The CSF/FM Center at the University of Medicine and Dentistry in Newark, New Jersey is one of the only nationallyfunded programs researching the causes, diagnosis and treatment of these chronic illnesses. Headed by one of the most published researchers of CFS, Benjamin H. Natelson, a neurologist and professor of Neurosciences, the NIH funded center takes a multidisciplinary approach to its research.
The diversity of the Center’s research projects is reflected in the varied medical specialties involved: neuroendocrinology, immunology, pulmonology, cardiovascular behavioral medicine, neuropsychology, exercise physiology, and muscle physiology.
The center describes its constellation of projects like “pieces of a mosaic [that] will fill certain gaps [in previous research], and together will provide a coherent picture of what might be wrong” with patients. Then this “coherent picture” will include information about specific biological mechanisms responsible for the symptoms of CFS and FM.
Multiple causes likely
The New Jersey researchers feel that multiple causes are most likely, and that this information could lead to diagnostic tools to break down the current CFS community into subgroups according to their actual medical problems. With more precise diagnosis in place, the subgroups can then receive much more effective treatment, hopefully targeting not just symptomatic manifestations, but the actual causes of the ailments.
Patients are divided into two subgroups according to symptom concentration: neurological or cardiovascular. Current research is primarily focused in these two areas. Additional research focuses on immune function, muscular and bioenergetic systems, or hormonal systems as the possible pathogenesis of CFS.
Neurological studies presently underway for CFS involve testing 1) brain blood flow, 2) immune function as revealed in cerebrospinal fluid, 3) cognitive performance as it relates to motor learning and 4) brain sites involved with auditory stimuli. Another study relating to the nervous system seeks to determine where pain originates in the brains of those with FM.
The cardiovascular study will test the hypothesis that patients with CFS have an unusually low blood flow in their brains that could account for their illness. Those conducting the actual test do not know which of the participants are CFS patients or healthy controls. To gauge blood flow, measurements are taken by a CAT (computerized tomography) scan before and after participants breathe a small amount of a harmless gas called xenon, otherwise knows as laughing gas. (The gas causes a euphoric giddy state that passes very quickly.)
Immune deficiencies examined
Another study underway at the center involves lumbar puncture, in which spinal fluid is retrieved to test for immunological abnormalities. While there has been much talk and investigation into the possibility that CFS is a type of immune system disorder, Natelson and his colleagues have not seen evidence for this from blood samples of the CFS population generally.
A 1999 study by the center examined CFS patients in an induced exhaustive state and compared them against sedentary controls. The result did not find abnormal immune response as tested from the CFS participants’ blood.
Another study was conducted at the center published in 1998, which examined the immune status of patients with either CFS, major depression, or multiple sclerosis. It did not reveal immune dysfunction or activation in the blood samples taken from the CFS patients. However, the doctors involved felt that these findings did not rule out the possibility of an immune dysfunction stemming from the brain. Consequently, the NJ CFS/FM center researchers are testing the cerebrospinal fluid of CFS patients for such neurologically involved immune abnormalities.
Center receives nearly $2 million for research
Numerous pilot studies and clinical trials are part of the research activity in progress at the Center. Nearly $900,000 in 1999 alone was dedicated to this facility, which was designated by the NIH in 1991 as a CFS Cooperative Research Center.
Indicating that this funding will continue, the NIH announced at the end of 1999 that it had granted 4 year awards. The first year total was $1.9 million, which went to the New Jersey CFS/FM Center and two other CFS Cooperative Research Centers operating out of Seattle’s University of Washington and the University of Miami in Florida.
Natelson is the director of New Jersey’s CFS/FM center as well as the affiliated Gulf War Research Center based out of the Veterans Affairs Hospital in East Orange, New Jersey. He is the author scores of scientific papers and the 1998 book, Facing and Fighting Fatigue: A Practical Approach.
As part of the facility’s research, careful attention is given to the comfort of participants so that patient symptoms are not unnecessarily exacerbated. Precautions are taken to prevent the headaches that sometimes can occur after a lumbar puncture spinal tap. If participants come from a distance, complimentary accommodations are available at a nearby hotel. Compensation, which varies according to the particular study, is also provided for the time and travel involved. Another benefit for approved participants is the free physical examination and lab tests.
More patients and healthy controls are needed to complete current studies underway at the center. Potential participants are encouraged to call the center at (973)676-7063.