Abstract
OBJECTIVES—To examine the proportions of type 1 and type 2 muscle fibres and the degree of muscle fibre atrophy and hypertrophy in patients with chronic fatigue syndrome in relation to lactate responses to exercise, and to determine to what extent any abnormalities found might be due to inactivity. METHODS—Quadriceps needle muscle biopsies were obtained from 105 patients with chronic fatigue syndrome and the proportions of type 1 and 2 fibres and fibre atrophy and hypertrophy factors were determined from histochemical preparations, using a semiautomated image analysis system. Forty one randomly selected biopsies were also examined by electron microscopy. Lactate responses to exercise were measured in the subanaerobic threshold exercise test (SATET). RESULTS—Inactivity would be expected to result in a shift to type 2 fibre predominance and fibre atrophy, but type 1 predominance (23%) was more common than type 2 predominance (3%), and fibre atrophy was found in only 10.4% of cases. Patients with increased lactate responses to exercise did have significantly fewer type 1 muscle fibres (p<0.043 males, p<0.0003 females), but there was no evidence that this group was less active than the patients with normal lactate responses. No significant ultrastructural abnormalities were found. CONCLUSION—Muscle histometry in patients with chronic fatigue syndrome generally did not show the changes expected as a result of inactivity. However, patients with abnormal lactate responses to exercise had a significantly lower proportion of mitochondria rich type 1 muscle fibres.
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- Arnold D. L., Bore P. J., Radda G. K., Styles P., Taylor D. J. Excessive intracellular acidosis of skeletal muscle on exercise in a patient with a post-viral exhaustion/fatigue syndrome. A 31P nuclear magnetic resonance study. Lancet. 1984 Jun 23;1(8391):1367–1369. doi: 10.1016/s0140-6736(84)91871-3. [DOI] [PubMed] [Google Scholar]
- Ball-Burnett M., Green H. J., Houston M. E. Energy metabolism in human slow and fast twitch fibres during prolonged cycle exercise. J Physiol. 1991 Jun;437:257–267. doi: 10.1113/jphysiol.1991.sp018594. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Behan P. O., Behan W. M., Bell E. J. The postviral fatigue syndrome--an analysis of the findings in 50 cases. J Infect. 1985 May;10(3):211–222. doi: 10.1016/s0163-4453(85)92488-0. [DOI] [PubMed] [Google Scholar]
- Behan W. M., More I. A., Behan P. O. Mitochondrial abnormalities in the postviral fatigue syndrome. Acta Neuropathol. 1991;83(1):61–65. doi: 10.1007/BF00294431. [DOI] [PubMed] [Google Scholar]
- Berg H. E., Dudley G. A., Hather B., Tesch P. A. Work capacity and metabolic and morphologic characteristics of the human quadriceps muscle in response to unloading. Clin Physiol. 1993 Jul;13(4):337–347. doi: 10.1111/j.1475-097x.1993.tb00334.x. [DOI] [PubMed] [Google Scholar]
- Booth F. W. Physiologic and biochemical effects of immobilization on muscle. Clin Orthop Relat Res. 1987 Jun;(219):15–20. [PubMed] [Google Scholar]
- Bowles N. E., Bayston T. A., Zhang H. Y., Doyle D., Lane R. J., Cunningham L., Archard L. C. Persistence of enterovirus RNA in muscle biopsy samples suggests that some cases of chronic fatigue syndrome result from a previous, inflammatory viral myopathy. J Med. 1993;24(2-3):145–160. [PubMed] [Google Scholar]
- Byrne E., Trounce I. Chronic fatigue and myalgia syndrome: mitochondrial and glycolytic studies in skeletal muscle. J Neurol Neurosurg Psychiatry. 1987 Jun;50(6):743–746. doi: 10.1136/jnnp.50.6.743. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Byrne E., Trounce I., Dennett X. Chronic relapsing myalgia (? Post viral): clinical, histological, and biochemical studies. Aust N Z J Med. 1985 Jun;15(3):305–308. doi: 10.1111/j.1445-5994.1985.tb04042.x. [DOI] [PubMed] [Google Scholar]
