Chronic Fatigue Syndrome Clinical Trial
Official title:
Exertional Exhaustion in Chronic Fatigue Syndrome
Post-exertional malaise was modeled by having Chronic Fatigue Syndrome (CFS) and sedentary control subjects perform submaximal exercise on 2 consecutive days with objective changes in brain function measured by magnetic resonance imaging (MRI) during cognitive tests before and after the 2 exercise sessions.
Chronic Fatigue Syndrome (CFS) and sedentary control subjects answered on-line advertisements
and word-of-mouth communications. Candidates gave verbal informed consent to discuss their
medical history during a telephone interview. If the met inclusion and exclusion criteria,
they were assigned an log-in code and password to complete an extensive on-line
questionnaire, and were scheduled for the 3 day in-patient study.
On the Screening Day subjects completed written informed consent, history and physical,
screening blood work, mental status exam, heart rate variability for orthostasis, and
dolorimetry for systemic hyperalgesia.
On Exercise Day 1, subjects had magnetic resonance imaging (MRI) for structure (MPRAGE),
white matter integrity (diffusion tensor imaging, DTI), and blood oxygenation level dependent
(BOLD) analysis during working memory tasks. The tasks were the simple stimulus-response
0-back "see a letter, push a button" task, and the difficult continuous 2-back task "see a
string of letters, remember the letters in order, press the button for the letter seen 2
previously ("2-back)".
The submaximal exercise test was performed in identical fashion on day 1 and day 2. Subjects
rested on a bicycle ergometer for 5 minutes for baseline cardiopulmonary (VO2) measurements.
They began pedalling with resistance increased in step wise fashion until their heart rate
reached 70% of predicted maximum heart rate (pHR = 220 - age). They pedaled 25 minutes at 70%
or until they felt they had their personal maximum effort (e.g. Borg Exertional Scale 19/20).
If they reached 25 minutes, then resistance was increased until they reached 85% of pHR.
Continuous EKG, symptoms and VO2 were followed from rest until 5 minutes after peak exercise.
Heart rate variability and symptoms were assessed during recumbent and standing posture to
assess orthostatic intolerance.
On Exercise Day 2, the same methods were used, but the order was reversed with the submaximal
exercise test first, followed by the identical MRI protocol.
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