Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome

Background Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and post-COVID condition can present similarities such as fatigue, brain fog, autonomic and neuropathic symptoms. Methods The study included 87 patients with post-COVID condition, 50 patients with ME/CFS, and 50 healthy controls...

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Autores: Azcue González, Naiara, Del Pino Sáez, Rocío, Acera Gil, María Ángeles, Fernández Valle, Tamara, Ayo Mentxakatorre, Naia, Pérez Concha, Tomás, Murueta-Goyena Larrañaga, Ane, Lafuente Sánchez, José Vicente, Prada, Alvaro, López de Munain Arregui, Adolfo José, Ruiz Irastorza, Guillermo, Martín Iglesias, Daniel, Ribacoba, Laureano, Gabilondo Cuellar, Iñigo, Gómez Esteban, Juan Carlos, Tijero Merino, Beatriz
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universidad del País Vasco
Repositorio:Addi. Archivo Digital para la Docencia y la Investigación
OAI Identifier:oai:addi.ehu.eus:10810/67469
Acceso en línea:http://hdl.handle.net/10810/67469
Access Level:acceso abierto
Palabra clave:cognition
dysautonomia
myalgic encephalomyelitis/chronic fatigue syndrome
post‑COVID condition
small fiber neuropathy
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dc.title.none.fl_str_mv Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome
title Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome
spellingShingle Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome
Azcue González, Naiara
cognition
dysautonomia
myalgic encephalomyelitis/chronic fatigue syndrome
post‑COVID condition
small fiber neuropathy
title_short Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome
title_full Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome
title_fullStr Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome
title_full_unstemmed Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome
title_sort Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome
dc.creator.none.fl_str_mv Azcue González, Naiara
Del Pino Sáez, Rocío
Acera Gil, María Ángeles
Fernández Valle, Tamara
Ayo Mentxakatorre, Naia
Pérez Concha, Tomás
Murueta-Goyena Larrañaga, Ane
Lafuente Sánchez, José Vicente
Prada, Alvaro
López de Munain Arregui, Adolfo José
Ruiz Irastorza, Guillermo
Martín Iglesias, Daniel
Ribacoba, Laureano
Gabilondo Cuellar, Iñigo
Gómez Esteban, Juan Carlos
Tijero Merino, Beatriz
author Azcue González, Naiara
author_facet Azcue González, Naiara
Del Pino Sáez, Rocío
Acera Gil, María Ángeles
Fernández Valle, Tamara
Ayo Mentxakatorre, Naia
Pérez Concha, Tomás
Murueta-Goyena Larrañaga, Ane
Lafuente Sánchez, José Vicente
Prada, Alvaro
López de Munain Arregui, Adolfo José
Ruiz Irastorza, Guillermo
Martín Iglesias, Daniel
Ribacoba, Laureano
Gabilondo Cuellar, Iñigo
Gómez Esteban, Juan Carlos
Tijero Merino, Beatriz
author_role author
author2 Del Pino Sáez, Rocío
Acera Gil, María Ángeles
Fernández Valle, Tamara
Ayo Mentxakatorre, Naia
Pérez Concha, Tomás
Murueta-Goyena Larrañaga, Ane
Lafuente Sánchez, José Vicente
Prada, Alvaro
López de Munain Arregui, Adolfo José
Ruiz Irastorza, Guillermo
Martín Iglesias, Daniel
Ribacoba, Laureano
Gabilondo Cuellar, Iñigo
Gómez Esteban, Juan Carlos
Tijero Merino, Beatriz
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv cognition
dysautonomia
myalgic encephalomyelitis/chronic fatigue syndrome
post‑COVID condition
small fiber neuropathy
topic cognition
dysautonomia
myalgic encephalomyelitis/chronic fatigue syndrome
post‑COVID condition
small fiber neuropathy
description Background Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and post-COVID condition can present similarities such as fatigue, brain fog, autonomic and neuropathic symptoms. Methods The study included 87 patients with post-COVID condition, 50 patients with ME/CFS, and 50 healthy controls (HC). The hemodynamic autonomic function was evaluated using the deep breathing technique, Valsalva maneuver, and Tilt test. The presence of autonomic and sensory small fiber neuropathy (SFN) was assessed with the Sudoscan and with heat and cold evoked potentials, respectively. Finally, a complete neuropsychological evaluation was performed. The objective of this study was to analyze and compare the autonomic and neuropathic symptoms in post-COVID condition with ME/CFS, and HC, as well as, analyze the relationship of these symptoms with cognition and fatigue. Results Statistically significant differences were found between groups in heart rate using the Kruskal–Wallis test (H), with ME/CFS group presenting the highest (H = 18.3; p ≤ .001). The Postural Orthostatic Tachycardia Syndrome (POTS), and pathological values in palms on the Sudoscan were found in 31% and 34% of ME/CFS, and 13.8% and 19.5% of post-COVID patients, respectively. Concerning evoked potentials, statistically significant differences were found in response latency to heat stimuli between groups (H = 23.6; p ≤ .01). Latency was highest in ME/CFS, and lowest in HC. Regarding cognition, lower parasympathetic activation was associated with worse cognitive performance. Conclusions Both syndromes were characterized by inappropriate tachycardia at rest, with a high percentage of patients with POTS. The prolonged latencies for heat stimuli suggested damage to unmyelinated fibers. The higher proportion of patients with pathological results for upper extremities on the Sudoscan suggested a non-length-dependent SFN.
