Impaired postural cerebral hemodynamics in young patients with chronic fatigue with and without orthostatic intolerance.
OBJECTIVE
To measure postural changes in cerebral hemodynamics in young patients with chronic fatigue with and without orthostatic intolerance.


METHODS
We studied 28 patients (age, 10 to 22 years) and 20 healthy control subjects (age, 6 to 27 years). Cerebral oxygenated hemoglobin (oxy-Hb) and deoxygenated Hb were noninvasively and continuously measured with near infrared spectroscopy during active standing. Beat-to-beat arterial pressure was monitored by Finapres.


RESULTS
Orthostatic intolerance determined by cardiovascular responses to standing was observed in 16 of 28 patients: instantaneous orthostatic hypotension in 8, delayed orthostatic hypotension in 2, and postural orthostatic tachycardia in 6. A rapid recovery of oxy-Hb by near infrared spectroscopy at the onset of active standing was not found in 15 of 16 patients with chronic fatigue and orthostatic intolerance and in 6 of 12 patients with chronic fatigue without orthostatic intolerance but only in 2 of 20 control subjects. Thirteen of 16 patients with orthostatic intolerance showed prolonged reduction in oxy-Hb during standing.


CONCLUSIONS
Impaired cerebral hemodynamics in patients with chronic fatigue syndrome and postural orthostatic tachycardia suggest a link between impaired cerebral oxygenation and chronic fatigue. However, this cannot explain the symptoms in patients meeting the criteria of chronic fatigue without orthostatic intolerance.
Tanaka
Hidetaka
H
Department of Pediatrics, Osaka Medical College, Takatsuki-shi, Japan.
Matsushima
Reiko
R
Tamai
Hiroshi
H
Kajimoto
Yoshinaga
Y
D000293:Adolescent; D000328:Adult; D002319:Cardiovascular System / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002648:Child; D002669:Child Welfare; D015673:Fatigue Syndrome, Chronic / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007024:Hypotension, Orthostatic / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D010108:Oxyhemoglobins / Q000378:metabolism; D011187:Posture / Q000502:physiology*; D013577:Syndrome; D013610:Tachycardia / Q000097:blood / Q000150:complications / Q000503:physiopathology
D010108:Oxyhemoglobins