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- Title
Symptoms of autonomic dysfunction in chronic fatigue syndrome.
- Authors
J.L. Newton; O. Okonkwo; K. Sutcliffe; A. Seth; J. Shin; D.E.J. Jones
- Abstract
Background: Chronic fatigue syndrome (CFS) is common and its cause is unknown. Aim: To study the prevalence of autonomic dysfunction in CFS, and to develop diagnostic criteria. Design: Cross-sectional study with independent derivation and validation phases. Methods: Symptoms of autonomic dysfunction were assessed using the Composite Autonomic Symptom Scale (COMPASS). Fatigue was assessed using the Fatigue Impact Scale (FIS). Subjects were studied in two groups: phase 1 (derivation phase), 40 CFS patients and 40 age- and sex-matched controls; phase 2 (validation phase), 30 CFS patients, 37 normal controls and 60 patients with primary biliary cirrhosis. Results: Symptoms of autonomic dysfunction were strongly and reproducibly associated with the presence of CFS or primary biliary cirrhosis (PBC), and correlated with severity of fatigue. Total COMPASS score >32.5 was identified in phase 1 as a diagnostic criterion for autonomic dysfunction in CFS patients, and was shown in phase 2 to have a positive predictive value of 0.96 (95%CI 0.86â0.99) and a negative predictive value of 0.84 (0.70â0.93) for the diagnosis of CFS. Discussion: Autonomic dysfunction is strongly associated with fatigue in some, but not all, CFS and PBC patients. We postulate the existence of a âcross-cuttingâ aetiological process of dysautonomia-associated fatigue (DAF). COMPASS >32.5 is a valid diagnostic criterion for autonomic dysfunction in CFS and PBC, and can be used to identify patients for targeted intervention studies.
- Subjects
MEDICAL research; CHRONIC fatigue syndrome; BIOLOGY; MEDICAL sciences
- Publication
QJM: An International Journal of Medicine, 2007, Vol 100, Issue 8, p519
- ISSN
1460-2725
- Publication type
Article
- DOI
10.1093/qjmed/hcm057