- Cohen M. E., Consolazio F., Johnson R. E. BLOOD LACTATE RESPONSE DURING MODERATE EXERCISE IN NEUROCIRCULATORY ASTHENIA, ANXIETY NEUROSIS, OR EFFORT SYNDROME. J Clin Invest. 1947 Mar;26(2):339–342. doi: 10.1172/JCI101814. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Connolly S., Smith D. G., Doyle D., Fowler C. J. Chronic fatigue: electromyographic and neuropathological evaluation. J Neurol. 1993 Jul;240(7):435–438. doi: 10.1007/BF00867358. [DOI] [PubMed] [Google Scholar]
- Edwards R. H., Newham D. J., Peters T. J. Muscle biochemistry and pathophysiology in postviral fatigue syndrome. Br Med Bull. 1991 Oct;47(4):826–837. doi: 10.1093/oxfordjournals.bmb.a072514. [DOI] [PubMed] [Google Scholar]
- Ferretti G., Antonutto G., Denis C., Hoppeler H., Minetti A. E., Narici M. V., Desplanches D. The interplay of central and peripheral factors in limiting maximal O2 consumption in man after prolonged bed rest. J Physiol. 1997 Jun 15;501(Pt 3):677–686. doi: 10.1111/j.1469-7793.1997.677bm.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Folgering H., von Herwaarden C. Exercise limitations in patients with pulmonary diseases. Int J Sports Med. 1994 Apr;15(3):107–111. doi: 10.1055/s-2007-1021029. [DOI] [PubMed] [Google Scholar]
- Fukuda K., Straus S. E., Hickie I., Sharpe M. C., Dobbins J. G., Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994 Dec 15;121(12):953–959. doi: 10.7326/0003-4819-121-12-199412150-00009. [DOI] [PubMed] [Google Scholar]
- Gibson H., Carroll N., Clague J. E., Edwards R. H. Exercise performance and fatiguability in patients with chronic fatigue syndrome. J Neurol Neurosurg Psychiatry. 1993 Sep;56(9):993–998. doi: 10.1136/jnnp.56.9.993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gibson J. N., Halliday D., Morrison W. L., Stoward P. J., Hornsby G. A., Watt P. W., Murdoch G., Rennie M. J. Decrease in human quadriceps muscle protein turnover consequent upon leg immobilization. Clin Sci (Lond) 1987 Apr;72(4):503–509. doi: 10.1042/cs0720503. [DOI] [PubMed] [Google Scholar]
- Grau J. M., Casademont J., Pedrol E., Fernández-Solà J., Cardellach F., Barros N., Urbano-Márquez A. Chronic fatigue syndrome: studies on skeletal muscle. Clin Neuropathol. 1992 Nov-Dec;11(6):329–332. [PubMed] [Google Scholar]
- Greenleaf J. E., Kozlowski S. Physiological consequences of reduced physical activity during bed rest. Exerc Sport Sci Rev. 1982;10:84–119. [PubMed] [Google Scholar]
- Hather B. M., Adams G. R., Tesch P. A., Dudley G. A. Skeletal muscle responses to lower limb suspension in humans. J Appl Physiol (1985) 1992 Apr;72(4):1493–1498. doi: 10.1152/jappl.1992.72.4.1493. [DOI] [PubMed] [Google Scholar]
- Hikida R. S., Gollnick P. D., Dudley G. A., Convertino V. A., Buchanan P. Structural and metabolic characteristics of human skeletal muscle following 30 days of simulated microgravity. Aviat Space Environ Med. 1989 Jul;60(7):664–670. [PubMed] [Google Scholar]
- Hsu Y. D., Lee W. H., Chang M. K., Shieh S. D., Tsao W. L. Blood lactate threshold and type II fibre predominance in patients with exertional heatstroke. J Neurol Neurosurg Psychiatry. 1997 Feb;62(2):182–187. doi: 10.1136/jnnp.62.2.182. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jaffe D. M., Terry R. D., Spiro A. J. Disuse atrophy of skeletal muscle. A morphometric study using image analysis. J Neurol Sci. 1978 Feb;35(2-3):189–200. doi: 10.1016/0022-510x(78)90002-3. [DOI] [PubMed] [Google Scholar]
- Jamal G. A., Hansen S. Electrophysiological studies in the post-viral fatigue syndrome. J Neurol Neurosurg Psychiatry. 1985 Jul;48(7):691–694. doi: 10.1136/jnnp.48.7.691. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lane R. J., Burgess A. P., Flint J., Riccio M., Archard L. C. Exercise responses and psychiatric disorder in chronic fatigue syndrome. BMJ. 1995 Aug 26;311(7004):544–545. doi: 10.1136/bmj.311.7004.544. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lane R. J., Woodrow D., Archard L. C. Lactate responses to exercise in chronic fatigue syndrome. J Neurol Neurosurg Psychiatry. 1994 May;57(5):662–663. doi: 10.1136/jnnp.57.5.662-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lloyd A. R., Gandevia S. C., Hales J. P. Muscle performance, voluntary activation, twitch properties and perceived effort in normal subjects and patients with the chronic fatigue syndrome. Brain. 1991 Feb;114(Pt 1A):85–98. [PubMed] [Google Scholar]
