Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BioPsychoSocial Medicine
Published in: BioPsychoSocial Medicine 1/2014

Open Access 01-12-2014 | Research

Orthostatic responses in adolescent chronic fatigue syndrome: contributions from expectancies as well as gravity

Authors: Vegard Bruun Wyller, Even Fagermoen, Dag Sulheim, Anette Winger, Eva Skovlund, Jerome Philip Saul

Published in: BioPsychoSocial Medicine | Issue 1/2014

Login to get access

Abstract

Background

Orthostatic intolerance is common in chronic fatigue syndrome (CFS), and several studies have documented an abnormal sympathetic predominance in the autonomic cardiovascular response to gravitational stimuli. The aim of this study was to explore whether the expectancies towards standing are contributors to autonomic responses in addition to the gravitational stimulus itself.

Methods

A total of 30 CFS patients (12–18 years of age) and 39 healthy controls underwent 20° head-up tilt test and a motor imagery protocol of standing upright. Beat-to-beat cardiovascular variables were recorded.

Results

At supine rest, CFS patients had significantly higher heart rate, diastolic blood pressure, and mean arterial blood pressure, and lower stroke index and heart rate variability (HRV) indices. The response to 20° head-up tilt was identical in the two groups. The response to imaginary upright position was characterized by a stronger increase of HRV indices of sympathetic predominance (power in the low-frequency range as well as the ratio low-frequency: high-frequency power) among CFS patients.

