Een studie van Maes, Johnson en Twisk bevestigt dat "chronische vermoeidheid" (CV),

CVS en ME (kenmerk: post-exertional malaise) drie verschillende diagnoses zijn,

en toont aan dat post-exertional malaise sterk gerelateerd is aan

kognitieve klachten en het subjektieve gevoel van infektie, en

dat ME, CVS en CV niet allen op basis van symptomen, maar ook op basis van

markers van inflammatie (IL-1α/IL-1β, TNFα en neopterine) onderscheiden kunnen worden.

De studie bevestigt het belang van de nieuwe ME-kriteria en het onderscheid ME vs. CVS.

Het zou goed zijn als de studie op basis van een objektieve maatstaf voor post-exertional malaise (dubbele fietstest), i.p.v. zelfrapportage zoals in deze studie, herhaald zou worden.

Myalgic Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS), and Chronic Fatigue (CF) are distinguished accurately: Results of supervised learning techniques applied on clinical and inflammatory data.

Psychiatry Res. 21 April 2012. doi: 10.1016/j.psychres.2012.03.031

Maes M., Twisk, F.N.M., Johnson, C.

Received 18 November 2011.

Accepted 17 March 2012.

Available online 21 April 2012.

There is much debate on the diagnostic classification of

Myalgic Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS) and chronic fatigue (CF).

Post-exertional malaise (PEM) is stressed as a key feature.

This study examines

whether CF and CFS, with and without PEM, are distinct diagnostic categories.

Fukuda's criteria were used to diagnose

144 patients with chronic fatigue and identify patients with CFS and CF,

i.e. those not fulfilling the Fukuda's criteria.

PEM was rated by means of a scale with defined scale steps between 0 and 6.

CFS patients were divided into

those with PEM lasting more than 24 h (labeled: ME) and

without PEM (labeled: CFS).

The 12-item Fibromyalgia and Chronic Fatigue Syndrome (FF) Rating Scale

was used to measure severity of illness.

Plasma interleukin-1 (IL-1), tumor necrosis factor (TNF)α, and lysozyme, and serum neopterin

were employed as external validating criteria.

Using fatigue, a subjective feeling of infection and PEM

we found that ME, CFS, and CF were distinct categories.

Patients with ME had

significantly higher scores on concentration difficulties and

a subjective experience of infection, and

higher levels of

IL-1, TNFα, and neopterin

than patients with CFS.

These biomarkers were significantly higher in ME and CFS than in CF patients.

PEM loaded highly on the first two factors subtracted from the data set,

i.e. "malaise-sickness" and "malaise-hyperalgesia".

Fukuda's criteria are adequate to make a distinction between ME/CFS and CF,

but ME/CFS patients should be subdivided into ME (with PEM) and CFS (without PEM).

Keywords

Chronic fatigue syndrome; Inflammation; Diagnosis; Criteria; Post-exertional malaise

http://www.sciencedirect.com/science/article/pii/S0165178112001400