- McCully K. K., Natelson B. H., Iotti S., Sisto S., Leigh J. S., Jr Reduced oxidative muscle metabolism in chronic fatigue syndrome. Muscle Nerve. 1996 May;19(5):621–625. doi: 10.1002/(SICI)1097-4598(199605)19:5<621::AID-MUS10>3.0.CO;2-Q. [DOI] [PubMed] [Google Scholar]
- Mero A., Jaakkola L., Komi P. V. Relationships between muscle fibre characteristics and physical performance capacity in trained athletic boys. J Sports Sci. 1991 Summer;9(2):161–171. doi: 10.1080/02640419108729877. [DOI] [PubMed] [Google Scholar]
- Müller E. A. Influence of training and of inactivity on muscle strength. Arch Phys Med Rehabil. 1970 Aug;51(8):449–462. [PubMed] [Google Scholar]
- Nashef L., Lane R. J. Screening for mitochondrial cytopathies: the sub-anaerobic threshold exercise test (SATET). J Neurol Neurosurg Psychiatry. 1989 Sep;52(9):1090–1094. doi: 10.1136/jnnp.52.9.1090. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ploutz-Snyder L. L., Tesch P. A., Crittenden D. J., Dudley G. A. Effect of unweighting on skeletal muscle use during exercise. J Appl Physiol (1985) 1995 Jul;79(1):168–175. doi: 10.1152/jappl.1995.79.1.168. [DOI] [PubMed] [Google Scholar]
- Preedy V. R., Smith D. G., Salisbury J. R., Peters T. J. Biochemical and muscle studies in patients with acute onset post-viral fatigue syndrome. J Clin Pathol. 1993 Aug;46(8):722–726. doi: 10.1136/jcp.46.8.722. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Roberts L., Byrne E. Single fibre EMG studies in chronic fatigue syndrome: a reappraisal. J Neurol Neurosurg Psychiatry. 1994 Mar;57(3):375–376. doi: 10.1136/jnnp.57.3.375. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schwartz M. S., Swash M., Gross M. Benign postinfection polymyositis. Br Med J. 1978 Nov 4;2(6147):1256–1257. doi: 10.1136/bmj.2.6147.1256. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sharpe M. C., Archard L. C., Banatvala J. E., Borysiewicz L. K., Clare A. W., David A., Edwards R. H., Hawton K. E., Lambert H. P., Lane R. J. A report--chronic fatigue syndrome: guidelines for research. J R Soc Med. 1991 Feb;84(2):118–121. doi: 10.1177/014107689108400224. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sisto S. A., LaManca J., Cordero D. L., Bergen M. T., Ellis S. P., Drastal S., Boda W. L., Tapp W. N., Natelson B. H. Metabolic and cardiovascular effects of a progressive exercise test in patients with chronic fatigue syndrome. Am J Med. 1996 Jun;100(6):634–640. doi: 10.1016/s0002-9343(96)00041-1. [DOI] [PubMed] [Google Scholar]
- Stokes M. J., Cooper R. G., Edwards R. H. Normal muscle strength and fatigability in patients with effort syndromes. BMJ. 1988 Oct 22;297(6655):1014–1017. doi: 10.1136/bmj.297.6655.1014. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Telerman-Toppet N., Bacq M., Khoubesserian P., Coërs C. Type 2 fiber predominance in muscle cramp and exertional myalgia. Muscle Nerve. 1985 Sep;8(7):563–567. doi: 10.1002/mus.880080704. [DOI] [PubMed] [Google Scholar]
- Wong R., Lopaschuk G., Zhu G., Walker D., Catellier D., Burton D., Teo K., Collins-Nakai R., Montague T. Skeletal muscle metabolism in the chronic fatigue syndrome. In vivo assessment by 31P nuclear magnetic resonance spectroscopy. Chest. 1992 Dec;102(6):1716–1722. doi: 10.1378/chest.102.6.1716. [DOI] [PubMed] [Google Scholar]
- Young A. The relative isometric strength of type I and type II muscle fibres in the human quadriceps. Clin Physiol. 1984 Feb;4(1):23–32. doi: 10.1111/j.1475-097x.1984.tb00641.x. [DOI] [PubMed] [Google Scholar]
- ZUBEK J. P., WILGOSH L. Prolonged immobilization of the body: changes in performance and in the electroencephalogram. Science. 1963 Apr 19;140(3564):306–308. doi: 10.1126/science.140.3564.306. [DOI] [PubMed] [Google Scholar]