Autonomic Nervous System dysfunction
A new two-year investigation

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. 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 therefore exists that there could be a problem with the autonomic nervous system.

Professor Julia Newton (pictured middle with nurses Katharine Wilton and Jessie Pairman) 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.

Professor Newton’s 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 (see box below), Professor Newton has reported that a simple-to-measure assessment of the heart rate response to standing was abnormal in a significant proportion of patients.

ME Research UK, the John Richardson Research Group and the Irish ME Trust have provided funding 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 fully examine 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 investigation, a series of linked studies will examine muscle bioenergetics – using state of the art magnetic resonance techniques, including assessment of liver fibrosis and percentage fat.