Weighting of orthostatic intolerance time measurements with standing difficulty score stratifies ME/CFS symptom severity and analyte detection

Sly Saint · Apr 13, 2018

Weighting of orthostatic intolerance time measurements with standing difficulty score stratifies ME/CFS symptom severity and analyte detection

Alice M. RichardsonEmail author,

Don P. Lewis,

Badia Kita,

Helen Ludlow,

Nigel P. Groome,

Mark P. Hedger,

David M. de Kretser and

Brett A. Lidbury

Journal of Translational Medicine201816:97
https://doi.org/10.1186/s12967-018-1473-z

© The Author(s) 2018

Received: 26 October 2017

Accepted: 5 April 2018

Published: 12 April 2018

Abstract
Background

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is clinically defined and characterised by persistent disabling tiredness and exertional malaise, leading to functional impairment.

Methods
This study introduces the weighted standing time (WST) as a proxy for ME/CFS severity, and investigates its behaviour in an Australian cohort. WST was calculated from standing time and subjective standing difficulty data, collected via orthostatic intolerance assessments. The distribution of WST for healthy controls and ME/CFS patients was correlated with the clinical criteria, as well as pathology and cytokine markers. Included in the WST cytokine analyses were activins A and B, cytokines causally linked to inflammation, and previously demonstrated to separate ME/CFS from healthy controls. Forty-five ME/CFS patients were recruited from the CFS Discovery Clinic (Victoria) between 2011 and 2013. Seventeen healthy controls were recruited concurrently and identically assessed.

Results
WST distribution was significantly different between ME/CFS participants and controls, with six diagnostic criteria, five analytes and one cytokine also significantly different when comparing severity via WST. On direct comparison of ME/CFS to study controls, only serum activin B was significantly elevated, with no significant variation observed for a broad range of serum and urine markers, or other serum cytokines.

Conclusions
The enhanced understanding of standing test behaviour to reflect orthostatic intolerance as a ME/CFS symptom, and the subsequent calculation of WST, will encourage the greater implementation of this simple test as a measure of ME/CFS diagnosis, and symptom severity, to the benefit of improved diagnosis and guidance for potential treatments.
Click to expand...

Uses another proxy 'WST'.
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-018-1473-z

BruceInOz · Apr 13, 2018

I'd have thought a comparison group of patients with orthostatic intolerance but NOT ME would have been essential. Not everyone with ME has OI.

Londinium · Apr 14, 2018

Interesting they found Activin B was elevated, as IIRC this has been cited as a potential biomarker before - though today I'm discovering that PEM and jetlag don't exactly mix well so I'll try and hunt for that later.

ETA: found it - https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-017-1161-4

So was this the same cohort of patients or is this evidence of replication?

Since2010 · Apr 16, 2018

@Londinium: This is the same team who found that Activin B was potential biomarker for ME. I believe the standing test findings and the Activin B findings were from the same patient cohort.

I was in the replication Activin B/standing test study in 2016-17. Don't know how it went or when it'll be published - because (unlike certain BPS research teams ) this team has ethics and doesn't tell participants how studies are going until they're published.

Tom Kindlon · Feb 5, 2020

They looked at diagnostic criteria, though I don't fully understand what the percentages represent at the moment.

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Weighting of orthostatic intolerance time measurements with standing difficulty score stratifies ME/CFS symptom severity and analyte detection

Sly Saint Senior Member (Voting Rights)

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Weighting of orthostatic intolerance time measurements with standing difficulty score stratifies ME/CFS symptom severity and analyte detection

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Since2010 Established Member

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