Determining
the Prevalence of Autonomic Dysfunction Update number 3 |
Symptoms of Autonomic Dysfunction in Many thanks to those who have helped us complete questionnaires
examining the role of symptoms of autonomic nervous system dysfunction
in CFS/ME. The results from these questionnaires alone have been very
useful to us and are to be published soon in a prestigious medical journal.
The tilt test studies are on-going at the RVI and further studies examining
pulse waves are about to start at the Freeman Hospital. Some people have
now also been invited back after the tilt tests to participate in muscle
MR studies at the new MR centre on the Newcastle General site. All these
studies are extremely exciting and providing really important understanding
of the biological processes that underlie Participants: 70 CFS/ME patients meeting Fukuda diagnostic criteria, 77 community controls and 60 patients with the autoimmune cholestatic liver disease primary biliary cirrhosis (PBC). 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 cohorts
Phase 1 (Derivation phase) 40 CFS/ME patients and Results: Symptoms of autonomic dysfunction were strongly
& reproducibly associated with the presence of CFS/ME or PBC and correlated
with severity of fatigue. Total COMPASS score was identified in phase
1 as a diagnostic criterion for CFS/ME 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 Conclusion: Autonomic dysfunction is strongly
associated with fatigue in some, but not all, CFS/ME and PBC patients.
We have postulated the existence of a “cross-cutting” aetiological
process of Dysautonomia-Associated Fatigue (DAF). COMPASS score is a valid
diagnostic criterion for DAF and can be used to identify etiologically
distinct subject groups for intervention studies. Dr Julia Newton |