Post-exertional Cognitive Dysfunction: A Distinctive Symptom Of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Nguyen, Anthony; Azevedo, Addisen S.; Chu, Lily; Davenport, Todd; Stevens, Staci; Stevens, Jared; VanNess, Mark
BACKGROUND: A hallmark feature of ME/CFS is post-exertional malaise (PEM), which can be challenging to identify due to its diverse symptoms. Previously, we found that post-exertional fatigue, cognitive dysfunction, functional decline, and lack of positive feelings distinguished healthy sedentary controls (SC) from people affected by ME/CFS (P-ME/CFS).
OBJECTIVE: To validate our findings in a larger sample of participants.
METHODS: Participants were required to be between 18-70 years old and to endorse low physical activity. P-ME/CFS had to fulfill Canadian Consensus Criteria. During and following two maximal cardiopulmonary exercise tests, participants completed an open-ended questionnaire inquiring about their symptoms at five time points.
Responses were classified into 20 symptom categories. Type/number of symptoms and recovery time were compared between the two groups using Fisher’s Exact tests and Mann-Whitney U tests. A p-value of <0.05 was deemed significant.
RESULTS: There were 172 study participants (90 P-ME/CFS, 82 SC, 72.7% female). Overall, P-ME/CFS endorsed a higher number of adverse symptom categories compared to SC (7.34 ± 2.79 vs 1.89 ± 1.54, p<0.0001).
Cognitive dysfunction best separated P-ME/CFS from SC (71.11% vs. 3.66%, respectively), followed by weakness, headache, and light-headedness (63.33% vs. 13.41%, 56.57% vs. 8.54%, 55.56% vs. 9.76%, p<0.001). Conversely, 57% more SC reported no remarkable symptoms (p<0.001).
45.6% P-ME/CFS vs. 1% of SC took longer than 7 days to recover (p<0.0001). Of the remainder, P-ME/CFS took much longer to recover compared to the SC (4.89 ± 1.928 vs 1.19 ± 1.35 days, p<0.00001).
CONCLUSION: Reflecting the previous study, post-exertional cognitive dysfunction most strongly differentiated P-ME/CFS from SC after maximal exercise. While other illness cohorts were not included and specificity cannot be inferred, combining symptoms other than fatigue with prolonged recovery time may accelerate the diagnosis of ME/CFS.
Web | DOI | PDF | Medicine & Science in Sports & Exercise | Poster abstract
Nguyen, Anthony; Azevedo, Addisen S.; Chu, Lily; Davenport, Todd; Stevens, Staci; Stevens, Jared; VanNess, Mark
BACKGROUND: A hallmark feature of ME/CFS is post-exertional malaise (PEM), which can be challenging to identify due to its diverse symptoms. Previously, we found that post-exertional fatigue, cognitive dysfunction, functional decline, and lack of positive feelings distinguished healthy sedentary controls (SC) from people affected by ME/CFS (P-ME/CFS).
OBJECTIVE: To validate our findings in a larger sample of participants.
METHODS: Participants were required to be between 18-70 years old and to endorse low physical activity. P-ME/CFS had to fulfill Canadian Consensus Criteria. During and following two maximal cardiopulmonary exercise tests, participants completed an open-ended questionnaire inquiring about their symptoms at five time points.
Responses were classified into 20 symptom categories. Type/number of symptoms and recovery time were compared between the two groups using Fisher’s Exact tests and Mann-Whitney U tests. A p-value of <0.05 was deemed significant.
RESULTS: There were 172 study participants (90 P-ME/CFS, 82 SC, 72.7% female). Overall, P-ME/CFS endorsed a higher number of adverse symptom categories compared to SC (7.34 ± 2.79 vs 1.89 ± 1.54, p<0.0001).
Cognitive dysfunction best separated P-ME/CFS from SC (71.11% vs. 3.66%, respectively), followed by weakness, headache, and light-headedness (63.33% vs. 13.41%, 56.57% vs. 8.54%, 55.56% vs. 9.76%, p<0.001). Conversely, 57% more SC reported no remarkable symptoms (p<0.001).
45.6% P-ME/CFS vs. 1% of SC took longer than 7 days to recover (p<0.0001). Of the remainder, P-ME/CFS took much longer to recover compared to the SC (4.89 ± 1.928 vs 1.19 ± 1.35 days, p<0.00001).
CONCLUSION: Reflecting the previous study, post-exertional cognitive dysfunction most strongly differentiated P-ME/CFS from SC after maximal exercise. While other illness cohorts were not included and specificity cannot be inferred, combining symptoms other than fatigue with prolonged recovery time may accelerate the diagnosis of ME/CFS.
Web | DOI | PDF | Medicine & Science in Sports & Exercise | Poster abstract
