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QJM. 2007 Aug;100(8):519-26. Epub 2007 Jul 7.

Symptoms of autonomic dysfunction in chronic fatigue syndrome.

Author information

1
Fatigue Interest group and Liver Research Group, Institute for Cellular Medicine, University of Newcastle, Newcastle, UK. julia.newton@nuth.nhs.uk

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 0.86-0.99) and a negative predictive value of 0.84 (0.70-0.93) 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 'cross-cutting' 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.

PMID:
17617647
DOI:
10.1093/qjmed/hcm057
[Indexed for MEDLINE]
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