Maes Michael, Anderson George, Morris Gerwyn, Berk Michael
Expert Opin Med Diagn. 2013 May;7(3):221-5. doi: 10.1517/17530059.2013.776039. Epub 2013 Feb 27.
The World Health Organization has classified myalgic encephalomyelitis (ME) as a neurological disease since 1969 considering chronic fatigue syndrome (CFS) as a synonym used interchangeably for ME since 1969. ME and CFS are considered to be neuro-immune disorders, characterized by specific symptom profiles and a neuro-immune pathophysiology. However, there is controversy as to which criteria should be used to classify patients with "chronic fatigue syndrome."
The Centers for Disease Control and Prevention (CDC) criteria consider chronic fatigue (CF) to be distinctive for CFS, whereas the International Consensus Criteria (ICC) stresses the presence of post-exertion malaise (PEM) as the hallmark feature of ME. These case definitions have not been subjected to rigorous external validation methods, for example, pattern recognition analyses, instead being based on clinical insights and consensus.
Pattern recognition methods showed the existence of three qualitatively different categories: (a) CF, where CF evident, but not satisfying full CDC syndrome criteria. (b) CFS, satisfying CDC criteria but without PEM. (c) ME, where PEM is evident in CFS. Future research on this "chronic fatigue spectrum" should, therefore, use the above-mentioned validated categories and novel tailored algorithms to classify patients into ME, CFS, or CF.
自1969年以来，世界卫生组织将肌痛性脑脊髓炎（ME）归类为一种神经疾病，自1969年起将慢性疲劳综合征（CFS）视为与ME可互换使用的同义词。ME和CFS被认为是神经免疫紊乱，其特征是具有特定的症状特征和神经免疫病理生理学。然而，对于应使用哪些标准来对“慢性疲劳综合征”患者进行分类存在争议。
疾病控制与预防中心（CDC）的标准认为慢性疲劳（CF）是CFS的独特特征，而国际共识标准（ICC）则强调运动后不适（PEM）的存在是ME的标志性特征。这些病例定义尚未经过严格的外部验证方法，例如模式识别分析，而是基于临床见解和共识。
模式识别方法显示存在三种性质不同的类别：（a）CF，其中CF明显，但不满足完整的CDC综合征标准。（b）CFS，满足CDC标准但无PEM。（c）ME，其中PEM在CFS中明显。因此，未来对这种“慢性疲劳谱系”的研究应使用上述经过验证的类别和新颖的定制算法将患者分类为ME、CFS或CF。
