Identifying subgroups in the chronic fatigue syndrome

AbstractThe chronic fatigue syndrome affecting a large patient population with different symptoms such as sleeplessness, tiredness and pain is examined in our center. Patients can be selected using different criteria, Fukuda's criteria being the most recommended nowadays and Holmes's criteria the earlier more restricted criteria. We evaluated in 40 patients(32 women, 8 men; mean age 43.0±7.8 years, mean±SD fulfilling Fukuda's criteria for tender points' pain pressure sensitivity and infrared thermography emission. By considering Holmes' (H) criteria for the chronic fatigue syndrome and fibromyalgia (F) criteria, we subdivided the population into 4 subgroups: (F+ H+, F+ H-, F- H+, F- H-). Fibromyalgia patients not fulfilling Holmes' criteria (F+ H-) were statistically different for pain pressure threshold (p = 0.03) from the other patients. Moreover, this first group showed a normal infrared thermographic emission considering pain, where the other patients showed a rather abnormal vasomotor reaction.

[1]  M. Werbach Nutritional strategies for treating chronic fatigue syndrome. , 2000, Alternative medicine review : a journal of clinical therapeutic.

[2]  D. Buchwald,et al.  Overlapping conditions among patients with chronic fatigue syndrome, fibromyalgia, and temporomandibular disorder. , 2000, Archives of internal medicine.

[3]  J. Couper,et al.  Cognitive behaviour therapy for adults with chronic fatigue syndrome. , 2000, The Cochrane database of systematic reviews.

[4]  B. Natelson,et al.  Natural history of severe chronic fatigue syndrome. , 1999, Archives of physical medicine and rehabilitation.

[5]  A. Barsky,et al.  Functional Somatic Syndromes , 1999, Annals of Internal Medicine.

[6]  L. Terenius,et al.  Chronic fatigue syndrome differs from fibromyalgia. No evidence for elevated substance P levels in cerebrospinal fluid of patients with chronic fatigue syndrome , 1998, Pain.

[7]  Long- and short-term blood pressure and RR-interval variability and psychosomatic distress in chronic fatigue syndrome. , 1998, Clinical science.

[8]  D. Armstrong,et al.  Monitoring healing of acute Charcot's arthropathy with infrared dermal thermometry. , 1997, Journal of rehabilitation research and development.

[9]  H. Calkins,et al.  Provocation of hypotension and pain during upright tilt table testing in adults with fibromyalgia. , 1997, Clinical and experimental rheumatology.

[10]  Michael R. Pierrynowski Diagnostic Accuracy of Technologies Used in Low Back Pain Assessment , 1997 .

[11]  J. Olesen,et al.  Evidence of qualitatively altered nociception in patients with fibromyalgia. , 1997, Arthritis and rheumatism.

[12]  R. Dotson,et al.  Clinical neurophysiology laboratory tests to assess the nociceptive system in humans. , 1997, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.

[13]  Jan Ekholm,et al.  Sensory dysfunction in fibromyalgia patients with implications for pathogenic mechanisms , 1996, Pain.

[14]  J A Hanley,et al.  Diagnostic Accuracy of Technologies Used in Low Back Pain Assessment: Thermography, Triaxial Dynamometry, Spinoscopy, and Clinical Examination , 1996, Spine.

[15]  A. Hackmann,et al.  Cognitive behaviour therapy for the chronic fatigue syndrome: a randomised controlled trial , 1996, BMJ.

[16]  K. Epstein The chronically fatigued patient. , 1995, The Medical clinics of North America.

[17]  Ian Hickie,et al.  The Chronic Fatigue Syndrome: A Comprehensive Approach to Its Definition and Study , 1994, Annals of Internal Medicine.

[18]  I. Hickie,et al.  The treatment of chronic fatigue syndrome: science and speculation. , 1994, The American journal of medicine.

[19]  I. Hickie,et al.  Immunologic and psychologic therapy for patients with chronic fatigue syndrome: a double-blind, placebo-controlled trial. , 1993, The American journal of medicine.

[20]  Uricchio Jv Diagnostic accuracy and clinical utility of thermography for lumbar radiculopathy. , 1992 .

[21]  Rothschild Bm Fibromyalgia: an explanation for the aches and pains of the nineties. , 1991 .

[22]  D L Kent,et al.  Diagnostic accuracy and clinical utility of thermography for lumbar radiculopathy. A meta-analysis. , 1991, Spine.

[23]  S. Langlois,et al.  Infrared thermographic imaging, magnetic resonance imaging, CT scan and myelography in low back pain. , 1990, British journal of rheumatology.

[24]  P. Tugwell,et al.  The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. , 1990, Arthritis and rheumatism.

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

[26]  A. Fischer Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold , 1987, Pain.

[27]  A. Fischer,et al.  Pressure Threshold Measurement for Diagnosis of Myofascial Pain and Evaluation of Treatment Results , 1986 .

[28]  A. Fischer Pressure threshold meter: its use for quantification of tender spots. , 1986, Archives of physical medicine and rehabilitation.

[29]  V. Kyle,et al.  Assessment of inflammation in the rheumatoid knee joint: correlation between clinical, radioisotopic, and thermographic methods. , 1986, Annals of the rheumatic diseases.

[30]  R. P. Clark Human Skin Temperature and Its Relevance in Physiology and Clinical Assessment , 1984 .

[31]  D. Grennan,et al.  Infra-red thermography in the assessment of sacro-iliac inflammation. , 1982, Rheumatology and rehabilitation.

[32]  Tichauer Er The objective corroboration of back pain through thermography. , 1977 .