Hypothalamic-Pituitary-Adrenal Axis Reactivity in Chronic Fatigue Syndrome and Health Under Psychological, Physiological, and Pharmacological Stimulation
Abstract
Objectives Subtle alterations of the hypothalamic-pituitary-adrenal (HPA) axis in chronic fatigue syndrome (CFS) have been proposed as a shared pathway linking numerous etiological and perpetuating processes with symptoms and observed physiological abnormalities. Because the HPA axis is involved in the adaptive responses to stress and CFS patients experience a worsening of symptoms after physical and psychological stress, we tested HPA axis functioning with three centrally acting stress tests. Methods We used two procedures mimicking real-life stressors and compared them with a standardized pharmacological neuroendocrine challenge test. CFS patients were compared with healthy control subjects regarding their cardiovascular and endocrine reactivity in a psychosocial stress test and a standardized exercise test, and their endocrine response in the insulin tolerance test (ITT). Results Controlling for possible confounding variables, we found significantly lower ACTH response levels in the psychosocial stress test and the exercise test, and significantly lower ACTH responses in the ITT, with no differences in plasma total cortisol responses. Also, salivary-free cortisol responses did not differ between the groups in the psychosocial stress test and the exercise test but were significantly higher for the CFS patients in the ITT. In all tests CFS patients had significantly reduced baseline ACTH levels. Conclusions These results suggest that CFS patients are capable of mounting a su…
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In CFS, the ability to recover after a stressor is impaired.
“In CFS, the ability to recover after a stressor is impaired (14)”
From The role of insomnia in the treatment of chronic fatigue. (2015) · cites this paper as [14]
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- Authors
- Gaab, J.
- Affiliations
- University of Zurich (CH)
- Corresponding author
- Gaab, J.
- ORCID
- Gaab, J.
- Venue
- Psychosomatic Medicine
- Published
- 2002-11-01
- Volume
- 64
- Issue
- 6
- Pages
- 951-962
- ISSN
- 0033-3174 (ISSN-L)
- 1534-7796
- OpenAlex
- W2088465748
- Cited by
- 127
- References
- 6
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 3 · 2015: 3 · 2014: 7 · 2013: 8 · 2012: 6
- FWCI
- 4.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- chronic fatigue syndrome, hypothalamic-pituitary-adrenal axis, ACTH response, cortisol, psychosocial stress, exercise stress, insulin tolerance test, salivary cortisol, stress reactivity, neuroendocrine dysfunction
- MeSH terms
- Adult, Analysis of Variance, Blood Glucose, Endocrine Glands, Exercise Test, Female, Heart Rate, Humans, Hypothalamo-Hypophyseal System, Insulin, Male, Middle Aged, Pituitary-Adrenal System, Psychometrics, Stress, Physiological, Stress, Psychological, Time Factors, Fatigue Syndrome, Chronic, Area Under Curve
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