Welcome to the 18th Emerge Australia Research Digest, where you will find summaries of some of the latest research and information about ME/CFS, with links to the complete articles.
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The importance of accurate diagnosis of ME/CFS in children and adolescents: a commentary
Authors: Geraghty K, Adeniji C.
This commentary identifies concerns with using broad diagnostic criteria for ME/CFS studies, which can lead to over-inflated and misleading results.
The ‘Fukuda’ criteria for diagnosis is most typically cited, which requires ‘new-onset fatigue lasting at least six months, accompanied by four or more of eight symptoms’. The criteria includes post-exertional malaise (PEM), muscle pain and unrefreshing sleep, among others. UK research often uses the even broader ‘Oxford’ criteria that only requires ‘fatigue which impairs physical and mental function for more than six months’.
The use of broader diagnostic criteria is concerning as it can tend to over-inflate treatment results. In addition to this, patients may be wrongfully offered psycho-behavioural therapies like cognitive behavioural therapy and/or graded exercise, which are based on inappropriate clinical results. The most severe cases of ME/CFS, where sufferers are bed or housebound, are also severely underrepresented when broader diagnostic criteria are used, as they are rarely included in these studies.
The commentary ends by urging researchers to adopt coherent and strict criteria for ME/CFS.
Initiating care of a patient with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
Author: Lapp C.
The paper, published in late January 2019, outlines best practice for primary care physicians of patients with ME/CFS. The author recommends using diagnostic criteria from the Institute of Medicine, Canadian Consensus Criteria, and the 1994 International Diagnostic Criteria. The paper also discusses management techniques, with particular emphasis placed on pacing and resting.
The paper finishes by encouraging physicians to be actively involved in disability advocacy for ME/CFS patients, as well as providing appropriate time and resources to the patient.
Prospective biomarkers from plasma metabolomics of myalgic encephalomyelitis/chronic fatigue syndrome implicate redox imbalance in disease symptomology
Authors: Germain A, Ruppert D, Levine S, Hanson M.
A recent study from the US surveyed 832 metabolites of 32 ME/CFS patients and compared them to ‘healthy’ controls to analyse the metabolic functions of people with ME/CFS.
The results indicate that ME/CFS patients may have low oxygen levels and suffer from oxidative stress. The study found metabolites of anoxia (lack of oxygen) in ME/CFS patients, which occur in states of low oxygenation. This produces oxidative stress, which could further interfere with metabolism and cause oxidative damage to tissues. The authors hypothesise that ‘disturbances in circulation and provision of oxygen to tissues could underlie many symptoms of ME/CFS’.
Overall, this study provides additional evidence that ME/CFS patients experience low oxygen levels, which creates stress on the body and disrupts normal energy production.
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