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Abnormalities in pH handling by peripheral muscle and potential regulation by the autonomic nervous system in chronic fatigue syndrome.
J Intern Med. 2010 Apr; 267(4):394-401.JI

Abstract

OBJECTIVES

To examine muscle acid handling following exercise in chronic fatigue syndrome (CFS/ME) and the relationship with autonomic dysfunction.

DESIGN

Observational study.

SETTING

Regional fatigue service. SUBJECTS & INTERVENTIONS: Chronic fatigue syndrome (n = 16) and age and sex matched normal controls (n = 8) underwent phosphorus magnetic resonance spectroscopy (MRS) to evaluate pH handling during exercise. Subjects performed plantar flexion at fixed 35% load maximum voluntary contraction. Heart rate variability was performed during 10 min supine rest using digital photophlethysmography as a measure of autonomic function.

RESULTS

Compared to normal controls, the CFS/ME group had significant suppression of proton efflux both immediately postexercise (CFS: 1.1 +/- 0.5 mmol L(-1) min(-1) vs. normal: 3.6 +/- 1.5 mmol L(-1) min(-1), P < 0.001) and maximally (CFS: 2.7 +/- 3.4 mmol L(-1) min(-1) vs. control: 3.8 +/- 1.6 mmol L(-1) min(-1), P < 0.05). Furthermore, the time taken to reach maximum proton efflux was significantly prolonged in patients (CFS: 25.6 +/- 36.1 s vs. normal: 3.8 +/- 5.2 s, P < 0.05). In controls the rate of maximum proton efflux showed a strong inverse correlation with nadir muscle pH following exercise (r(2) = 0.6; P < 0.01). In CFS patients, in contrast, this significant normal relationship was lost (r(2) = 0.003; P = ns). In normal individuals, the maximum proton efflux following exercise were closely correlated with total heart rate variability (r(2) = 0.7; P = 0.007) this relationship was lost in CFS/ME patients (r(2) < 0.001; P = ns).

CONCLUSION

Patients with CFS/ME have abnormalities in recovery of intramuscular pH following standardised exercise degree of which is related to autonomic dysfunction. This study identifies a novel biological abnormality in patients with CFS/ME which is potentially open to modification.

Authors+Show Affiliations

Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20433583

Citation

Jones, D E J., et al. "Abnormalities in pH Handling By Peripheral Muscle and Potential Regulation By the Autonomic Nervous System in Chronic Fatigue Syndrome." Journal of Internal Medicine, vol. 267, no. 4, 2010, pp. 394-401.
Jones DE, Hollingsworth KG, Taylor R, et al. Abnormalities in pH handling by peripheral muscle and potential regulation by the autonomic nervous system in chronic fatigue syndrome. J Intern Med. 2010;267(4):394-401.
Jones, D. E., Hollingsworth, K. G., Taylor, R., Blamire, A. M., & Newton, J. L. (2010). Abnormalities in pH handling by peripheral muscle and potential regulation by the autonomic nervous system in chronic fatigue syndrome. Journal of Internal Medicine, 267(4), 394-401. https://doi.org/10.1111/j.1365-2796.2009.02160.x
Jones DE, et al. Abnormalities in pH Handling By Peripheral Muscle and Potential Regulation By the Autonomic Nervous System in Chronic Fatigue Syndrome. J Intern Med. 2010;267(4):394-401. PubMed PMID: 20433583.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Abnormalities in pH handling by peripheral muscle and potential regulation by the autonomic nervous system in chronic fatigue syndrome. AU - Jones,D E J, AU - Hollingsworth,K G, AU - Taylor,R, AU - Blamire,A M, AU - Newton,J L, PY - 2010/5/4/entrez PY - 2010/5/4/pubmed PY - 2010/6/15/medline SP - 394 EP - 401 JF - Journal of internal medicine JO - J Intern Med VL - 267 IS - 4 N2 - OBJECTIVES: To examine muscle acid handling following exercise in chronic fatigue syndrome (CFS/ME) and the relationship with autonomic dysfunction. DESIGN: Observational study. SETTING: Regional fatigue service. SUBJECTS & INTERVENTIONS: Chronic fatigue syndrome (n = 16) and age and sex matched normal controls (n = 8) underwent phosphorus magnetic resonance spectroscopy (MRS) to evaluate pH handling during exercise. Subjects performed plantar flexion at fixed 35% load maximum voluntary contraction. Heart rate variability was performed during 10 min supine rest using digital photophlethysmography as a measure of autonomic function. RESULTS: Compared to normal controls, the CFS/ME group had significant suppression of proton efflux both immediately postexercise (CFS: 1.1 +/- 0.5 mmol L(-1) min(-1) vs. normal: 3.6 +/- 1.5 mmol L(-1) min(-1), P < 0.001) and maximally (CFS: 2.7 +/- 3.4 mmol L(-1) min(-1) vs. control: 3.8 +/- 1.6 mmol L(-1) min(-1), P < 0.05). Furthermore, the time taken to reach maximum proton efflux was significantly prolonged in patients (CFS: 25.6 +/- 36.1 s vs. normal: 3.8 +/- 5.2 s, P < 0.05). In controls the rate of maximum proton efflux showed a strong inverse correlation with nadir muscle pH following exercise (r(2) = 0.6; P < 0.01). In CFS patients, in contrast, this significant normal relationship was lost (r(2) = 0.003; P = ns). In normal individuals, the maximum proton efflux following exercise were closely correlated with total heart rate variability (r(2) = 0.7; P = 0.007) this relationship was lost in CFS/ME patients (r(2) < 0.001; P = ns). CONCLUSION: Patients with CFS/ME have abnormalities in recovery of intramuscular pH following standardised exercise degree of which is related to autonomic dysfunction. This study identifies a novel biological abnormality in patients with CFS/ME which is potentially open to modification. SN - 1365-2796 UR - https://www.unboundmedicine.com/medline/citation/20433583/Abnormalities_in_pH_handling_by_peripheral_muscle_and_potential_regulation_by_the_autonomic_nervous_system_in_chronic_fatigue_syndrome_ L2 - https://doi.org/10.1111/j.1365-2796.2009.02160.x DB - PRIME DP - Unbound Medicine ER -