title: Malfunctioning of the autonomic nervous system in patients with chronic fatigue syndrome: a systematic literature review.
abstract: BACKGROUND
  It is hypothesised that the autonomic nervous system responds differently to various stressors in patients with chronic fatigue syndrome (CFS) compared with healthy controls. The goal is to systematically review the scientific literature addressing the functioning of the autonomic nervous system in patients with CFS.
  
  
  METHODS
  All studies that were identified through electronic databases (PubMed and Web of Science) were screened for eligibility based on the selection criteria and assessed (two independent raters) for methodological quality using a methodological checklist for case-control studies.
  
  
  RESULTS
  Twenty-seven case-control studies were included. The methodological quality varied between 50% and 71·4%. Some studies showed different responses to head-up tilt and other autonomous testing.
  
  
  CONCLUSIONS
  Although comparison between the included case-control studies was difficult, we can conclude that there are differences in autonomous response between patients with CFS and healthy controls. The heart rate dynamic response during the head-up tilt test differs between patients with CFS and healthy controls, supporting the increased prevalence of postural orthostatic tachycardia syndrome. The autonomic response can be useful for the diagnosis of CFS.
authors.affiliation: Pain in Motion Research Group, Departments of Human Physiology and Rehabilitation Sciences, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium; Pain in Motion Research Group, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
authors.forename: Deborah
authors.initials: D
authors.lastname: Van Cauwenbergh
authors.forename: Jo
authors.initials: J
authors.lastname: Nijs
authors.forename: Daphne
authors.initials: D
authors.lastname: Kos
authors.forename: Laura
authors.initials: L
authors.lastname: Van Weijnen
authors.forename: Filip
authors.initials: F
authors.lastname: Struyf
authors.forename: Mira
authors.initials: M
authors.lastname: Meeus
mesh_terms: D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000503:physiopathology*; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000503:physiopathology*; D005712:Galvanic Skin Response / Q000502:physiology; D018475:Head-Down Tilt / Q000502:physiology; D006801:Humans; D009483:Neuropsychological Tests
keywords: Autonomic nervous system; dysautonomia; heart rate variability; marker; parasympathetic; stress; sympathetic