Transcript Waking Brain Rhythms in CFS

SAN 2011
• 5th – 8th May
Thessaloniki
• CHRONIC FATIGUE SYNDROME
SYMPOSIUM
Chairs: Aisha Cortoos & Andreas Ioannides
Waking Brain Rhythms in CFS
Implications For A Model of
CNS Dysfunction
Lesley Parkinson
Tomas Ros, Alan Parkinson,
John Gruzelier,Rajendra Sharma.
History
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Onset
Quality
Intensity
Frequency
Duration
Symptoms
Therapies tried
What helps?
Muscle History
• Where did you come on Sports Day in the
100m or 1500m?
• Can you swim ?
• What is the furthest distance you have
covered?
Primary Organic Fatigue
• Anaemia
• Mineral deficiency
• Viral infection
• Fungal infection
• Functional hypoglycaemia
Tests and Treatment
• Comprehensive blood biochemistry
• Hair mineral analysis
• Stool culture
Comprehensive Digestive Stool
Analysis
1. Digestion / Absorption
2. Gut Immunology
3. Metabolic Markers
4. Microbiology
5. Parasitology
6. Additional Markers
Parasitology – Why Test?
• Approximately 22% of all
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samples examined reveal
the presence of
potentially clinically
relevant parasites
This implies that a
significant portion of the
population suffers from
infection of parasites,
many of whom may not
even experience
gastrointestinal
symptoms.
Digestive Stool Analysis
• Giardia lamblia: 20 years ago not a pathogen,
now leading in USA pathogens. Variety of
intestinal symptoms (may be asymptomatic).
Chronic diarrhoea, abdominal cramping,
bloating, increased frequency of bowel
movements, fatigue & loss of body weight.
Transmission is through hand to mouth due to
cysts in the faeces. Source of infection is in
streams and lakes, not killed by chlorination.
Linked to M.E./CFIDS
Psychological Fatigue
• Stress
• Depression
• Anxiety
• Aggression
Adrenal Stress Test
Amino Acid Analysis
Hair Mineral Analysis
Subjects
• 30 individuals
• Age Range 20 – 50 years
• 18 females
• 12 males
Questionnaire/Rating Scales
• Activity Schedule
• Sleep level and quality
• Mood State
• Locus of Control-Multidimensional Health
• Fatigue Rating
• Symptoms Checklist
• Bells CSF Disability Scale
QEEG
Full Head 19 Channel
5 minutes “Eyes Open” – at rest
5 minutes “Eyes Closed”-at rest
20 minsVisual Continuous PerformanceTask
Analysis
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Spectral Analysis
Topographical Analysis
1Hz Topographs and
Frequency Band Topographs
2-4 Hz delta
4-7 Hz theta
8-11Hz alpha
>15 Hz beta
Compared With
• Russian Academy of Sciences
• Human Brain Institute
• Normative Data Base
QEEG Results
Eyes Closed
• 25 Subjects (17 females, 8males)
• Showed significant power abnormalities in
terms of increase in the delta(2-4Hz)
theta(4-7Hz)and alpha(8-11Hz)wavebands
Eyes Open and VCPT
• 27 subjects (17 females,10 males)
• Showed significant power abnormalities in
terms of persistent global and/or focal
elevated beta(15-25Hz) wavebands
indicative of EEG hyperactivity or
hyperarousal
Beta Wave Hyperactivity
• Can be a response to
• Stress
• Infection
• Toxicity
• Closed head injury
• Has been linked to sleep inefficiency
“New Model”
• Disrupted “faster” (>15Hz) brain rhythms
in CFS during eyes open and an induced
mental fatigue condition(VCPT)is
suggestive of cortical hyper-arousal which
may explain why cognitive dysfunction
worsens with extended workload as the
system “burns out”.
“New Model” cont:
• There is likely to be a link between sleep
dysfunction in CFS and EEG
hyperactivity/cortical hyperarousal.
• So we have a “cumulating sleep – debt “
model whereby reduced sleep efficiency
which is CNS mediated leads to mental
fatigue whilst also contributing to physical
fatigue.
What else is “new”?
• Haemoencephalography to look at frontal
perfusion
• The correlation between blood perfusion
and EEG alpha waveband activity is strong
• Correlations have been reported between
hypoperfusion and increases in delta and
theta waveband activity.
• At the cellular level blood flow and
vascular abnormalities have been found
Arteriograph
• Measures
• Central and Peripheral blood flow
• Arterial health
• Blood pressure
• Cardiac output
Mitochondrial Function
• ATP – ADP cycle which also depends on
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magnesium status.
TLP -Translocator Protein
One study found only 24% people with CFS had
normal levels of TLP and the level of depletion
correlated with the severity of the fatigue
Fatigue, exhaustion and “brain fog” could be
mitochondria related.
• SODase – mops up free radicals
Gene Studies and DNA
• Gene expression studies have found
associations with
• Immune cells,
• skeletal muscle tone and function
• Thyroid efficiency
• Mitochondrial function
DNA Adducts
• Genomic DNA is analysed for the presence
of organic chemicals and toxic metals.
• Location
• Gene specificity