Cardiovascular Responses of Women With Chronic Fatigue Syndrome to Stressful Cognitive Testing Before and After Strenuous Exercise

Objective The purpose of this study was to compare the cardiovascular responses of patients with chronic fatigue syndrome (CFS) to healthy control subjects when performing stressful cognitive tasks before and after strenuous exercise. Method Beat-by-beat blood pressure and electrocardiogram were recorded on 19 women with CFS and 20 healthy nonexercising (ie, sedentary) women while they performed cognitive tests before, immediately after, and 24 hours after incremental exercise to exhaustion. Results Diminished heart rate (p < .01) and systolic (p < .01) and diastolic (p < .01) blood pressure responses to stressful cognitive testing were seen in patients with CFS when compared with healthy, sedentary controls. This diminished stress response was seen consistently in patients with CFS across three separate cognitive testing sessions. Also, significant negative correlations between self-ratings of CFS symptom severity and cardiovascular responses were seen (r = −0.62, p < .01). Conclusions Women with CFS have a diminished cardiovascular response to cognitive stress; however, exercise did not magnify this effect. Also, the data showed that the patients with the lowest cardiovascular reactivity had the highest ratings of CFS symptom severity, which suggests that the individual response of the patient with CFS to stress plays a role in the common complaint of symptoms worsening after stress.

[1]  S. Wessely,et al.  Chronic fatigue syndrome: a stress disorder? , 1996, British journal of hospital medicine.

[2]  B. Natelson,et al.  Cardiovascular Stress Responses and Their Relation to Symptoms in Gulf War Veterans With Fatiguing Illness , 2000, Psychosomatic medicine.

[3]  T. Dinan,et al.  Blunted adrenocorticotropin and Cortisol responses to corticotropin‐releasing hormone stimulation in chronic fatigue syndrome , 1998, Acta psychiatrica Scandinavica.

[4]  J. Goldstein,et al.  Cardiac Involvement in Patients with Chronic Fatigue Syndrome as Documented with Holter and Biopsy Data in Birmingham, Michigan, 1991‐1993 , 1997 .

[5]  R. Thayer.  The biopsychology of mood and arousal , 1989 .

[6]  E. Sternberg.  Hyperimmune fatigue syndromes: diseases of the stress response? , 1993, The Journal of rheumatology.

[7]  T. Wein,et al.  Orthostatic intolerance in the chronic fatigue syndrome. , 1999, Journal of the autonomic nervous system.

[8]  Christie Golden,et al.  Stroop Color and Word Test: Manual for Clinical and Experimental Uses. , 1978 .

[9]  D H Streeten,et al.  Long- and short-term blood pressure and RR-interval variability and psychosomatic distress in chronic fatigue syndrome. , 1999, Clinical science.

[10]  S. Lawrie,et al.  Effects of exercise on cognitive and motor function in chronic fatigue syndrome and depression , 1998, Journal of neurology, neurosurgery, and psychiatry.

[11]  B. Natelson,et al.  Cardiovascular response during head-up tilt in chronic fatigue syndrome. , 1999, Clinical physiology.

[12]  J. Ricker,et al.  Clinical validation of the Oral Trail Making Test , 1996 .

[13]  C. Schenck,et al.  Cognitive Slowing and Working Memory Difficulties in Chronic Fatigue Syndrome , 1997, Psychosomatic medicine.

[14]  B. E. Welch,et al.  CARDIOVASCULAR DECONDITIONING FROM SPACE CABIN SIMULATOR CONFINEMENT. , 1964, Aerospace medicine.

[15]  G. Chrousos,et al.  The concepts of stress and stress system disorders. Overview of physical and behavioral homeostasis. , 1992, JAMA.

[16]  H. Calkins,et al.  The relationship between neurally mediated hypotension and the chronic fatigue syndrome. , 1995, JAMA.

[17]  S. Aggarwal,et al.  Increased production of interleukin-6 by adherent and non-adherent mononuclear cells during 'natural fatigue' but not following 'experimental fatigue' in patients with chronic fatigue syndrome. , 1999, International journal of molecular medicine.

[18]  James F. Jones,et al.  Chronic fatigue syndrome: a working case definition. , 1988, Annals of internal medicine.

[19]  S. Sisto,et al.  Physical activity before and after exercise in women with chronic fatigue syndrome. , 1998, QJM : monthly journal of the Association of Physicians.

[20]  A. Komaroff,et al.  Does the chronic fatigue syndrome involve the autonomic nervous system? , 1997, The American journal of medicine.

[21]  H C Beh.  Effect of noise stress on chronic fatigue syndrome patients. , 1997, The Journal of nervous and mental disease.

[22]  B. Grubb,et al.  The Postural Orthostatic Tachycardia Syndrome: A Potentially Treatable Cause of Chronic Fatigue, Exercise Intolerance, and Cognitive Impairment in Adolescents , 2000, Pacing and clinical electrophysiology : PACE.

[23]  K. Light,et al.  Hemodynamic stress responses in men and women examined as a function of female menstrual cycle phase. , 1994, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[24]  A. Beck,et al.  An inventory for measuring depression. , 1961, Archives of general psychiatry.

[25]  M. Rogers,et al.  Postexercise hypotension reduces cardiovascular responses to stress , 1993, Journal of hypertension.

[26]  K. Vandenborne,et al.  Autonomic testing in patients with chronic fatigue syndrome. , 1998, The American journal of medicine.

[27]  M. Allen,et al.  Evaluation of beta-adrenergic influences on cardiovascular and metabolic adjustments to physical and psychological stress. , 1986, Psychophysiology.

[28]  Beh Hc.  Effect of noise stress on chronic fatigue syndrome patients , 1997 .

[29]  A Steptoe,et al.  The inhibition of cardiovascular responses to mental stress following aerobic exercise. , 1991, Psychophysiology.

[30]  Susan K. Johnson,et al.  Influence of exhaustive treadmill exercise on cognitive functioning in chronic fatigue syndrome. , 1998, The American journal of medicine.