Background and Aims of the Proposed Investigation

Vasovagal syncope is an exaggerated tendency towards the common faint where disordered autonomic nervous system regulation of blood pressure leads to hypotension and subsequent syncope. Patients with vasovagal syncope suffer from fatigue (fig 1: Newton et al., Circulation submitted) and are frequently affected with symptoms consistent with a diagnosis of chronic fatigue syndrome (CFS/ME). This has lead to the hypothesis that vasovagal syncope and CFS/ME share a common biological pathway and that this is likely to be related to autonomic dysfunction.

In recent years, orthostatic (or tilt) training has been described in several small studies as an effective treatment for neurally mediated vasovagal syncope, with a pilot series from our unit confirming not only improvements in blackout symptoms but also autonomic parameters on tilt training in patients with vasovagal syncope.

Considering the high prevalence of autonomic dysfunction in CFS/ME safe, non-invasive interventions that have the potential to improve autonomic nervous system abnormalities have the potential to be treatments in CFS/ME.

We therefore propose the first trial of home orthostatic training (HOT therapy) in patients with CFS/ME, with a comprehensive analysis of factors likely to reflect modulation of the autonomic nervous system.

We are hoping to start this study in the next few months. If you would like more information and have CFS/ME diagnosed within the last 2 years and have been seen in one of the clinical services, then please get in touch and we will be able to send you further information. There are no needles, nothing invasive. Participants will need to visit us at the RVI on 3 occasions but transport can be arranged if necessary.

Many thanks for your continued support of our research.

Julia Newton

[email protected]
0191 2825237