title: Enhanced vagal withdrawal during mild orthostatic stress in adolescents with chronic fatigue.
abstract: BACKGROUND
  Hemodynamic abnormalities have been documented in the chronic fatigue syndrome (CFS), indicating functional disturbances of the autonomic nervous system responsible for cardiovascular regulation. The aim of this study was to investigate autonomic heart rate control during mild orthostatic stress in adolescents with CFS.
  
  
  METHODS
  A total of 14 CFS patients and 56 healthy controls having equal distribution of age and gender underwent lower body negative pressure (LBNP) of horizontal line 20 mmHg. The RR interval (RRI) was recorded continuously, and spectral power densities were computed in the low-frequency (LF) band (0.04-0.15 Hz) and the high-frequency (HF) band (0.15-0.50 Hz) from segments of 120-second length, using an autoregressive algorithm. In addition, the time-domain indices SDNN, pNN50, and r-MSSD were computed.
  
  
  RESULTS
  At rest, CFS had lower RRI than controls (P < 0.05), but indices of variability were similar in the two groups. During LBNP, compared to controls, CFS patients had lower normalized and absolute HF power and r-MSSD (P < 0.05), and higher RRI (P < 0.001), normalized LF power and LF/HF (P < 0.05).
  
  
  CONCLUSIONS
  During mild orthostatic stress, adolescents with CFS appear to have enhanced vagal withdrawal, leading to a sympathetic predominance of heart rate control compared to controls. Possible underlying mechanisms include hypovolemia and abnormalities of reflex mechanisms.
authors.affiliation: Department of Pediatrics, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway. brwylle@online.no
authors.forename: Vegard Bruun
authors.initials: VB
authors.lastname: Wyller
authors.forename: Riccardo
authors.initials: R
authors.lastname: Barbieri
authors.forename: Erik
authors.initials: E
authors.lastname: Thaulow
authors.forename: J Philip
authors.initials: JP
authors.lastname: Saul
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D004562:Electrocardiography / Q000379:methods / Q000706:statistics & numerical data; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D018737:Hand Strength; D006339:Heart Rate; D006801:Humans; D008150:Lower Body Negative Pressure / Q000379:methods*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods / Q000706:statistics & numerical data; D009664:Norway; D012146:Rest; D012815:Signal Processing, Computer-Assisted; D016683:Supine Position