Sensory characterization of somatic parietal tissues in humans with Chronic Fatigue Syndrome (CFS)

Patients with chronic fatigue syndrome (CFS) mainly complain
of symptoms in the musculoskeletal domain (myalgias, fatigue).

In 21 CFS patients the deep (muscle) versus superficial
(skin, subcutis) sensitivity to pain was explored by
measuring pain thresholds to electrical stimulation
unilaterally in the deltoid, trapezius and quadriceps and
overlying skin and subcutis in comparison with normal
subjects. Thresholds in patients were normal in skin and
subcutis but significantly lower than normal(hyperalgesia)
in muscles (P < 0.001) in all sites. The selective muscle
hypersensitivity corresponded also to fiber abnormalities at
musclebiopsy (quadriceps) performed in nine patients which
were absent in normal subjects (four cases): morphostructural
alterations of the sarchomere, fatty degeneration and fibrous
regeneration, inversion of the cytochrome oxidase/succinate
dehydrogenase ratio, pleio/polymorphism andmonstruosity of
mitochondria, reduction of some mitochondrial enzymatic
activities and increments of common deletion of 4977 bp of
mitochondrial DNA 150-3000 times the normal values. By
showing both sensory (diffuse hyperalgesia) and anatomical
(degenerative picture) changes at muscle level, the results
suggest a role played by peripberal mechanisms in the genesis
of CFS symptoms. They would exclude the heightened perception
of physiological signals from all districts hypothesized by
some authors,especially as the hyperalgesia is absent in

Vecchiet L, Montanari G, Pizzigallo E, Iezzi S, de Bigontina P,
Dragani L, Vecchiet J, Giamberardino MA

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