Metabolic and Neurocognitive Responses to an Exercise Challenge In Chronic Fatigue Syndrome (CFS)

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[Note: See also related abstract "Post-exertional Symptomology in Chronic Fatigue Syndrome."]

Journal: Medicine & Science in Sports & Exercise: Volume 39(5) Supplement, May 2007, p S445

Authors and affiliation: VanNess, J. Mark; Snell, Christopher R.; Stevens, Staci R.; Stiles, Travis L. University of the Pacific, Stockton, California. [E-mail: ] Supported by the CFIDS Association of America.

A comprehensive view of CFS patients during conditions of post-exertional malaise can provide an integrated perspective on the pathophysiology of the illness.

Purpose: To compare the metabolic responses and neurocognitive consequences of a maximal exercise challenge between CFS and control subjects.

Methods: Twenty (n=20) women with CFS and twenty (n=20) sedentary control subjects performed a graded exercise test to maximal exertion.

Cardiopulmonary analysis was performed during the exercise test.

Blood samples for plasma lactate and glucose were collected before and after the test.

Nasal acoustic rhinometry (NAR) was used to measure nasal cross-sectional area and volume on both nostrils before and after the exercise test.

Neurocognitive function was measured before and after the exercise test using the CalCap computer program.

Results: Multivariate analysis of cardiopulmonary variables found a significant difference between groups; Wilks' ? = 0.053, F = 6.393 (7, 20), p>0.01.

Follow-up univariate tests with alpha levels adjusted to account for inflation of the error term indicated that CFS patients scored significantly lower on measures of peak workload (116±19 vs. 176±26 Watts), peak ventilation (70±22 vs. 102±16 L), peak VO2 (23.4±6.4 vs. 32.0±4.5 ml/kg/min), and VO2 and workload at anaerobic threshold (9.7±2.3 vs. 17.3±3.9ml/kg/min and 42±12 vs. 75±21 Watts respectively).

For the CalCap, a group by test (2X3) factorial MANOVA with dependent variables; simple reaction time (SRT) and three levels of choice reaction time (CRT), produced a significant main effect for group; Wilks Lambda = 0.85, F=4.76 (4, 105), p=0.001.

Follow up discriminant function analysis indicated that the CRT measures were more important in differentiating CFS than was SRT. The CFS group was slower on all measures.

Conclusion: These results indicate that exercise performance and neurocognitive abnormalities exist in CFS. The lack of any significant differences in lactate, glucose or nasal rhinometry precludes clear explanation for these differences.

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3 thoughts on “Metabolic and Neurocognitive Responses to an Exercise Challenge In Chronic Fatigue Syndrome (CFS)”

  1. dchartier says:

    I was diagnosed 41/2 years ago with Fibro than it transformed into CFIDS with CEB. The first year of testing showed no Mono. After I couldn’t get out of my seat one day I went home from work and realized that something was very wrong. More so then I had already suffered. In the meanwhile I was sent to a specialist that tested me for numerous things. The finality of that test indicated that I had chronic epstein barr, thyroid disease, adrenal exhaustion, and IBS. I still suffer from all of these to this day. I do work out between my flareups/relapses and that consists of an hour of cardio and weight lifting 4 times a week. I have been told that would not be possible with this diagnosis.
    I function better when I am working out and I’m in less pain, however, if something emotionally stressful comes up in my life (and with this disease it’s always something) I can relapse. It also seems like it’s once every 8-12 months. This is where I can barely get out of bed. I was an athlete before this disease and I will continue to do this as long as I can breath. I definitely have memory and congnitive problems as well as just trying to intellectualise something.
    My point here is I am trying to avoid disability as long as possible. I do believe if I wasn’t working out I would be on disability but I don’t recommend it for anyone else who wasn’t active previous to this condition. I was wondering if anyone else has CEB and functions at this level and how they manage it.

    1. Katy47 says:

      I do believe certain people can have CFIDS and still workout intensely. It just depends on the particular manifestation and severity of your case. I’ve been a massage therapist for 7 years with CFS and I specialize in deep tissue massage. However, I’m having a bad relapse at the moment. If I’d had health insurance I might have been able to head this thing off better using ceratin preventive tricks. My lab work is pending but I’d bet several things are off.

      My advice is to trust your intuition regarding your self-care, get thorough lab work, supplement therapy, massage or acupuncture, and sleep deeply even if it means taking Ambien or something. There aren’t any quick fixes, esp. for the emotional stressors, however.


    2. dchartier says:

      I think my case is pretty severe considering I can’t remember too much for a short term memory. My Titers are also high for EBV and Mycoplasma. I can ask the same question 4 times in one day. (It can get really embarrassing ) I thought I had read all the books out there on the market until I saw this particular book by Burrrrton Goldberg and Larry Trivieri, Jr called Chronic fatigue, Fibromyalgia and Lyme disease. They state they have actally “cured” people with Chronic EBV. I think they are full of Sh–!

      I have tried all the alternative methods along with the conventiional. I was paying more and more for supplements every time I went to the doctor. It was unreal…it ended up being around $4oo.oo per month. It didn’t cure Shi–! So… I have no idea where these supposed people are that they have completely cured. I was told by one of my docs that once you have the antibodies for “just recently” and “now” on the Epstein Barr there is nothing you can do except manage the disease.

      I take a lot of pain meds to get through the flu like feeling everyday. If I didn’t have the meds there is no way I could work. As it stands today…I had to bring in an FMLA form to continue working. It’s a battle to get out of bed and we also have a meditation room where I can go to sleep at lunch. THis is probably my 10th job since my diagnosis. It’s also the longest I have been able to keep a job but they are really getting impossible to deal with and I think they are looking to fire me.

      I am currently labled as severly disabled after having an FCE done at Vocational Rehabilitation. I don’t know what I can ask for as I have lost almost all the assets I own. I don’t even have a home phone which is scarey. Does anyone know what they can help you with at Voc Rehab?

      My car is falling apart and I can’ t afford to pay for any maintenance on it. I am eventually going to file bankruptcy considering I have so much debt now and make 1/3 the salary I previously made. I live by myself and I did have a dog that was signed off as a companion dog and she was hit by a car just recently. She passed on Labor Day. It was a horrible time for me.

      I just don’t know where to go from here. I am consistenly itchy which drives me crazy. I hate it and I am real close to just giving up.

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