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https://www.researchsquare.com/article/rs-3388628/v1
Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome
Naiara Azcue1
Rocio Del Pino2
Marian Acera1
Tamara Fernandez Valle1
Naia Ayo Mentxakatorre1
Tomás Pérez Concha3
Ane Murueta-Goyena4
Jose Vicente Lafuente4
Álvaro Prada-Iñurrategui5
Adolfo López de Munain6
Guillermo Ruiz-Irastorza1
Daniel Martín-Iglesias1
Laureano Ribacoba3
Iñigo Gabilondo1
Juan Carlos Gómez-Esteban1
Beatriz Tijero-Merino1
1 Biocruces Bizkaia Health Research Institute: Instituto de Investigacion Sanitaria Biocruces Bizkaia,
2 IIS Biocruces Bizkaia: Instituto de Investigacion Sanitaria Biocruces Bizkaia,
3 Cruces University Hospital: Hospital Universitario Cruces,
4 UPV/EHU: Universidad del Pais Vasco,
5 Hospital de Donostia: Hospital Universitario de Donostia,
6 Donostia Ospitalea: Hospital Universitario de Donostia
https://doi.org/10.21203/rs.3.rs-3388628/v1
This work is licensed under a CC BY 4.0 License
Background
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and post-COVID condition can present similarities such as fatigue, brain fog, autonomic and neuropathic symptoms.
Methods
The study included 87 patients with post-COVID condition, 50 patients with ME/CFS, and 50 HC. The hemodynamic autonomic function was evaluated using the deep breathing technique, Valsalva maneuver, and Tilt test. The presence of autonomic and sensory small fiber neuropathy (SFN) was assessed with the Sudoscan and with heat and cold evoked potentials, respectively. Finally, a complete neuropsychological evaluation was performed. The objective of this study was to analyze and compare the autonomic and neuropathic symptoms in post-COVID condition with ME/CFS, and healthy controls (HC), as well as, analyze the relationship of these symptoms with cognition and fatigue.
Results
Statistically significant differences were found between groups in heart rate, with ME/CFS group presenting the highest (H = 18.3; p ≤ .001). The Postural Orthostatic Tachycardia Syndrome (POTS), and pathological values in palms on the Sudoscan were found in 31% and 34% of ME/CFS, and 13.8% and 19.5% of post-COVID patients, respectively. Concerning evoked potentials, statistically significant differences were found in response latency to heat stimuli between groups (H = 23.6; p ≤ .01). Latency was highest in ME/CFS, and lowest in HC. Regarding cognition, lower parasympathetic activation was associated with worse cognitive performance.
Conclusions
Both syndromes were characterized by inappropriate tachycardia at rest, with a high percentage of patients with POTS. The prolonged latencies for heat stimuli suggested damage to unmyelinated fibers. The higher proportion of patients with pathological results for upper extremities on the Sudoscan suggested a non-length-dependent SFN.
https://www.researchsquare.com/article/rs-3388628/v1
Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome
Naiara Azcue1
Rocio Del Pino2
Marian Acera1
Tamara Fernandez Valle1
Naia Ayo Mentxakatorre1
Tomás Pérez Concha3
Ane Murueta-Goyena4
Jose Vicente Lafuente4
Álvaro Prada-Iñurrategui5
Adolfo López de Munain6
Guillermo Ruiz-Irastorza1
Daniel Martín-Iglesias1
Laureano Ribacoba3
Iñigo Gabilondo1
Juan Carlos Gómez-Esteban1
Beatriz Tijero-Merino1
1 Biocruces Bizkaia Health Research Institute: Instituto de Investigacion Sanitaria Biocruces Bizkaia,
2 IIS Biocruces Bizkaia: Instituto de Investigacion Sanitaria Biocruces Bizkaia,
3 Cruces University Hospital: Hospital Universitario Cruces,
4 UPV/EHU: Universidad del Pais Vasco,
5 Hospital de Donostia: Hospital Universitario de Donostia,
6 Donostia Ospitalea: Hospital Universitario de Donostia
https://doi.org/10.21203/rs.3.rs-3388628/v1
This work is licensed under a CC BY 4.0 License
Background
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and post-COVID condition can present similarities such as fatigue, brain fog, autonomic and neuropathic symptoms.
Methods
The study included 87 patients with post-COVID condition, 50 patients with ME/CFS, and 50 HC. The hemodynamic autonomic function was evaluated using the deep breathing technique, Valsalva maneuver, and Tilt test. The presence of autonomic and sensory small fiber neuropathy (SFN) was assessed with the Sudoscan and with heat and cold evoked potentials, respectively. Finally, a complete neuropsychological evaluation was performed. The objective of this study was to analyze and compare the autonomic and neuropathic symptoms in post-COVID condition with ME/CFS, and healthy controls (HC), as well as, analyze the relationship of these symptoms with cognition and fatigue.
Results
Statistically significant differences were found between groups in heart rate, with ME/CFS group presenting the highest (H = 18.3; p ≤ .001). The Postural Orthostatic Tachycardia Syndrome (POTS), and pathological values in palms on the Sudoscan were found in 31% and 34% of ME/CFS, and 13.8% and 19.5% of post-COVID patients, respectively. Concerning evoked potentials, statistically significant differences were found in response latency to heat stimuli between groups (H = 23.6; p ≤ .01). Latency was highest in ME/CFS, and lowest in HC. Regarding cognition, lower parasympathetic activation was associated with worse cognitive performance.
Conclusions
Both syndromes were characterized by inappropriate tachycardia at rest, with a high percentage of patients with POTS. The prolonged latencies for heat stimuli suggested damage to unmyelinated fibers. The higher proportion of patients with pathological results for upper extremities on the Sudoscan suggested a non-length-dependent SFN.
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