Autonomic nervous system dysfunction: a two-year investigation
Prof. Julia Newton
Fatigue Interest Group and Liver Research Group, Institute of Cellular Medicine, University of Newcastle, Newcastle, UK
Funding for this study has been provided by the John Richardson Research Group, the Irish ME Trust and ME Research UK.
Background and aims
The autonomic nervous system controls cardiovascular, digestive and respiratory functions, and has a range of other important roles. When it goes wrong, the consequences can be severe. Since one of the key difficulties that ME/CFS patients face is standing, most especially standing still, without experiencing symptoms such as dizziness, altered vision, nausea, fatigue etc., the possibility exists that there could be a problem with the autonomic nervous system.
Prof. Julia Newton of the School of Clinical Medical Sciences, University of Newcastle, received a grant from ME Research UK and the regional ME/CFS service in 2007 to examine a large group of patients using a battery of tests of heart rate and blood pressure. The Cardiovascular Laboratory in which the tests were done is one of the largest autonomic testing labs in Europe, with all the necessary equipment and expertise for comprehensive autonomic testing. Her results, published in the Quarterly Journal of Medicine (August 2007), showed that in three-quarters of the patients, autonomic dysfunction was present, a very unexpected finding. Furthermore, in a separate study, Prof. Newton has reported that a simple-to-measure assessment of the heart rate response to standing was abnormal in a significant proportion of patients.
Funding has now been provided for the next phase of the work: a two-year project exploring some of the mechanisms behind these autonomic problems in ME/CFS patients. The investigation has two broad aims. The first is to examine fully the people attending the Newcastle CFS/ME Clinical Service, and develop a database of patients who can be followed up over the long term. The second is to begin to answer the question, “Does the autonomic dysfunction in people with ME/CFS arise in association with abnormalities of brain, muscle and liver, as has already been shown in other patients with other illnesses?”.
For this, a series of linked studies will examine muscle bioenergetics (using state of the art MRI techniques), structural and functional brain abnormalities (also using MRI), and structural and functional liver abnormalities (using fibrosis quantification and percentage fat assessment by MRI).