Orthostatic responses in adolescent chronic fatigue syndrome: contributions from expectancies as well as gravity

BioPsychoSocial Medicine

Vegard Bruun Wyller⁶  Even Fagermoen²  Dag Sulheim⁵  Anette Winger³  Eva Skovlund⁴  Jerome Philip Saul¹ 

[1] Department of Pediatrics, Medical University of South Carolina, Charleston, USA

[2] Department of Anesthesiology and Critical Care, Oslo University Hospital, Oslo, Norway

[3] Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway

[4] School of Pharmacy, University of Oslo, Oslo, Norway

[5] Department of Pediatrics, Lillehammer County Hospital, Lillehammer, Norway

[6] Department of Pediatrics, Akershus University Hospital, Nordbyhagen, Norway

关键词: Orthostatic intolerance;    Expectancies;    Chronic fatigue syndrome;    Autonomic nervous system;    Adolescence;   

Others  :  1082316
DOI  :  10.1186/1751-0759-8-22

 received in 2014-04-26, accepted in 2014-09-04,  发布年份 2014

【 摘 要 】

Background

Orthostatic intolerance is common in chronic fatigue syndrome (CFS), and several studies have documented an abnormal sympathetic predominance in the autonomic cardiovascular response to gravitational stimuli. The aim of this study was to explore whether the expectancies towards standing are contributors to autonomic responses in addition to the gravitational stimulus itself.

Methods

A total of 30 CFS patients (12–18 years of age) and 39 healthy controls underwent 20° head-up tilt test and a motor imagery protocol of standing upright. Beat-to-beat cardiovascular variables were recorded.

Results

At supine rest, CFS patients had significantly higher heart rate, diastolic blood pressure, and mean arterial blood pressure, and lower stroke index and heart rate variability (HRV) indices. The response to 20° head-up tilt was identical in the two groups. The response to imaginary upright position was characterized by a stronger increase of HRV indices of sympathetic predominance (power in the low-frequency range as well as the ratio low-frequency: high-frequency power) among CFS patients.

Conclusions

These results suggest that in CFS patients expectancies towards orthostatic challenge might be additional determinants of autonomic cardiovascular modulation along with the gravitational stimulus per se.

【 授权许可】

   
2014 Wyller et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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