Pediatric CFS in a Community-Based Sample

描述（由申请人提供）：现有已发表的儿科流行病学CFS研究与第一代成人CFS患病率研究相似，因为它们要么有不良的抽样计划(例如，在医疗中心招募；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有色人种，他们不太可能获得医疗保健（Dobbins等人，1997年），或未能包括医疗检查（Jones等人，2004年）。我们将确定儿童慢性疲劳综合症的患病率在一个人口统计学多样化的样本中，受试者不受疾病、寻求帮助行为或不同的医疗保健系统的影响。此外，我们将评估以社区为基础的儿童CFS患儿样本中的直立性不耐受（OI）症状，这些患儿在寻求帮助行为或获得医疗保健系统的差异方面没有偏见。在拟议的研究中，与社区为基础的对照组相比，在站立压力下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)将作为社区为基础的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结果因为它与总心输出量，总血流量有关

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.