Hypothalamic-pituitary-adrenal axis function in chronic fatigue syndrome.
There is evidence for a hypofunction of the hypothalamic-pituitary-adrenal (HPA) axis in a proportion of the patients with chronic fatigue syndrome (CFS), despite the negative studies and methodological difficulties. In this review, we focus on challenge studies and on the role of the HPA axis in the pathogenesis of CFS. Mild hypocortisolism, blunted adrenocorticotropin response to stressors and enhanced negative feedback sensitivity to glucocorticoids are the main findings. Several underlying mechanisms have been proposed. Currently, it is a matter of debate whether these disturbances have a primary role in the pathogenesis of CFS. However, even if the HPA axis dysfunctions are secondary to other factors, they are probably a relevant factor in symptom propagation in CFS.
Van Den Eede
Filip
F
Department of Psychiatry, University Hospital Antwerp, Edegem, Belgium. filip.van.den.eede@uza.be
Moorkens
Greta
G
Van Houdenhove
Boudewijn
B
Cosyns
Paul
P
Claes
Stephan J
SJ
D015673:Fatigue Syndrome, Chronic / Q000134:cerebrospinal fluid / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D010913:Pituitary-Adrenal System / Q000502:physiology*
D006854:Hydrocortisone