Relationship between Cardiopulmonary, Mitochondrial and Autonomic Nervous System Function Improvement after an Individualised Activity Programme upon Chronic Fatigue Syndrome Patients

Abstract

Background: The therapeutic effects of exercise from structured activity programmes have recently been questioned; as a result, this study examines the impact of an Individualised Activity Program (IAP) on the relationship with cardiovascular, mitochondrial and fatigue parameters. Methods: Chronic fatigue syndrome (CFS) patients were assessed using Chalder Fatigue Questionnaire (CFQ), Fatigue Severity Score (FSS) and the Fatigue Impact Scale (FIS). VO2peak, VO2submax and heart rate (HR) were assessed using cardiopulmonary exercise testing. Mfn1 and Mfn2 levels in plasma were assessed. A Task Force Monitor was used to assess ANS functioning in supine rest and in response to the Head-Up Tilt Test (HUTT). Results: Thirty-four patients completed 16 weeks of the IAP. The CFQ, FSS and FIS scores decreased significantly along with a significant increase in Mfn1 and Mfn2 levels (p = 0.002 and p = 0.00005, respectively). The relationships between VO2 peak and Mfn1 increase in response to IAP (p = 0.03) and between VO2 at anaerobic threshold and ANS response to the HUTT (p = 0.03) were noted. Conclusions: It is concluded that IAP reduces fatigue and improves functional performance along with changes in autonomic and mitochondrial function. However, caution must be applied as exercise was not well tolerated by 51% of patients.

Metabolomic Evidence for Peroxisomal Dysfunction in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

“…Peroxisomal β-oxidation of very long-chain fatty acids leads to their breakdown into short-chain products that serve as substrates for mitochondrial β-oxidation [ 34 ]. We posit that this crosstalk between mitochondria and peroxisomes plays an important role in maintaining energy homeostasis, and that dysregulation contributes to the fatigue and cognitive dysfunction that are hallmarks of ME/CFS [ 35 , 36 ].…”

The Link Between Energy-Related Sensations and Metabolism: Implications for Treating Fatigue

“…Higher mitochondrial activity correlated with lower scores of burnout and depression both at baseline and in the follow-up of the study ( Brand et al, 2020 ). Implementing an individualized activity program for CFS patients resulted in a significant reduction of different fatigue measures, an increase in mitochondrial function measured through levels of transmembrane proteins mitofusin 1 and 2 (Mfn1, Mfn2), peak VO2, and a decrease in the ratio of sympathetic to parasympathetic activity during the head-up tilt test ( Kujawski et al, 2021 ). Interestingly, those changes in autonomic functions were related to increases in submaximal VO2 ( Kujawski et al, 2021 ).…”

“…Implementing an individualized activity program for CFS patients resulted in a significant reduction of different fatigue measures, an increase in mitochondrial function measured through levels of transmembrane proteins mitofusin 1 and 2 (Mfn1, Mfn2), peak VO2, and a decrease in the ratio of sympathetic to parasympathetic activity during the head-up tilt test ( Kujawski et al, 2021 ). Interestingly, those changes in autonomic functions were related to increases in submaximal VO2 ( Kujawski et al, 2021 ). It should be noted that such an intervention did not appear to be well-tolerated by CFS patients, since the drop-out rate was 51% ( Kujawski et al, 2021 ).…”

“…Interestingly, those changes in autonomic functions were related to increases in submaximal VO2 ( Kujawski et al, 2021 ). It should be noted that such an intervention did not appear to be well-tolerated by CFS patients, since the drop-out rate was 51% ( Kujawski et al, 2021 ). This is consistent with the idea that it might be hard for CFS patients to profit from more intensive aerobic exercise due to the severe fatigue symptoms they might experience afterwards ( Puetz et al, 2008 ).…”

Special Issue “Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: Diagnosis and Treatment”

“…The therapy of CFS/ME is problematic due to lack of knowledge on the etiopathogenesis of this disease, with application of the unconventional and conventional treatments: Tirelli and colleagues compared the application of oxygen–ozone autohemotherapy (O 2 -O 3 -AHT) in male vs. female patients, evaluating the differences in their responses to this approach [ 15 ]. The effects of exercise from a structured activity program have been disputed; Kujawski S. et al, with a multidisciplinary study, examined the impact of a personalized program of activities associated with cardiovascular, mitochondrial and fatigue parameters, showing a reduction in fatigue and an improving functional performance [ 16 ]. An important conventional therapeutic approach is the effect of s.c. IgG self-treatment in ME/CFS patients with IgG/IgG subgroup deficiency.…”