Pediatric CFS in a Community-Based Sample

描述(申请人提供)：现有发表的CFS儿童流行病学研究与第一代成人CFS患病率研究相似，因为它们要么有糟糕的抽样计划(例如，在医疗中心招募；Nijhof等人，2011年)，要么存在系统性偏见，将某些人排除在外，如社会经济地位较低的青年和较不可能获得医疗保健的有色人种(Dobbins等人，1997年)，或者没有包括体检(Jones等人，2004年)。我们将在人口统计学上不同的参与者样本中确定儿科CFS的患病率，这些样本不受疾病、寻求帮助的行为或不同的医疗保健系统准入的影响。此外，我们将在社区样本中评估立位不耐受(OI)症状，这些儿童患有儿童CFS，他们不会因寻求帮助的行为或获得医疗保健系统的差别而产生偏见。在拟议的研究中，在立位应激期间对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CFS的生物标记物，与基于社区的对照组相比。我们认为，认知疲劳、认知丧失和头晕是脑血流异常的一种功能，因为它与心输出量、总血流量有关。 在立位应激源作用下的血容量、区域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同发现，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所致。总而言之，这项拟议的研究将确定以社区为基础的样本中儿童慢性疲劳综合征的患病率，以及不同群体(例如，不同年龄组、性别)中慢性疲劳综合征的相对频率。这项研究还将确定患有CFS的年轻人和对照组中立位异常的流行率，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.