Deconstructing post-exertional malaise in myalgic encephalomyelitis/ chronic fatigue syndrome: A patient-centered, cross-sectional survey

Post-exertional malaise (PEM) is considered to be the hallmark characteristic of myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS). Yet, patients have rarely been asked in formal studies to describe their experience of PEM. To describe symptoms associated with and the time course of PEM....

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Bibliographic Details
Published in:PloS one 2018-06, Vol.13 (6), p.e0197811-e0197811
Main Authors: Chu, Lily, Valencia, Ian J, Garvert, Donn W, Montoya, Jose G
Format: Article
Language:English
Subjects:
Adult
Biology and Life Sciences
Care and treatment
Chronic fatigue syndrome
Cognitive ability
Cross-Sectional Studies
Diagnosis
Disease control
Emotions
Encephalomyelitis
Exercise
Fatigue
Fatigue Syndrome, Chronic - complications
Fatigue Syndrome, Chronic - physiopathology
Female
Goodness of fit
Headache
Humans
Infectious diseases
Inflammation
Lupus
Male
Medical research
Medicine
Medicine and Health Sciences
Middle Aged
Mood
Multiple sclerosis
Muscle pain
Muscles
Pain
Patient-centered care
Patients
Physical Exertion
Physical fitness
Research and Analysis Methods
Researchers
Sleep
Social Sciences
Statistical tests
Surveys and Questionnaires
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Summary:Post-exertional malaise (PEM) is considered to be the hallmark characteristic of myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS). Yet, patients have rarely been asked in formal studies to describe their experience of PEM. To describe symptoms associated with and the time course of PEM. One hundred and fifty subjects, diagnosed via the 1994 Fukuda CFS criteria, completed a survey concerning 11 symptoms they could experience after exposure to two different types of triggers. We also inquired about onset and duration of PEM and included space for subjects to write in any additional symptoms. Results were summarized with descriptive statistics; McNemar's, paired t-, Fisher's exact and chi-square goodness-of-fit tests were used to assess for statistical significance. One hundred and twenty-nine subjects (90%) experienced PEM with both physical and cognitive exertion and emotional distress. Almost all were affected by exertion but 14 (10%) reported no effect with emotion. Fatigue was the most commonly exacerbated symptom but cognitive difficulties, sleep disturbances, headaches, muscle pain, and flu-like feelings were cited by over 30% of subjects. Sixty percent of subjects experienced at least one inflammatory/ immune-related symptom. Subjects also cited gastrointestinal, orthostatic, mood-related, neurologic and other symptoms. Exertion precipitated significantly more symptoms than emotional distress (7±2.8 vs. 5±3.3 symptoms (median, standard deviation), p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0197811