Cerebral and systemic hemodynamics changes during upright tilt in chronic fatigue syndrome

Alexander Y. Razumovsky, Karen DeBusk, Hugh Calkins, Sally Snader, Katherine E. Lucas, Pranav Vyas, Daniel F Hanley, Peter Rowe

Research output: Contribution to journalArticle

Abstract

Background and Purpose. During head-up tilt (HUT), patients with chronic fatigue syndrome (CFS) have higher rates of neurally mediated hypotension (NMH) and postural tachycardia syndrome (POTS) than healthy controls. The authors studied whether patients with CFS were also more likely to have abnormal cerebral blood flow velocity (CBFV) compared with controls in response to orthostatic stress. Methods. Transcranial Doppler monitoring of middle cerebral artery (MCA) CBFV was performed during 3-stage HUT prospectively in 26 patients with CFS and 23 healthy controls. At the same time, continuous monitoring of arterial blood pressure (BP), heart rate (HR), endtidal CO2 (ET-CO2) were performed. Results are reported as mean ± SD. Results. NMH developed in 21 patients with CFS and in 14 controls (P = .22). POTS was present in 9 CFS patients and 7 controls (P = .76). Supine HR was higher in CFS patients, but all other hemodynamics and CBFV measures were similar at baseline. The median time to hypotension did not differ, but the median time to onset of orthostatic symptoms was shorter in those with CFS (P <.001). The CBFV did not differ between groups in the supine posture, at 1 or 5 minutes after upright tilt, at 5 or 1 minute before the end of the test, or at termination of the test. Mean CBFV fell at termination of tilt testing in those with CFS and controls. ET-CO2 was lower at termination of the test in those with CFS versus controls (P = .002). Conclusions. The results of this study are not consistent with the hypothesis that patients with CFS have a distinctive pattern of MCA CBFV changes in response to orthostatic stress.

Original languageEnglish (US)
Pages (from-to)57-67
Number of pages11
JournalJournal of Neuroimaging
Volume13
Issue number1
DOIs
StatePublished - Jan 2003

Fingerprint

Chronic Fatigue Syndrome
Cerebrovascular Circulation
Hemodynamics
Blood Flow Velocity
Postural Orthostatic Tachycardia Syndrome
Hypotension
Middle Cerebral Artery
Heart Rate
Head
Posture
Arterial Pressure

Keywords

  • Autonomic nervous system
  • Cerebral circulation
  • Chronic fatigue syndrome
  • Orthostatic intolerance
  • Ultrasonics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Neuroscience(all)
  • Radiological and Ultrasound Technology

Cite this

Cerebral and systemic hemodynamics changes during upright tilt in chronic fatigue syndrome. / Razumovsky, Alexander Y.; DeBusk, Karen; Calkins, Hugh; Snader, Sally; Lucas, Katherine E.; Vyas, Pranav; Hanley, Daniel F; Rowe, Peter.

In: Journal of Neuroimaging, Vol. 13, No. 1, 01.2003, p. 57-67.

Research output: Contribution to journalArticle

Razumovsky, Alexander Y. ; DeBusk, Karen ; Calkins, Hugh ; Snader, Sally ; Lucas, Katherine E. ; Vyas, Pranav ; Hanley, Daniel F ; Rowe, Peter. / Cerebral and systemic hemodynamics changes during upright tilt in chronic fatigue syndrome. In: Journal of Neuroimaging. 2003 ; Vol. 13, No. 1. pp. 57-67.
@article{d88d006ea63b409383717158ec493c7d,
title = "Cerebral and systemic hemodynamics changes during upright tilt in chronic fatigue syndrome",
abstract = "Background and Purpose. During head-up tilt (HUT), patients with chronic fatigue syndrome (CFS) have higher rates of neurally mediated hypotension (NMH) and postural tachycardia syndrome (POTS) than healthy controls. The authors studied whether patients with CFS were also more likely to have abnormal cerebral blood flow velocity (CBFV) compared with controls in response to orthostatic stress. Methods. Transcranial Doppler monitoring of middle cerebral artery (MCA) CBFV was performed during 3-stage HUT prospectively in 26 patients with CFS and 23 healthy controls. At the same time, continuous monitoring of arterial blood pressure (BP), heart rate (HR), endtidal CO2 (ET-CO2) were performed. Results are reported as mean ± SD. Results. NMH developed in 21 patients with CFS and in 14 controls (P = .22). POTS was present in 9 CFS patients and 7 controls (P = .76). Supine HR was higher in CFS patients, but all other hemodynamics and CBFV measures were similar at baseline. The median time to hypotension did not differ, but the median time to onset of orthostatic symptoms was shorter in those with CFS (P <.001). The CBFV did not differ between groups in the supine posture, at 1 or 5 minutes after upright tilt, at 5 or 1 minute before the end of the test, or at termination of the test. Mean CBFV fell at termination of tilt testing in those with CFS and controls. ET-CO2 was lower at termination of the test in those with CFS versus controls (P = .002). Conclusions. The results of this study are not consistent with the hypothesis that patients with CFS have a distinctive pattern of MCA CBFV changes in response to orthostatic stress.",
keywords = "Autonomic nervous system, Cerebral circulation, Chronic fatigue syndrome, Orthostatic intolerance, Ultrasonics",
author = "Razumovsky, {Alexander Y.} and Karen DeBusk and Hugh Calkins and Sally Snader and Lucas, {Katherine E.} and Pranav Vyas and Hanley, {Daniel F} and Peter Rowe",
year = "2003",
month = "1",
doi = "10.1177/1051228402239719",
language = "English (US)",
volume = "13",
pages = "57--67",
journal = "Journal of Neuroimaging",
issn = "1051-2284",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Cerebral and systemic hemodynamics changes during upright tilt in chronic fatigue syndrome

