The neuroendocrinology of chronic fatigue syndrome and fibromyalgia.

Content Provider	Semantic Scholar
Author	Parker, A. J. Wessely, Stefan Cleare, Anthony J.
Copyright Year	2001
Abstract	BACKGROUND Disturbance of the HPA axis may be important in the pathophysiology of chronic fatigue syndrome (CFS) and fibromyalgia. Symptoms may be due to: (1) low circulating cortisol; (2) disturbance of central neurotransmitters; or (3) disturbance of the relationship between cortisol and central neurotransmitter function. Accumulating evidence of the complex relationship between cortisol and 5-HT function, make some form of hypothesis (3) most likely. We review the methodology and results of studies of the HPA and other neuroendocrine axes in CFS. METHOD Medline, Embase and Psychlit were searched using the Cochrane Collaboration strategy. A search was also performed on the King's College CFS database, which includes over 3000 relevant references, and a citation analysis was run on the key paper (Demitrack et al. 1991). RESULTS One-third of the studies reporting baseline cortisol found it to be significantly low, usually in one-third of patients. Methodological differences may account for some of the varying results. More consistent is the finding of reduced HPA function, and enhanced 5-HT function on neuroendocrine challenge tests. The opioid system, and arginine vasopressin (AVP) may also be abnormal, though the growth hormone (GH) axis appears to be intact, in CFS. CONCLUSIONS The significance of these changes, remains unclear. We have little understanding of how neuroendocrine changes relate to the experience of symptoms, and it is unclear whether these changes are primary, or secondary to behavioural changes in sleep or exercise. Longitudinal studies of populations at risk for CFS will help to resolve these issues.
Starting Page	75
Ending Page	81
Page Count	7
File Format	PDF HTM / HTML
Alternate Webpage(s)	http://simonwessely.com/Downloads/Publications/CFS/137.pdf
PubMed reference number	11722149v1
Volume Number	31
Issue Number	8
Journal	Psychological medicine
Language	English
Access Restriction	Open
Subject Keyword	Antidepressive Agents Arginine Argipressin Axis vertebra BaseLine dental cement Chronic Fatigue Syndrome Congenital Abnormality Corticotropin-Releasing Hormone Depressive disorder Down-Regulation Fibromyalgia Gland Hectopascal Hydrocortisone Infectious Mononucleosis Large Neuroendocrinology Neurohormones Neurosecretory Systems Neurotransmitters Patients Post-Traumatic Stress Disorder Serotonin Stress, Psychological Temporomandibular Joint Dysfunction Syndrome Virus attribution citation hypothalamic-pituitary-adrenal axis monoamine pegvisomant
Content Type	Text
Resource Type	Article