Chronic Fatigue Syndrome in Adolescents

青少年慢性疲劳综合症

• 批准号: 6679707
• 负责人: Renee Rita Taylor
• 金额: $ 50.93万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-01 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6679707
• 关键词: adolescence (12-20); adrenocorticotropic hormone; behavior test; biomarker; body physical activity; chronic fatigue syndrome; clinical research; comorbidity; cortisol; cytokine; disease /disorder proneness /risk; epidemiology; fatigue; human subject; longitudinal human study; mental disorder diagnosis; mononucleosis; natural killer cells; physical fitness; posture; psychological adaptation; psychological stressor; psychological tests; sleep; stressor

DESCRIPTION: In the Senate Labor, Health and Human Services Appropriations Report, it was recommended that researchers explore issues related to the etiology and natural course of chronic fatigue syndrome using longitudinal, repeated-measures designs, with particular attention to pediatric samples. Researchers have documented the development of a fatigue syndrome following mononucleosis in prospective studies of adults. One objective of the proposed investigation is to prospectively study the relationship between infection with mononucleosis and the onset and course of chronic fatigue syndrome over time in adolescents. The following hypotheses will be tested using a prospective, case-control design: (1) Baseline predictors of post-infectious CFS and fatigue severity at 6 months will include greater levels of baseline psychological distress, having a psychiatric diagnosis at baseline, a greater degree of stressful life events at baseline, and higher levels of activity prior to initial infection; (2) Adolescents with CFS, compared with matched controls, will report higher levels of psychological distress, higher rates of psychiatric diagnoses, a greater degree of stressful life events, and lower levels of physical activity following infection at the 6-, 12-, 24- month time points; and (3) Compared with matched controls, adolescents with CFS will demonstrate lower levels of salivary cortisol (peak and trough), reduced natural killer cell function and count, and elevated proinflammatory cytokines at the 6-, 12-, and 24- month time points. At the 6-month time point (clinic visit), adolescents with CFS will also demonstrate higher rates of orthostatic intolerance; and (4) In response to an exercise challenge test at the six-month time point, compared with matched controls, adolescents with CFS will demonstrate lower levels of salivary cortisol and plasma ACTH, and elevated cytokines - illustrating impaired communication between neuroendocrine and immune systems with physical stress. An exploration of the nature and timing of these relationships would provide a preliminary model of etiology and natural course of illness for adolescents with post-viral chronic fatigue syndrome. Results from this investigation may assist physicians in identifying adolescents at high risk for CFS and allow them to initiate preventative measures.

描述：在参议院劳动，卫生和公共服务拨款报告中，建议研究人员使用纵向，重复测量的设计探索与慢性疲劳综合征的病因和自然过程有关的问题，并特别关注小儿样本。研究人员已经记录了在成年人的前瞻性研究中单核细胞增多症后疲劳综合征的发展。拟议的研究的一个目的是前瞻性研究与单核细胞增多症的感染与青少年的慢性疲劳综合症的发作和过程之间的关系。以下假设将使用前瞻性的，病例对照设计进行测试：（1）感染后CFS的基线预测因素和6个月时的疲劳严重程度将包括更大的基线心理困扰，基线时具有精神病学诊断，基线的精神病学诊断，基线的高度更高的压力性生活，以及在基线之前的较高活动水平，至最初的感染水平更高； （2）与匹配的对照组相比，患有CFS的青少年将报告心理困扰水平更高，精神诊断率更高，压力更大的压力寿命事件以及在6个，12个，12个，24个月的时间点感染后的体育活动水平较低； （3）与匹配的对照组相比，具有CFS的青少年将表明唾液皮质醇水平较低（峰值和槽），自然杀伤细胞功能和计数降低，并在6个，12个月和24个月的时间点上升高促炎细胞因子。在6个月的时间点（诊所访问），患有CFS的青少年也将表现出更高的体位不耐受率。 （4）与匹配的对照组相比，在六个月时间的运动挑战测试中，患有CFS的青少年将证明唾液皮质醇和血浆ACTH的水平较低，细胞因子升高 - 说明神经内分泌和具有物理压力的免疫系统之间的沟通性受损。对这些关系的性质和时机的探索将为患有病毒后慢性疲劳综合征的青少年提供病因和自然病程的初步模型。这项调查的结果可以帮助医生确定CFS高风险的青少年，并允许他们采取预防措施。