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Determining the Prevalence of Autonomic Dysfunction Update number 3 |
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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 |