Posted 5-16-08

Study Launched to Uncover the Mysteries of Chronic Fatigue Syndrome

(CDC) -- Researchers from the Centers for Disease Control and Prevention (CDC) and Emory University School of Medicine in Atlanta recently launched the most comprehensive population-based clinical study to date of patients with chronic fatigue syndrome (CFS). The study includes about 90 patients from Atlanta who will participate in the three-day in-patient clinical trial. Researchers hope results from the study will help them better understand how the syndrome affects people and lead to more successful treatment.

"We're learning more about the complexities of the illness that is chronic fatigue syndrome," said William C. Reeves, M.D., Chief of the Chronic Fatigue Syndrome Research Program at CDC. "Launching this research study with Emory will help us draw a clearer picture of how CFS affects people that ultimately could lead to more effective treatment of patients with CFS."

Each designated participant will spend three days at Emory University Hospital General Clinical Research Center (GCRC). Participants will undergo repeated blood draws and salivary sampling in addition to computerized testing and functional Magnetic Resonance Imaging (fMRI) of the brain. The study is planned to be completed within a year.

CFS, a condition characterized by fatigue, memory problems, and pain, may be more widespread than once thought. Experts estimate that between one and four million people in the United States may suffer from CFS. Unfortunately, an estimated 80 percent of all CFS patients have not yet been diagnosed by a medical provider.

The CDC-Emory study is designed to evaluate mechanisms of the illness with an emphasis on alterations in the regulation of hormones and the immune system as well as alterations in the brain circuits involved in cognitive function and mental fatigue. The molecular and genetic aspects of these alterations will also be explored.

"We believe this research will lead us to a better understanding of the causes of CFS, both from a psychological and biological standpoint," says Andrew Miller, M.D., Timmie Professor of Psychiatry and Behavioral Sciences at Emory and Emory principal investigator of the study. "We believe that this study will open doors that may lead us to better ways of diagnosing and treating CFS in the future."

CFS – The Larger Public Health Impact
It is estimated that only half of CFS patients have sought medical attention and fewer than one in five have been diagnosed and treated. This is a particular source of concern since early treatment could be associated with a significantly higher rate of recovery. Often, patients may report symptoms like being frequently exhausted, or having difficulty sleeping and concentrating, which may be linked to many other causes.

Dr. Reeves said, "CFS is often difficult to diagnose and physicians rely on patients reporting symptoms to identify the illness. There is no disease specific laboratory test for CFS, and the diagnosis is often made through a process of eliminating other causes that may explain the patients' signs and symptoms."

CFS occurs most frequently in women ages 40-60, but affects all races, sexes, and age groups, and can be as disabling as multiple sclerosis and chronic obstructive pulmonary disease. The condition can also take a tremendous personal and social toll on patients and their families, with a quarter of those affected by CFS either unemployed or on disability assistance.

"Our economic impact studies show that a family in which someone has CFS could forego up to $20,000 a year in annual earnings and wages, and that a quarter of them are either on disability or out of work following the illness," explains Reeves. "It is a serious public health problem."

If you think you or someone you know might be suffering from CFS, consult a health care professional to learn more about options that are available for you. For more information on CFS, visit www.cdc.gov/cfs.

Milestones of Previous CFS Studies

• CDC estimates that 2.5% of Georgians ages 18-59 years suffer from chronic fatigue syndrome. This represents a six- to ten-fold higher prevalence than previous estimates from other areas.

• CDC estimates that the average family in which a member suffers from CFS foregoes $20,000 in annual earnings and wages, nearly half the median US household income.

• CDC studies reveal that early life stress and accumulated lifetime stress are strongly and significantly associated with CFS. The current study at Emory Hospital will further clarify these findings.

• CDC research reveals that abnormally low morning concentrations of the hormone cortisol may be correlated with more severe fatigue in CFS patients, especially in women.

• CDC research has demonstrated that multiple types of early childhood trauma are important risk factors for CFS.

• CDC has conducted numerous studies to better understand the symptoms which would be included in the definition of chronic fatigue syndrome. Ultimately, this research has provided a formal case definition for CFS and provides clinicians a guide for diagnosing patients.

Additional Information
CDC has a comprehensive provider education program that includes outreach nationally at conferences, grand rounds, and through on-line continuing education. This outreach is aimed at aiding providers in the diagnosis, management, and treatment of CFS.

CDC purposely attempts to publish research on CFS in open-access journals to aid the public, patients, and providers in obtaining the most up-to-date information on this illness. For more information on the studies being conducted by CDC on chronic fatigue syndrome and the resulting research, please see the CFS website: http://www.cdc.gov/cfs/cfsresearch.htm.