Pediatric CFS in a Community-Based Sample

描述（由申请人提供）：现有已发表的儿科CFS流行病学研究与第一代成人CFS患病率研究相似，因为它们的采样计划较差（例如，医学中心的招募; Nijhof等人，2011年），或排除某些人的系统性偏见，如社会经济地位较低的青年和那些不太可能获得医疗保健的有色人种（Dobbins等人，1997年），或未能包括医学检查（琼斯等人，2004年）。我们将确定儿童CFS的患病率在一个人口统计学上多样化的参与者样本中，不受疾病，寻求帮助的行为或医疗保健系统的差异。此外，我们将评估直立不耐受（OI）的症状，在一个以社区为基础的样本的儿童CFS，谁是公正的寻求帮助的行为，或差异获得医疗保健系统。在拟议的研究中，对直立性应激期间进行的精神任务的可量化反应（a）将在操作上定义中枢疲劳和神经认知障碍，（B）将作为与基于社区的对照组相比时基于社区的CFS的生物标志物。我们认为，认知疲劳、认知丧失和头晕是脑血流异常的一个功能，因为它与总心输出量、总血流量、总血流量和总血流量有关。 容积、局部血流量和血容量分布。此外，我们将能够解决关于脑血流的不一致的发现，我们认为，这是由于测量脑血流速度对动脉压的反应的不同方法。总之，这项拟议的研究将确定儿童CFS在以社区为基础的样本中的患病率，以及CFS在不同群体中的相对频率（例如，不同年龄组、性别）。这项研究还将确定CFS和对照组青年中直立性异常的患病率，并将研究其与神经认知功能的关系。

DESCRIPTION (provided by applicant): Existing published pediatric epidemiologic CFS studies are similar to the first generation of adult CFS prevalence studies in that they have had either poor sampling plans (e.g., recruitment at medical centers; Nijhof et al., 2011), or systematic biases that excluded certain people such as youth of lower socioeconomic status and those of color who were less likely to have access to health care (Dobbins et al., 1997), or failed to include a medical examination (Jones et al., 2004). We will determine the prevalence of pediatric CFS in a demographically diverse sample of participants unbiased by illness, help-seeking behaviors, or differential access to the health care system. In addition, we will assess orthostatic intolerance (OI) symptoms in a community-based sample of children with pediatric CFS, who are unbiased by help-seeking behaviors, or differential access to the health care system. In the proposed study, the quantifiable response to a mental task undertaken during orthostatic stress (a) will operationally define central fatigue and neurocognitive impairment and (b) will be applied as a biomarker for community-based CFS when compared to a community-based control group. We believe that cognitive fatigue, cognitive loss, and dizziness are a function of abnormalities in cerebral blood flow as it relates to total cardiac output, total blood volume, regional blood flow, and blood volume distribution during the orthostatic stressor. In addition, we will be able to resolve discrepant findings regarding cerebral blood flow, which, we believe, are due to the differing ways of measuring the response of cerebral blood flow velocity to arterial pressure. In summary, this proposed study will determine the prevalence of pediatric CFS in a community-based sample, as well as the relative frequency of CFS among various groups (e.g., different age groups, genders). This study will also identify the prevalence of orthostatic abnormalities among youth with CFS and controls and will examine its relationship with neurocognitive functioning.