Issa Anindita, Lin Jin-Mann S, Chen Yang, Attell Jacob, Brimmer Dana, Bertolli Jeanne, Natelson Benjamin H, Lapp Charles W, Podell Richard N, Kogelnik Andreas M, Klimas Nancy G, Peterson Daniel L, Bateman Lucinda, Unger Elizabeth R
Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
Booz Allen Hamilton, Inc., Atlanta, GA 30309, USA.
J Clin Med. 2025 Sep 5;14(17):6269. doi: 10.3390/jcm14176269.
: Symptoms of autonomic dysfunction are common in infection-associated chronic conditions and illnesses (IACCIs), including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This study aimed to evaluate autonomic symptoms and their impact on ME/CFS illness severity. : Data came from a multi-site study conducted in seven ME/CFS specialty clinics during 2012-2020. Autonomic dysfunction was assessed using the Composite Autonomic Symptom Scale 31 (COMPASS-31), medical history, and a lean test originally described by the National Aeronautics and Space Administration (NASA). Illness severity was assessed using Patient-Reported Outcomes Measurement Information System measures, the 36-item short-form, as well as the CDC Symptom Inventory. This analysis included 442 participants who completed the baseline COMPASS-31 assessment, comprising 301 individuals with ME/CFS and 141 healthy controls (HC). : ME/CFS participants reported higher autonomic symptom burden than HC across three assessment tools (all < 0.0001), including the COMPASS-31 total score (34.1 vs. 6.8) and medical history indicators [dizziness or vertigo (42.6% vs. 2.8%), cold extremities (38.6% vs. 5.7%), and orthostatic intolerance (OI, 33.9% vs. 0.7%)]. Among ME/CFS participants, 97% had at least one autonomic symptom. Those with symptoms in the OI, gastrointestinal, and pupillomotor domains had significantly higher illness severity than those without these symptoms. : ME/CFS patients exhibit a substantial autonomic symptom burden that correlates with greater illness severity. Individualized care strategies targeting dysautonomia assessment and intervention may offer meaningful improvements in symptom management and quality of life for those with ME/CFS and similar chronic conditions.
自主神经功能障碍症状在感染相关的慢性病和疾病（IACCIs）中很常见，包括肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）。本研究旨在评估自主神经症状及其对ME/CFS疾病严重程度的影响。：数据来自2012年至2020年期间在七个ME/CFS专科诊所进行的一项多中心研究。使用综合自主神经症状量表31（COMPASS - 31）、病史以及美国国家航空航天局（NASA）最初描述的倾斜试验来评估自主神经功能障碍。使用患者报告结局测量信息系统测量工具、36项简表以及美国疾病控制与预防中心症状量表来评估疾病严重程度。该分析纳入了442名完成基线COMPASS - 31评估的参与者，其中包括301名ME/CFS患者和141名健康对照（HC）。：在三种评估工具中，ME/CFS患者报告的自主神经症状负担均高于HC（均P < 0.0001），包括COMPASS - 31总分（34.1对6.8）以及病史指标[头晕或眩晕（42.6%对2.8%）、四肢发冷（38.6%对5.7%）和直立不耐受（OI，33.9%对0.7%）]。在ME/CFS患者中，97%至少有一种自主神经症状。在OI、胃肠道和瞳孔运动领域有症状的患者，其疾病严重程度显著高于没有这些症状的患者。：ME/CFS患者表现出大量的自主神经症状负担，且与更高的疾病严重程度相关。针对自主神经功能障碍评估和干预的个体化护理策略可能会显著改善ME/CFS患者及类似慢性病患者的症状管理和生活质量。