publishDate 2023
dc.date.none.fl_str_mv 2023
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/10810/67469
url http://hdl.handle.net/10810/67469
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-023-04678-3
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
http://creativecommons.org/licenses/by/3.0/es/
Atribución 3.0 España
eu_rights_str_mv openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/3.0/es/
Atribución 3.0 España
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv reponame:Addi. Archivo Digital para la Docencia y la Investigación
instname:Universidad del País Vasco
instname_str Universidad del País Vasco
reponame_str Addi. Archivo Digital para la Docencia y la Investigación
collection Addi. Archivo Digital para la Docencia y la Investigación
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue SyndromeAzcue González, NaiaraDel Pino Sáez, RocíoAcera Gil, María ÁngelesFernández Valle, TamaraAyo Mentxakatorre, NaiaPérez Concha, TomásMurueta-Goyena Larrañaga, AneLafuente Sánchez, José VicentePrada, AlvaroLópez de Munain Arregui, Adolfo JoséRuiz Irastorza, GuillermoMartín Iglesias, DanielRibacoba, LaureanoGabilondo Cuellar, IñigoGómez Esteban, Juan CarlosTijero Merino, Beatrizcognitiondysautonomiamyalgic encephalomyelitis/chronic fatigue syndromepost‑COVID conditionsmall fiber neuropathyBackground Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and post-COVID condition can present similarities such as fatigue, brain fog, autonomic and neuropathic symptoms. Methods The study included 87 patients with post-COVID condition, 50 patients with ME/CFS, and 50 healthy controls (HC). The hemodynamic autonomic function was evaluated using the deep breathing technique, Valsalva maneuver, and Tilt test. The presence of autonomic and sensory small fiber neuropathy (SFN) was assessed with the Sudoscan and with heat and cold evoked potentials, respectively. Finally, a complete neuropsychological evaluation was performed. The objective of this study was to analyze and compare the autonomic and neuropathic symptoms in post-COVID condition with ME/CFS, and HC, as well as, analyze the relationship of these symptoms with cognition and fatigue. Results Statistically significant differences were found between groups in heart rate using the Kruskal–Wallis test (H), with ME/CFS group presenting the highest (H = 18.3; p ≤ .001). The Postural Orthostatic Tachycardia Syndrome (POTS), and pathological values in palms on the Sudoscan were found in 31% and 34% of ME/CFS, and 13.8% and 19.5% of post-COVID patients, respectively. Concerning evoked potentials, statistically significant differences were found in response latency to heat stimuli between groups (H = 23.6; p ≤ .01). Latency was highest in ME/CFS, and lowest in HC. Regarding cognition, lower parasympathetic activation was associated with worse cognitive performance. Conclusions Both syndromes were characterized by inappropriate tachycardia at rest, with a high percentage of patients with POTS. The prolonged latencies for heat stimuli suggested damage to unmyelinated fibers. The higher proportion of patients with pathological results for upper extremities on the Sudoscan suggested a non-length-dependent SFN.This study has been funded by Instituto de Salud Carlos III (ISCIII) through the project PI20/01076 and co‑funded by the European Union, EITB maratoia (BIOS21/COV/006) and grants for health research projects from the Basque Government (2021111006). Azcue, N. received a pre‑doctoral research grant from the basque government (PRE_2022_2_0111).BMC202420242023info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10810/67469reponame:Addi. Archivo Digital para la Docencia y la Investigacióninstname:Universidad del País VascoIngléshttps://translational-medicine.biomedcentral.com/articles/10.1186/s12967-023-04678-3info:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by/3.0/es/© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Atribución 3.0 Españaoai:addi.ehu.eus:10810/674692026-06-18T09:23:17Z
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