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Published in: BMC Musculoskeletal Disorders 1/2021

Open Access 01-12-2021 | Physical Therapy | Research article

Possible involvement of the autonomic nervous system in cervical muscles of patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS)

Authors: Takayoshi Matsui, Kazuhiro Hara, Makoto Iwata, Shuntaro Hojo, Nobuyuki Shitara, Yuzo Endo, Hideoki Fukuoka, Masaki Matsui, Hiroshi Kawaguchi

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

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Abstract

Background

Patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) sometimes present with stiffness of the cervical muscles. To investigate the pathophysiology of ME/CFS, this observational study compared patients with versus without recovery from ME/CFS through local modulation of the cervical muscles.

Methods

Over a period of 11 years, a total of 1226 inpatients with ME/CFS who did not respond to outpatient care were enrolled in this study. All patients received daily cervical muscle physical therapy during hospitalization. Self-rated records documenting the presence or absence of ME/CFS, as well as the representative eight symptoms that frequently accompany it at admission and discharge, were compared. Pupil diameter was also measured to examine autonomic nervous system function involvement.

Results

The recovery rate of ME/CFS after local therapy was 55.5%, and did not differ significantly by sex, age strata, and hospitalization period. The recovery rates of the eight symptoms were variable (36.6–86.9%); however, those of ME/CFS in the symptom subpopulations were similar (52.3–55.8%). The recovery rates of all symptoms showed strong associations with that of ME/CFS (p < 0.001). The pupil diameter was more constricted in the ME/CFS-recovered patients than in the ME/CFS-unrecovered patients in the total population and the subpopulations stratified by sex, age, and hospitalization period.

Conclusions

There was a strong association between the recovery of ME/CFS and other related whole-body symptoms. The recovery of ME/CFS may be partly linked to amelioration of the autonomic nervous system in the cervical muscles.

Trial registration

UMIN000036634. Registered 1 May 2019 - Retrospectively registered.
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Metadata
Title
Possible involvement of the autonomic nervous system in cervical muscles of patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS)
Authors
Takayoshi Matsui
Kazuhiro Hara
Makoto Iwata
Shuntaro Hojo
Nobuyuki Shitara
Yuzo Endo
Hideoki Fukuoka
Masaki Matsui
Hiroshi Kawaguchi
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-021-04293-7

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