From the Journal of Rehabilitation Research and Development (JRRD), 10 September 2013.
Association between cognitive performance, physical fitness, and physical activity level in women with chronic fatigue syndrome
Kelly Ickmans, PT, MSc(1-3), Peter Clarys, PE, BR Sc, PhD(4), Jo Nijs,PT, PhD(1-3,*), Mira Meeus, PT, PhD(1-2,5), Dirk Aerenhouts, PE, PhD (4), Evert Zinzen, PE, PT, PhD(6), Senne Aelbrecht, PE(1,6), Geert Meersdom, MN(7), Luc Lambrecht, MD, PhD(8), Nathalie Pattyn, MD, PhD(9)
1) Pain in Motion Research Group (PIM), Department of Human Physiology, Vrije Universiteit Brussel, Brussels, Belgium;
2) PIM, Division of Musculoskeletal Physiotherapy, Department of Health Care Sciences, Artesis University College Antwerp, Antwerpen, Belgium;
3) PIM, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium;
4) Department of Human Biometry and Biomechanics, Vrije Universiteit Brussel, Brussels, Belgium;
5) Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium;
6) Department of Sports Training and Movement Education, Vrije Universiteit Brussel, Brussels, Belgium;
7) CVS Contactgroep VZW, Brugge, Belgium;
8) Private practice for internal medicine, Ghent/Aalst, Belgium;
9) Department of Human Physiology, Vrije Universiteit Brussel, Brussels, Belgium; and VIPER Research Unit, Royal Military Academy, Brussels, Belgium
* Address all correspondence to Jo Nijs, PT, PhD; Vrije Universiteit Brussel, Faculty of Physical Education and Physiotherapy, Department of Human Physiology, Building L, Pleinlaan 2, 1050 Brussels, Belgium;
fax: +32-2-6292876. Email: Jo.Nijs@vub.ac.be
Limited scientific evidence suggests that physical activity is directly related to cognitive performance in patients with chronic fatigue syndrome (CFS).
To date, no other study has examined the direct relationship between cognitive performance and physical fitness in these patients. This study examined whether cognitive performance and physical fitness are associated in female patients with CFS and investigated the association between cognitive performance and physical activity level (PAL) in the same study sample.
We hypothesized that patients who performed better on cognitive tasks would show increased PALs and better performance on physical tests. The study included 31 women with CFS and 13 healthy inactive women.
Participants first completed three cognitive tests. Afterward, they undertook a test to determine their maximal handgrip strength, performed a bicycle ergometer test, and were provided with an activity monitor.
In patients with CFS, lower peak oxygen uptake and peak heart rate were associated with slower psychomotor speed (p<0.05). Maximal handgrip strength was correlated with working memory performance (p<0.05). Both choice and simple reaction time were lower in patients with CFS relative to healthy controls (p<0.05 and p<0.001, respectively). In conclusion, physical fitness, but not PAL, is associated with cognitive performance in female patients with CFS.
From Psychoneuroendocrinology, 6 September 2013. [Epub ahead of print]
Differing leukocyte gene expression profiles associated with fatigue in patients with prostate cancer versus chronic fatigue syndrome.
Light KC, Agarwal N, Iacob E, White AT, Kinney AY, Vanhaitsma TA, Aizad H, Hughen RW, Bateman L, Light AR.
Department of Anesthesiology, University of Utah Health Sciences Center, Salt Lake City, UT, USA. Electronic address: email@example.com.
Androgen deprivation therapy (ADT) often worsens fatigue in patients with prostate cancer, producing symptoms similar to chronic fatigue syndrome (CFS). Comparing expression (mRNA) of many fatigue-related genes in patients with ADT-treated prostate cancer versus with CFS versus healthy controls, and correlating mRNA with fatigue severity may clarify the differing pathways underlying fatigue in these conditions.
Quantitative real-time PCR was performed on leukocytes from 30 fatigued, ADT-treated prostate cancer patients (PCF), 39 patients with CFS and 22 controls aged 40-79, together with ratings of fatigue and pain severity. 46 genes from these pathways were included: (1) adrenergic/monoamine/neuropeptides, (2) immune, (3) metabolite-detecting, (4) mitochondrial/energy, (5) transcription factors.
PCF patients showed higher expression than controls or CFS of 2 immune transcription genes (NR3C1 and TLR4), chemokine CXCR4, and mitochondrial gene SOD2. They showed lower expression of 2 vasodilation-related genes (ADRB2 and VIPR2), 2 cytokines (TNF and LTA), and 2 metabolite-detecting receptors (ASIC3 and P2RX7). CFS patients showed higher P2RX7 and lower HSPA2 versus controls and PCF. Correlations with fatigue severity were similar in PCF and CFS for only DBI, the GABA-A receptor modulator (r=-0.50, p<0.005 and r=-0.34, p<0.05). Purinergic P2RY1 was correlated only with PCF fatigue and pain severity (r=+0.43 and +0.59, p=0.025 and p=0.001). CONCLUSIONS PCF patients differed from controls and CFS in mean expression of 10 genes from all 5 pathways. Correlations with fatigue severity implicated DBI for both patient groups and P2RY1 for PCF only. These pathways may provide new targets for interventions to reduce fatigue.
From the Journal of Health Psychology, 20 September 2013. (e-published before print).
Understanding medical students' views of Chronic Fatigue Syndrome: A qualitative study
Alexandra Laura Stenhoff(*), Shireen Sadreddini, Sarah Peters, Alison Wearden
* University of Manchester, UK, Email: firstname.lastname@example.org
Chronic fatigue syndrome receives little attention in the medical curriculum. This study explores UK medical students' knowledge of and attitudes towards chronic fatigue syndrome.
Semi-structured interviews (average length 22 minutes) were conducted with 21 participants (7 females and 14 males) in years 3 (n=4), 4 (n=11) and 5 (n=6) of their studies. Inductive thematic analysis taking a realist perspective produced three themes: limited knowledge, influences on attitudes and training needs.
Students acquired their knowledge and attitudes largely from informal sources and expressed difficulty understanding chronic fatigue syndrome within a traditional biomedical framework. Incorporating teaching about chronic fatigue syndrome into the medical curriculum within the context of a biopsychosocial understanding of illness could encourage more positive attitudes towards chronic fatigue syndrome.
The ME Association has a close, campaigning interest in the education of the next generation of UK doctors. Here's a snippet on the subject taken from the summary of the last meeting of our Board of Trustees on 16 September 2013:
At the December 2012 meeting, BS and NS led a discussion on how the subject of ME/CFS was covered (or not covered) in both ward-based education and lecture material at UK medical schools. It was agreed that NS would take this forward by initially talking to some medical schools about what (if anything) they teach medical students about ME/CFS. A more comprehensive survey of the situation may then follow with the aim of producing a report that can be submitted to the APPG on ME.
NS updated trustees on progress at the April meeting. As part of an ongoing project with a local charity, Integrated Neurological Services, students from St George's Medical School and the Richmond and Kingston ME Group, she and others from the group have been raising awareness with medical students about the experience of people with ME and their carers. Following the encouragement of some of the students she has approached St George's directly about the possibility of facilitating ME awareness training as part of the curriculum. The next step is for a presentation outline to be prepared for their consideration.
NS agreed to follow up a decision to send copies of the new MEA purple booklet to Clinical Deans at all UK Medical Schools. NS reported that she now had contact details for clinical leads in all but 2 UK medical schools. Two copies of the MEA purple booklet will now be sent to all UK medical schools, plus a covering letter, along with an offer to supply further copies.