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Psychiatry Investig. 2019 Jan;16(1):71-79. doi: 10.30773/pi.2018.10.26. Epub 2019 Jan 7.

Multidimensional Comparison of Cancer-Related Fatigue and Chronic Fatigue Syndrome: The Role of Psychophysiological Markers.

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Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Psychiatry, Konkuk University Medical Center, Seoul, Republic of Korea.
Department of Psychiatry, Dong-A University Hospital, Busan, Republic of Korea.
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.



The present study compared cancer-related fatigue (CRF) and chronic fatigue syndrome (CFS) using multidimensional measurements with the aim of better understanding characteristics and exploring markers of two similar fatigue syndromes.


Twenty-five patients with CRF and twenty patients with CFS completed questionnaires, including the Fatigue Severity Scale (FSS), Hospital Anxiety Depression Scale (HADS), Perceived Stress Scale (PSS), and Pittsburgh Sleep Quality Index (PSQI). Additionally, levels of high sensitivity C-reactive protein (hs-CRP), heart rate variability (HRV), and electroencephalography (EEG) were obtained. Neurocognitive functioning was also evaluated.


Both groups showed comparable levels of psychological variables, including fatigue. Compared to CFS subjects, CRF patients had significantly higher hs-CRP levels and a reduced HRV-index. The within-group analyses revealed that the FSS score of the CRF group was significantly related to scores on the HADS-anxiety, HADS-depression, and PSQI scales. In the CFS group, FSS scores were significantly associated with scores on the PSS and the absolute delta, theta, and alpha powers in frontal EEG.


Findings indicate that different pathophysiological mechanisms underlie CFS and CRF. Inflammatory marker and HRV may be potential biomarkers for distinguishing two fatigue syndromes and frontal EEG parameters may be quantitative biomarkers for CFS.


Biomarkers; Cancer; Electrocardiography; Electroencephalography; Fatigue

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