Chronic Fatigue Syndrome (CFS): A disorder of central cholinergic transmission

MCM: studied effect of pyridostigmine on growth hormone secretion in
12 CFS (CDC 1994) and 16 controls. Normally, pyridostigmine
(a cholinesterase inhibitor) increases CNS acetycholine, which
increases the inhibition of somatostatin-releasing neurons,
which increases GH secretion from the somatotrophs. There
were no sign differences in baseline GH but stimulated GH in
CFS was significantly higher (17.07 vs. 6.84, p<0.002).
Similar response seen in 10 pts with chronic exposure to
organophosphates and neurobehavioral syndrome.

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