A PROSPECTIVE STUDY OF CHRONIC FATIGUE SYNDROME IN ADOLESCENTS

青少年慢性疲劳综合征的前瞻性研究

• 批准号: 7376858
• 负责人: Renee Rita Taylor
• 金额: $ 3.84万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-12-01 至 2006-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7376858
• 关键词: PROSPECTIVE; STUDY; CHRONIC; FATIGUE; SYNDROME

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. In the Senate Labor, Health and Human Services Appropriations Report (2001), it was recommended that researchers explore issues related to the etiology and natural course of chronic fatigue syndrome (CFS) 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 (Buchwald, Rea, Katon, Russo, & Ashley, 2000; White, 1993; White et al., 1998). 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 plasma cortisol and adrenocorticotropin hormone (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.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子弹和调查员（PI）可能已经从其他NIH来源获得了主要资金，因此可以在其他清晰的条目中代表。列出的机构适用于该中心，这不一定是调查员的机构。在参议院劳工，卫生和公共服务拨款报告（2001年）中，建议研究人员使用纵向，重复测量设计探讨与慢性疲劳综合征（CFS）有关的病因和自然过程，并特别关注儿科样本。研究人员已经记录了成人前瞻性研究中单核细胞增多症后疲劳综合征的发展（Buchwald，Rea，Katon，Katon，Russo和Ashley，2000; White，1993; White等，1998）。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）响应在六个月时间的运动挑战测试中，与匹配的对照组相比，具有CFS的青少年将证明血浆皮质醇和肾上腺皮质激素激素（ACTH）的水平较低，并且细胞因子升高，表明神经穿刺和免疫系统与身体胁迫之间的交流受损。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。