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Licensed Unlicensed Requires Authentication Published by De Gruyter October 10, 2022

Orthostatic intolerance and neurocognitive impairment in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

  • Caroline L. Gaglio , Mohammed F. Islam , Joseph Cotler and Leonard A. Jason EMAIL logo
From the journal Epidemiologic Methods

Abstract

Objectives

The Institute of Medicine (IOM 2015. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness. Washington: The National Academies Press) suggested new criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), which requires an endorsement of either neurocognitive impairment or orthostatic intolerance (OI) in addition to other core symptoms. While some research supports the inclusion of OI as a core symptom, others argue that overlap with neurocognitive impairment does not justify the either/or option. The current study assessed methods of operationalizing OI using items from the DePaul Symptom Questionnaire (DSQ-1 and -2) as a part of the IOM criteria. Evaluating the relationship between OI and neurocognitive symptoms may lead to a better understanding of diagnostic criteria for ME/CFS.

Methods

Two-hundred and forty-two participants completed the DSQ. We examined how many participants met the IOM criteria while endorsing different frequencies and severities of various OI symptoms.

Results

Neurocognitive impairment was reported by 93.4% of respondents. OI without concurrent neurocognitive symptoms only allowed for an additional 1.7–4.5% of participants to meet IOM criteria.

Conclusions

Neurocognitive symptoms and OI overlap in ME/CFS, and our results do not support the IOM’s inclusion of neurocognitive impairment and OI as interchangeable symptoms. Furthermore, our findings highlight the need for a uniform method of defining and measuring OI via self-report in order to accurately study OI as a symptom of ME/CFS.


Corresponding author: Leonard A. Jason, Center for Community Research, DePaul University, Chicago, USA, E-mail:

Approved by DePaul University Institutional Review Board - Chronic Illness Symptom Study, #PF020317PSY.


Award Identifier / Grant number: 1R01NS111105-01A1

Acknowledgments

The authors would like to thank Karl E. Conroy for his assistance in the preparation of this manuscript.

  1. Research funding: The authors appreciate the funding provided by the National Institute of Neurological Disorders and Stroke (project number 1R01NS111105-01A1)

  2. Author contribution: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The local Institutional Review Board deemed the study exempt from review.

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Received: 2021-08-24
Revised: 2022-06-30
Accepted: 2022-09-15
Published Online: 2022-10-10

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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