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Norepinephrine and epinephrine responses to physiological and pharmacological stimulation in chronic fatigue syndrome

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By J. Strahler et al. • • July 28, 2013

By J. Strahler et al.


Chronic fatigue syndrome (CFS) is characterized by fatigue lasting 6 months or longer. CFS has been associated with a disturbed (re-)activity of the autonomic nervous system. However, the sympathetic adrenomedulla (SAM) remains under-examined in CFS.

To investigate SAM reactivity, we implemented a submaximal cycle ergometry (ERGO) and a pharmacological test (Insulin Tolerance Test, ITT) in 21 CFS patients and 20 age-, sex-, and BMI-matched controls. Plasma norepinephrine and epinephrine were collected once before and twice after the tests (+10/+20, and +30min).

Lower baseline levels and attenuated responses of epinephrine to the ERGO were found in CFS patients compared to controls, while the groups did not differ in their responses to the ITT.

To conclude, we found evidence of altered sympathetic-neural and SAM reactivity in CFS. Exercise stress revealed a subtle catecholaminergic hyporeactivity in CFS patients. It is conceivable that inadequate catecholaminergic responses to physical exertion might contribute to CFS symptoms.

Source: Biol Psychol. 2013 Jun 13;94(1):160-166. doi: 10.1016/j.biopsycho.2013.06.002. [Epub ahead of print], Strahler J, Fischer S, Nater UM, Ehlert U, Gaab J. Clinical Biopsychology, Department of Psychology, University of Marburg, Gutenbergstrasse 18, 35032 Marburg, Germany. Electronic address:

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