AU - Razumovsky, Alexander Y.

AU - DeBusk, Karen

AU - Calkins, Hugh

AU - Snader, Sally

AU - Lucas, Katherine E.

AU - Vyas, Pranav

AU - Hanley, Daniel F

AU - Rowe, Peter

PY - 2003/1

Y1 - 2003/1

N2 - Background and Purpose. During head-up tilt (HUT), patients with chronic fatigue syndrome (CFS) have higher rates of neurally mediated hypotension (NMH) and postural tachycardia syndrome (POTS) than healthy controls. The authors studied whether patients with CFS were also more likely to have abnormal cerebral blood flow velocity (CBFV) compared with controls in response to orthostatic stress. Methods. Transcranial Doppler monitoring of middle cerebral artery (MCA) CBFV was performed during 3-stage HUT prospectively in 26 patients with CFS and 23 healthy controls. At the same time, continuous monitoring of arterial blood pressure (BP), heart rate (HR), endtidal CO2 (ET-CO2) were performed. Results are reported as mean ± SD. Results. NMH developed in 21 patients with CFS and in 14 controls (P = .22). POTS was present in 9 CFS patients and 7 controls (P = .76). Supine HR was higher in CFS patients, but all other hemodynamics and CBFV measures were similar at baseline. The median time to hypotension did not differ, but the median time to onset of orthostatic symptoms was shorter in those with CFS (P <.001). The CBFV did not differ between groups in the supine posture, at 1 or 5 minutes after upright tilt, at 5 or 1 minute before the end of the test, or at termination of the test. Mean CBFV fell at termination of tilt testing in those with CFS and controls. ET-CO2 was lower at termination of the test in those with CFS versus controls (P = .002). Conclusions. The results of this study are not consistent with the hypothesis that patients with CFS have a distinctive pattern of MCA CBFV changes in response to orthostatic stress.

AB - Background and Purpose. During head-up tilt (HUT), patients with chronic fatigue syndrome (CFS) have higher rates of neurally mediated hypotension (NMH) and postural tachycardia syndrome (POTS) than healthy controls. The authors studied whether patients with CFS were also more likely to have abnormal cerebral blood flow velocity (CBFV) compared with controls in response to orthostatic stress. Methods. Transcranial Doppler monitoring of middle cerebral artery (MCA) CBFV was performed during 3-stage HUT prospectively in 26 patients with CFS and 23 healthy controls. At the same time, continuous monitoring of arterial blood pressure (BP), heart rate (HR), endtidal CO2 (ET-CO2) were performed. Results are reported as mean ± SD. Results. NMH developed in 21 patients with CFS and in 14 controls (P = .22). POTS was present in 9 CFS patients and 7 controls (P = .76). Supine HR was higher in CFS patients, but all other hemodynamics and CBFV measures were similar at baseline. The median time to hypotension did not differ, but the median time to onset of orthostatic symptoms was shorter in those with CFS (P <.001). The CBFV did not differ between groups in the supine posture, at 1 or 5 minutes after upright tilt, at 5 or 1 minute before the end of the test, or at termination of the test. Mean CBFV fell at termination of tilt testing in those with CFS and controls. ET-CO2 was lower at termination of the test in those with CFS versus controls (P = .002). Conclusions. The results of this study are not consistent with the hypothesis that patients with CFS have a distinctive pattern of MCA CBFV changes in response to orthostatic stress.

KW - Autonomic nervous system

KW - Cerebral circulation

KW - Chronic fatigue syndrome

KW - Orthostatic intolerance

KW - Ultrasonics

UR - http://www.scopus.com/inward/record.url?scp=0037218657&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037218657&partnerID=8YFLogxK

U2 - 10.1177/1051228402239719

DO - 10.1177/1051228402239719

M3 - Article

C2 - 12593133

AN - SCOPUS:0037218657

VL - 13

SP - 57

EP - 67

JO - Journal of Neuroimaging

JF - Journal of Neuroimaging

SN - 1051-2284

IS - 1

ER -