Thesis An experimental study investigating the link between symptom reporting and heart rate variability in CFS patients, 2023, Dest & Grosemans

https://documentserver.uhasselt.be/bitstream/1942/41042/1/1b9fa48e-2513-4665-8ba1-a6b1eb7f2056.pdf

Master thesis

An experimental study investigating the link between symptom reporting and heart rate variability in chronic fatigue syndrome patients

Jentro Dest
Daan Grosemans

.Abstract

Background:

Chronic fatigue syndrome (CFS) is characterized by chronic physical and cognitive fatigue.

Studies showed that psychological and physiological dysfunctions can play a role in its pathology.

Objectives:

This study aimed to explore the altered symptom perception and autonomic nervous system dysfunction in patients via laboratory and daily life measurements

Methods:

We included five CFS patients and seven healthy controls (HC).

We assessed daily life symptoms via experience sampling method.

In the laboratory, we assessed fatigue via the Fatigue and energy scale, stress via a visual analogue scale and heart rate variability (HRV).

We performed all measurements in rest and in an exercise condition.

Results:

This study found that CFS patients had higher resting heart rate (HR) and reduced heart rate variability (HRV) during activity.

Before and after exercise, there was a negative correlation between HRV and mental loss of energy (LOE) and cognitive function.

CFS patients experienced increased mental LOE and physical fatigue at rest and following exercise.

Prior to and after laboratory tests, they had heightened general physical fatigue, mental LOE, physical LOE, and cognitive function loss.

Conclusion:

This study emphasizes the interaction between psychological and physiological components while revealing the complicated CFS symptomatology in their daily life and during laboratory testing.

Understanding the complex interactions between symptoms and HRV offers new perspectives on the complex nature of CFS, which could lead to better diagnosis and treatment strategies.

Keywords: Chronic fatigue syndrome (CFS), laboratory, real-life, Heart rate variability (HRV), fatigue, stress.

 

Who is responsible for this garbage?

 

Kids.

 

Yes, I was referring to the supervisors.

 

They seem to be using stress where either exertion or strain would make more sense. Pretty much 99% of the time when stress is used in a medical setting, it would be better replaced with exertion, and here is no exception.

I used strain above in the sense of burden, mostly because I've been using a WHOOP device for 2 months and that's the measure of total exertion they use. I found that it matches my experience of how much I exerted throughout the day. As does my HRV. The strain measure is a mix of pulse rate, HRV, resting heart rate and activity levels.

I've been getting a lot of help in those 2 months and made significant improvements. I also saw my HRV rise significantly in that time span, and having stabilized in recent weeks, it mostly goes up and down depending on my daily strain, how much I exerted and well I recovered, having a lot to do with how good my sleep was. My average and resting heart rates have also dropped significantly, although I think mostly from dietary changes, making sure I take plenty of sodium and a good balance of electrolytes to match.

WHOOP uses a strain calculation that goes from about 4 (I don't think it's possible to get a zero, usually wake up around 4-5) for total immobile rest up to 21, with anything above 14 being overreaching, the equivalent of a whole day of arduous physical labor, and anything above 18 being unsustainable for more than a few days. I find that this strain measure quite matches up with how worn out I feel at the end of the day.

I barely do anything on most days, and my average is 14.8. In the first few weeks when I did even less, it was around 7-8. I've resumed cleaning up a bit, doing dishes, preparing my meals, going upstairs to eat dinner. Then I was able to go out of the house a bit. I often hit 15+ and once hit 17.5, despite being barely more active than an average 80 year-old. 15+ at my age would normally be a high activity day, with lots of work, activity and no or barely any rest throughout.

My HRV now averages around 72, from an early 40, then 64 the next month. I have zero 'stress' in the typical psychosocial sense. This is all exertion, mental and physical. Stress is mostly a useless term for the most part here, other than in adding exertion. It really seems like medicine isn't able to accept that mental exertion is not inherently different from physical exertion, there is no separate supply of energy for it, and neurons can tire out just as well as muscles, just differently. Emotions aren't some special category either, they function and use energy and metabolites the same way as classical 'thinking' does.

My symptoms have improved quite a lot along with my HRV, and match drops quite well. It's sad that they botched up this study, they just seem to be looking at it from the wrong angle, and with far too much bias in trying to cram in some psychosomatic ideas about 'stress' having a different meaning than exertion, even though it perfectly substitutes.

I'm really not sure how this was approved as a Master's thesis. Master's is not the right level to do original studies like this, although the fact that it's not particularly worse than the average research out there speaks a lot more about the general state of non-pharmaceutical clinical research than anything else. I predict a good future for this person in evidence-based medicine, things really at that bad out there, the blind teaching the blind about all the things they've never seen.

 

How does that amount to stress? Almost without fail, where 'stress' is used to mean something else than exertion, and the same is true about almost all uses of anxiety, you can perfectly substitute with "I don't like this situation". Which, in my opinion, is a perfectly reasonable take most of the time. There are many good survival reasons to want to get out of situations one doesn't like.

The words used in mental health had to be stripped of all meaning so they could be crammed in as puzzles pieces for old psychosomatic beliefs. And sure enough, they simply have no meaning anymore. It would be very hard to manage a more perfect way to fail not only physical health, but mental health as well. Basically everything has to be rebuilt from scratch or it just keeps getting stuck on the same loops.

And of all things, it's likely going to be machines who will manage it. Because if they don't, it sure as hell isn't going to be humans pulling it off. Long Covid has made it all clear, the endless loop of failure is truly endless. There are still too many layers of mysticism, it's going to take a full physical, down to the atom, understanding of the whole organism to achieve even a basic understanding of psychology, same as biology doesn't make sense without understanding basic physical and chemical forces, and that too will require machines anyway.

Not that it removes from it. Understanding that all the parts of nature can be explained by mathematical equations doesn't make their outcome any less seemingly magical, less grand. But without technology, magic is still the default, if not the only thing around. We just freaking love this stuff.

 

The thesis writes:

"The study topics and research questions were determined in collaboration with Msc. Y. Dooms and Dr. Maaike Van Den Houte. Due to the fact that the study was a component of an ongoing research project, we were not involved in decisions about research design or methodology"