Conclusions

These results suggest that in CFS patients expectancies towards orthostatic challenge might be additional determinants of autonomic cardiovascular modulation along with the gravitational stimulus per se.
Appendix
Available only for authorised users
Literature
1.
Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A: The chronic fatigue syndrome: a comprehensive approach to its definition and study. Ann Int Med. 1994, 121: 953-959. 10.7326/0003-4819-121-12-199412150-00009.CrossRefPubMed
2.
Royal College of Paediatrics and Child Health: Evidence based guidelines for the management of CFS/ME (chronic fatigue syndrome/myalgic encephalopathy) in children and young adults. 2004, London: Royal College of Paediatrics and Child Health
3.
Kennedy G, Underwood C, Belch JJ: Physical and functional impact of chronic fatigue syndrome/myalgic encephalomyelitis in childhood. Pediatrics. 2010, 125: e1324-e1330. 10.1542/peds.2009-2644.CrossRefPubMed
4.
Missen A, Hollingwort W, Eaton N, Crawley E: The financial and psychological impacts on mothers of children with chronic fatigue syndrome (CFS/ME). Child Care Health Dev. 2012, 38: 505-512. 10.1111/j.1365-2214.2011.01298.x.CrossRefPubMed
5.
Jones JF, Nisenbaum R, Solomon L, Reyes M, Reeves WC: Chronic fatigue syndrome and other fatiguing illnesses in adolescents: a population-based study. J Adolesc Health. 2004, 35: 34-40. 10.1016/j.jadohealth.2003.09.007.CrossRefPubMed
6.
Nijhof SL, Maijer K, Bleijenberg G, Uiterwaal CS, Kimpen JL, van der Putte EM: Adolescent chronic fatigue syndrome: prevalence, incidence, and morbidity. Pediatrics. 2011, 127: e1169-e1175. 10.1542/peds.2010-1147.CrossRefPubMed
7.
Wyller VB, Saul JP, Walløe L, Thaulow E: Sympathetic cardiovascular control during orthostatic stress and isometric exercise in adolescent chronic fatigue syndrome. Eur J Appl Physiol. 2008, 102: 623-632. 10.1007/s00421-007-0634-1.CrossRefPubMed
8.
Rowe PC, Bou-Holaigah I, Kan JS, Calkins H: Is neutrally mediated hypotension an unrecognised cause of chronic fatigue?. Lancet. 1995, 345: 623-624. 10.1016/S0140-6736(95)90525-1.CrossRefPubMed
9.
Wyller VB, Barbieri R, Thaulow E, Saul JP: Enhanced vagal withdrawal during mild orthostatic stress in adolescents with chronic fatigue. Ann Noninvasive Electrocardiol. 2008, 13: 67-73. 10.1111/j.1542-474X.2007.00202.x.CrossRefPubMed
10.
Wyller VB, Due R, Saul JP, Amlie JP, Thaulow E: Usefulness of an abnormal cardiovascular response during low-grade head-up tilt-test for discriminating adolescents with chronic fatigue from healthy controls. Am J Cardiol. 2007, 99: 997-1001. 10.1016/j.amjcard.2006.10.067.CrossRefPubMed
11.
Wyller VB, Barbieri R, Saul P: Blood pressure variability and closed-loop baroreflex assessment in adolescent chronic fatigue syndrome during supine rest and orthostatic stress. Eur J Appl Physiol. 2011, 111: 497-502. 10.1007/s00421-010-1670-9.PubMedCentralCrossRefPubMed
12.
13.
Pervanidou P, Chrousos GP: Neuroendocrinology of post-traumatic stress disorder. Prog Brain Res. 2010, 182: 149-160.CrossRefPubMed
14.
Malloney EM, Boneva R, Nater UM, Reeves WC: Chronic fatigue syndrome and high allostatic load: results from a population-based case–control study in Georgia. Psychosom Med. 2009, 71: 549-556. 10.1097/PSY.0b013e3181a4fea8.CrossRef
15.
Goldstein DS: The autonomic nervous system in health and disease. 2001, New York: Marcel Dekker
16.
McEwen B: Protective and damaging effects of stress mediators: central role of the brain. Dialogues Clin Neurosci. 2006, 8: 283-297.
17.
Ursin H, Eriksen HR: Sensitization, subjective health complaints, and sustained arousal. Ann N Y Acad Sci. 2001, 993: 119-129.
18.
National Institute for Health and Clinical Excellence: Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy). Diagnosis and management of CFS/ME in adults and children. 2007, London: NICE clinical guideline, 53:
19.
Sulheim D, Fagermoen E, Winger A, Andersen AM, Godang K, Müller F, Rowe PC, Saul JP, Skovlund E, Oie MG, Wyller VB: Disease mechanisms and clonidine treatment in adolescent chronic fatigue syndrome: a combined cross-sectional and randomized clinical trial. JAMA Pediatr. 2014, 168: 351-360. 10.1001/jamapediatrics.2013.4647.CrossRefPubMed
20.
Demougeut L, Normand H, Denise P, Papaxanthis C: Discrete and effortful imagined movements do not specifically activate the autonomic nervous system. PLoS One. 2009, 4: e6769-10.1371/journal.pone.0006769.CrossRef
21.
Fortin J, Habenbacher W, Heller A, Hacker A, Grüllenberger R, Innerhover J, Passath H, Wagner C, Haitchi G, Flotzinger D, Pacher R, Wach P: Non-invasive beat-to-beat cardiac output monitoring by an improved method of transthoracic bioimpedance measurement. Comput Biol Med. 2006, 36: 1185-1203. 10.1016/j.compbiomed.2005.06.001.CrossRefPubMed
22.
Fortin J, Habenbacher W, Gruellenberger R, Wach P, Skrabal F: Real-time monitor forhemodynamic beat-to-beat parameteres and power spectra analysis of the biosignals. Conf Proc IEEE Eng Med Biol Soc. 1998, 20: 360-363.
23.
Suarez GA, Opfer-Gehrking TL, Offord KP, Atkinson EK, O’Brien PC, Low PA: The autonomic symptom profile: a new instrument to assess autonomic symptoms. Neurology. 1999, 52: 523-528. 10.1212/WNL.52.3.523.CrossRefPubMed
24.
Wyller VB, Saul JP, Amlie JP, Thaulow E: Sympathetic predominance of cardiovascular regulation during mild orthostatic stress in adolescent chronic fatigue syndrome. Clin Physiol Funct Imaging. 2007, 27: 231-238. 10.1111/j.1475-097X.2007.00743.x.CrossRefPubMed
25.
Peckerman A, LaManca JJ, Dahl KA, Chemitiganti R, Qureishi B, Natelson B: Abnormal impedance cardiography predicts symptom severity in chronic fatigue syndrome. Am J Med Sci. 2003, 326: 55-60. 10.1097/00000441-200308000-00001.CrossRefPubMed
26.
Elstad M, Toska K, Chon KH, Raeder EA, Cohen RJ: Respiratory sinus arrhythmia:opposite effects on systolic and mean arterial pressure in supine humans. J Physiol. 2001, 536: 251-259. 10.1111/j.1469-7793.2001.t01-1-00251.x.PubMedCentralCrossRefPubMed
27.
Grassi G, Serevalle G, Calhoun DA, Mancia G: Physical training and baroreceptor control of sympathetic nerve activity in humans. Hypertension. 1994, 23: 294-301. 10.1161/01.HYP.23.3.294.CrossRefPubMed
28.
O’Sullivan SE, Bell C: The effects of exercise training on human cardiovascular reflex control. J Auton Nerv Syst. 2000, 81: 16-24. 10.1016/S0165-1838(00)00148-X.CrossRefPubMed
29.
Decety J, Jeannerod M, Germain M, Pastene J: Vegetative response during imagined movement is proportional to mental effort. Behav Brain Res. 1991, 42: 1-5. 10.1016/S0166-4328(05)80033-6.CrossRefPubMed
30.
Saul JP: Beat to beat variations of heart rate reflect modulation of cardiac autonomic outflow. News Physiol Sci. 1990, 5: 32-37.
Metadata
Title
Orthostatic responses in adolescent chronic fatigue syndrome: contributions from expectancies as well as gravity
Authors
Vegard Bruun Wyller
Even Fagermoen
Dag Sulheim
Anette Winger
Eva Skovlund
Jerome Philip Saul
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BioPsychoSocial Medicine / Issue 1/2014
Electronic ISSN: 1751-0759
DOI
https://doi.org/10.1186/1751-0759-8-22

Other articles of this Issue 1/2014

BioPsychoSocial Medicine 1/2014 Go to the issue

Reviewer acknowledge

Reviewer acknowledgement 2013

Short report

Depressive symptoms of female nursing staff working in stressful environments and their association with serum creatine kinase and lactate dehydrogenase – a preliminary study

Research

Development of a novel, short, self-completed questionnaire on empowerment for patients with type 2 diabetes mellitus and an analysis of factors affecting patient empowerment

Research

The outcome of treatment for anorexia nervosa inpatients who required urgent hospitalization

Research

Psychosocial perception of adults with onychomycosis: a blinded, controlled comparison of 1,017 adult Hong Kong residents with or without onychomycosis

Review

Acupuncture therapy: mechanism of action, efficacy, and safety: a potential intervention for psychogenic disorders?