Enhanced sensitivity of the peripheral cholinergic vascular response in patients with chronic fatigue syndrome, 2000, Spence et al.

Enhanced sensitivity of the peripheral cholinergic vascular response in patients with chronic fatigue syndrome
Vance A Spence; Faisel Khan; Jill J.F Belch

Patients with chronic fatigue syndrome have a variety of clinical symptoms, with associated physical, psychological, and social disability. The syndrome is poorly understood; the etiology and pathophysiology are not known.

Cholinergic mechanisms are important in the control of peripheral skin perfusion (1,2) and, in part, are regulated by endothelial cells (3). We have developed a method for assessing endothelial function in which acetylcholine is delivered transdermally across intact skin using iontophoresis (4), and the vascular responses are measured by laser Doppler imaging (5). These techniques have been used in many patients with cardiovascular disease, in whom endothelial dysfunction and impaired vasodilatation are common.

We have now applied this methodology to investigate cholinergic activity in patients with chronic fatigue syndrome to see if the reported evidence of central nervous system cholinergic sensitivity in these patients (6) is widespread.

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