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A Comprehensive Update of the Current Understanding of Chronic Fatigue Syndrome, 2021, Noor et al

Discussion in 'General ME/CFS news' started by Sly Saint, Sep 21, 2021.

  1. Sly Saint

    Sly Saint Senior Member (Voting Rights)

    This is a comprehensive literature review of chronic fatigue syndrome (CFS). We provide a description of the background, etiology, pathogenesis, diagnosis, and management regarding CFS. CFS is a multifaceted illness that has many symptoms and a wide array of clinical presentations. As of recent, CFS has been merged with myalgic encephalomyelitis (ME).

    Much of the difficulty in its management has stemmed from a lack of a concrete understanding of its etiology and pathogenesis. There is a potential association between dysfunction of the autoimmune, neuroendocrine, or autonomic nervous systems and the development of CFS. Possible triggering events, such as infections followed by an immune dysregulation resulting have also been proposed. In fact, ME/CFS was first described following Epstein Barr virus (EBV) infections, but it was later determined that it was not always preceded by EBV infection.

    Patient diagnosed with CFS have shown a noticeably earlier activation of anaerobic metabolism as a source of energy, which is suggestive of impaired oxygen consumption. The differential diagnoses range from tick-borne illnesses to psychiatric disorders to thyroid gland dysfunction. Given the many overlapping symptoms of CFS with other illnesses makes diagnosing it far from an easy task.

    The Centers for Disease Control and Prevention (CDC) considers it a diagnosing of exclusion, stating that self-reported fatigue for at minimum of six months and four of the following symptoms are necessary for a proper diagnosis: memory problems, sore throat, post-exertion malaise, tender cervical or axillary lymph nodes, myalgia, multi-joint pain, headaches, and troubled sleep.

    In turn, management of CFS is just as difficult. Treatment ranges from conservative, such as cognitive behavioral therapy (CBT) and antidepressants, to minimally invasive management. Minimally invasive management involving ranscutaneous electrical acupoint stimulation of target points has demonstrated significant improvement in fatigue and associated symptoms in a 2017 randomized controlled study.

    The understanding of CFS is evolving before us as we continue to learn more about it. As further reliable studies are conducted, providing a better grasp of what the syndrome encompasses, we will be able to improve our diagnosis and management of it.


    Last edited: Sep 21, 2021
    sebaaa, Milo, SNT Gatchaman and 2 others like this.
  2. Trish

    Trish Moderator Staff Member

    What a strange abstract. Why would they pick out CBT, antidepressants and a single study of electrical stimulation of acupuncture points as treatments?
    The authors are all as far as I can see specialists in pain and anaesthesiology, so perhaps that skews their perspective.
    Michelle, sebaaa, Milo and 7 others like this.
  3. ME/CFS Skeptic

    ME/CFS Skeptic Senior Member (Voting Rights)

    This refers to a study that is only available in Chinese:

    Li J, Xie J, Pan Z, Guo X, Li Y, Fu R. [Chronic fatigue syndrome
    treated with transcutaneous electrical acupoint stimulation: a randomized controlled trial]. Zhongguo Zhen Jiu. 2017;37(12):1276–9. doi: 10.13703/j.0255-2930.2017.12.006. [PubMed: 29354991].
  4. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

    London, UK
    This is just an essay done by a trainee sent off as a review publication.
    The first author probably knows little or nothing about CFS.
    Michelle, sebaaa, Milo and 10 others like this.
  5. Hutan

    Hutan Moderator Staff Member

    Aotearoa New Zealand
    Either that, or they have shares in a company planning to import and sell the transcutaneous electrical acupoint stimulation machines, and they needed a 'scientifically proven' paper in English to support the marketing...
    Michelle and Peter Trewhitt like this.
  6. dave30th

    dave30th Senior Member (Voting Rights)

    I think the paper was written by a computer algorithm.
    Michelle, Lilas, EzzieD and 2 others like this.
  7. Forbin

    Forbin Senior Member (Voting Rights)

    I wondered what the exotic sounding "ranscutaneous" form of electrical acupoint stimulation was. Apparently, it's just a typo for "transcutaneous."
    Michelle, Hutan, Trish and 1 other person like this.
  8. Milo

    Milo Senior Member (Voting Rights)

    Sure. And then you will read this article cited in a year or 2, from someone who have done a poor job at lit. review. That’s the problem with scientific publications.
    Michelle, voner, rvallee and 6 others like this.

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