Trial Report Post-Exertional Malaise in ME/CFS and Post-Acute Sequelae of Severe Acute Respiratory Syndrome 2 Infection, 2024, Sluka

https://www.sciencedirect.com/science/article/abs/pii/S1526590024002475

The Journal of Pain
Volume 25, Issue 4, Supplement, April 2024, Pages 51-52


Post-Exertional Malaise in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Post-Acute Sequelae of Severe Acute Respiratory Syndrome 2 Infection

KA Sluka, AJ Janowski, G Berardi, S McNally
University of Iowa

Available online 12 April 2024, Version of Record 12 April 2024.


https://doi.org/10.1016/j.jpain.2024.01.238Get rights and content

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and post-acute sequelae of SARS-CoV-2 infection (PASC) are complex clinical conditions sharing several symptoms hallmarked by post-exertional malaise (PEM).

PEM is a severe exacerbation of symptoms after minor physical or mental exertion starting 6-24 hours after activity and can last for days or even weeks.

Little is known about the relationship between PEM severity and fatigue, pain, function, and psychological measures.

Our purpose was to compare two methods of collecting PEM data:
(1) DePaul Symptom Questionnaire – PEM (DSQ-PEM) taken at baseline
and
(2) a sum score of different 0-10 scales measuring physical and mental fatigue, pain, function, and psychological constructs taken pre-exercise and 24hr post-exercise.

A change score was calculated between the sum of these 0-10 scales which we termed task-specific PEM (TS-PEM).

Survey data was collected from 60 individuals with ME/CFS (n=30) and PASC (n=30).

Univariate analyses were used to separately correlate the DSQ-PEM and TS-PEM with pain, fatigue, function, and psychological factors respectively.

Stepwise model selection was performed to determine the best fit model for each PEM method. Higher DSQ-PEM severity was associated with higher depression (HADSepression), lower levels of function (PROMIS Physical Function-6b), and individuals with ME/CFS who reported greater symptom severity (total model R2=0.63).

Higher levels of CS-PEM severity were associated with lower levels of baseline fatigue (Brief Fatigue Inventory) and lower levels of early life stress (ACES) (total model R2=0.12).

The DSQ-PEM and CS-PEM demonstrate different associations with baseline fatigue, pain, function, and psychological measures suggesting they capture different constructs.

Funded by the National Institutes of Health (R01AR077418) and the Foundation for Physical Therapy Research: PODS I and II.