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Post-exertional malaise: our latest research round-up

October 19, 2016

Each month, Action for M.E. Volunteer Pharmacist Emily Beardall explains some of the recently published research studies on M.E.

Please note this is not an exhaustive list – we have selected to highlight the studies that we think are most likely to resonate with the daily lives of those affected by the condition. We will also report separately on further studies of significance, as and when they are published.

You can search online directory PubMed for most studies about M.E. published in peer-reviewed journals.

The following studies were published online between 22 August 2016 and 21 September 2016. In each case, we have used the same name for the illness as the researchers publishing the paper.

Post-exertional malaise

A study in the Journal of Health Psychology looked at the delayed post-exertional malaise (PEM) experienced by people with CFS/M.E. after exertion. The research was carried out as an online survey of 704 patients self-reporting as having CFS/M.E. which were recruited through patient groups, social media, and online forums. The authors found that there are two components of PEM; a general worsening of CFS/M.E. symptoms and specific fatigue of muscles, and that the majority of the patients experience both. However, a sub-group of patients did not have the muscle fatigue component, and these were more likely to be working full or part-time. The study also found that patients living alone had worse PEM, which the authors suggest is because they have to do more to look after themselves compared with those who live with family or a partner.

Presence of abnormal biological findings relates to quality of life

A study in the Journal of Translational Medicine compared the underlying biological abnormalities found in previous M.E./CFS research with how symptoms impair quality of life. Although this was a small study, there were marked differences between people with M.E./CFS and the healthy controls in biomarkers of the by-products of exercise, muscle function, oxygen use and the immune system. These differences corresponded with the quality of life scores. The authors concluded that linking these muscle and blood test results with scales for measuring health-related quality of life could be used as a way of assessing the severity level of a person’s M.E.

Infections prior to development of CFS/M.E. in children

This Norwegian study published in BMC Family Practice examined the primary care records of children with CFS/M.E. prior to diagnosis of CFS/M.E. to look for common factors which may have played a part in triggering their illness. Compared with the general child population in Norway, those with CFS/M.E. were found to often have diagnoses of depression, anxiety, migraine, muscle pain, and infections. 11% of the children had infectious mononucleosis, commonly known as glandular fever, within the two years before receiving their diagnosis. For around half of the children with CFS/M.E. it had taken a year or longer to receive a specific diagnosis of CFS/M.E. from a specialist. The authors comment that this delay in diagnosis and treatment is not optimal.

HPV vaccine side effects

A study in the journal Drug Safety analysed a global database of reported cases of side effects of vaccines to establish whether there is a link between the HPV vaccine and the development of side effects such as headache, dizziness and fatigue, similar to those seen in complex regional pain syndrome (CRPS), postural orthostatic tachycardia syndrome (POTS), and CFS. A POTS specialist at the CMRC conference explained that the age people have the HPV vaccine is 12 and this coincides with the age that many people’s POTS or CFS develops, so this may give the false impression that the HPV vaccine can cause CRPS, POTS or CFS. The study’s authors also concluded that an association between the HPV vaccine’s side effects and these chronic illnesses is uncertain and that more research is needed.