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Heterogeneity in Chronic Fatigue Syndrome (CFS): evidence from magnetic resonance spectroscopy of muscle

  [ 42 votes ]   [ Discuss This Article ]
By Lane RJ, Barrett MC, Taylor DJ, Kemp GJ, Lodi R • • May 6, 1998

It has been shown previously that some patients with chronic
fatigue syndrome show an abnormal increase in plasma lactate
following a short period of moderate exercise, in the
sub-anaerobic threshold exercise test (SATET). This cannot be
explained satisfactorily by the effects of 'inactivity' or
'deconditioning', and patients with abnormal lactate responses
to exercise (SATET +ve) have been found to have significantly
fewer Type 1 muscle fibres in quadriceps biopsies than SATET
-ve patients. We performed phosphorus magnetic resonance
spectroscopy on forearm muscles of 10 SATET +ve patients, 9
SATET -ve patients and 13 sedentary volunteers. There were no
differences in resting spectra between these groups but at the
end of exercise, intracellular pH in the SATET +ve patients
was significantly lower than in both the SATET - ve cases and
controls (P < 0.03), and the SATET +ve patients also showed a
significantly lower ATP synthesis rate during recovery (P <
0.01), indicating impaired mitochondrial oxidative
phosphorylation. These observations support other evidence
which indicates that chronic fatigue syndrome is a
heterogeneous disorder, and confirms the view that some
chronic fatigue syndrome patients have a peripheral component
to their fatigue.

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