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Abnormal thermoregulatory responses in adolescents with Chronic Fatigue Syndrome: Relation to clinical symptoms

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By VB Wyller, et al. • • July 11, 2007

[Note: Thermoregulatory response is the body's response to external temperature changes so as to maintain a constant internal temperature. It involves secretion of neurotransmitters controlled by the sympathetic nervous system - the part of the autonomic nervous system that becomes more active in response to stress.]

Journal: Pediatrics. 2007 Jul;120(1):e129-37.

Authors and affiliations: Wyller VB, Godang K, Mørkrid L, Saul JP, Thaulow E, Walløe L. Department of Pediatrics, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway. [E-mail: ]

PMID: 17606539

Objectives: Chronic Fatigue Syndrome is a common and disabling disease of unknown etiology

Accumulating evidence indicates dysfunction of the autonomic nervous system. To further explore the pathophysiology of Chronic Fatigue Syndrome, we investigated thermoregulatory responses dependent on catecholaminergic effector systems in adolescent patients with Chronic Fatigue Syndrome.

Patients and methods. A consecutive sample of 15 patients with Chronic Fatigue Syndrome aged 12 to 18 years and a volunteer sample of 57 healthy control subjects of equal gender and age distribution were included. Plasma catecholamines and metanephrines were measured before and after strong cooling of 1 hand.

Acral skin blood flow, tympanic temperature, heart rate, and mean blood pressure were measured during moderate cooling of 1 hand. In addition, clinical symptoms indicative of thermoregulatory disturbances were recorded

Results. Patients with Chronic Fatigue Syndrome reported significantly more shivering, sweating, sudden change of skin color, and feeling unusually warm. At baseline, patients with Chronic Fatigue Syndrome had higher levels of norepinephrine, heart rate, epinephrine, and tympanic temperature than control subjects.

During cooling of 1 hand, acral skin blood flow was less reduced, vasoconstrictor events occurred at lower temperatures, and tympanic temperature decreased more in patients with Chronic Fatigue Syndrome compared with control subjects.

Catecholamines increased and metanephrines decreased similarly in the 2 groups.

Conclusions. Adolescent patients with Chronic Fatigue Syndrome have abnormal catecholaminergic-dependent thermoregulatory responses both at rest and during local skin cooling, supporting a hypothesis of sympathetic dysfunction and possibly explaining important clinical symptoms.

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