DeleteYou're definitely right! I had no idea this disease was so complex. I wonder why women are more likely to develop this syndrome- increased stressors in their lives?
ReplyDeleteBroderick suggest females are more likely to develop CFS because their sex hormones are more likely to push the HPA axis and immune system into a deficient steady state. High hormonal levels (estradiol) and a malfunctioning HPA axis may caused this autoimmune disorder.
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