Chronic Fatigue Syndrome Cooperative Research Center



		CFS-CRC Chronic Fatigue Syndrome Cooperative Research Center Funding source Department of Health and Human Services and the National Institute of Health. Description of work The Chronic Fatigue Syndrome Cooperative Research Center (CFS-CRC) is an integrated, multi-faceted research project. It capitalizes on a large, well-organized data base already collected, and will address a number of practical and theoretical issues in the clinical assessment, etiology, and pathogenesis of chronic fatigue syndrome (CFS). Basic science and clinical research are incorporated to develop an interdisciplinary research program of scientific and programmatic importance for CFS patients, clinicians, and researchers. These investigations reflect our central theme: the immunmological, virological, and psychosocial characterization of CFS and the development of practical, clinically relevant approaches to the evaluation of patients with CFS using an approach that targets specific phases of the illness. In our model of the four “P”s, CFS may occur in a vulnerable individual in whom atopy, psychiatric disorders, female gender, or other genetic, environmental, or cultural predisposing factors are present. Subsequently, a viral infection, accident, or other acute or chronic stressor triggers or precipitates illness. Although in most persons the initial viral infection or other trigger is contained and resolves spontaneously, in some the acute condition becomes chronic. During this transition period (typically within the first 6 months of illness), predictors of chronicity become apparent, such as the development of immune and/or neuroendocrine dysfunction that themselves may lead to additional symptoms. Symptoms then lead to disability, which is both due to, and results in, psychological distress, social dysfunction, stress, and other factors, that perpetuate illness. Objectives: Use monozygotic twins discordant for CFS and subjects with post-infectious fatigue following documented mononucleosis to identify the predisposing factors, precipitants, predictors, and perpetuators of chronicity in patients with CFS and post-infectious fatigue; Characterize CFS in terms of clinical and functional status, psychiatric and neuropsychological dysfunction, sleep impairment, and other parameters; Characterize CFS immunologically using monozygotic twins discordant for CFS, and to utilize basic science techniques in a theoretically guided fashion, to search for a novel infectious agent in individuals at high risk for infection based on clinical and laboratory data; Compare the symptoms and clinical features of CFS to a syndrome of post-infectious fatigue following documented acute infectious mononucleosis; Develop and evaluate the operating characteristics of measures for assessing immunological, neurocognitive, and psychosocial dysfunction in CFS; Use longitudinal follow-up studies to clarify the natural history, prognosis, and predictors of improvement of CFS and post-infectious fatigue. These goals will be accomplished through four individual Research Projects and Administrative, Biostatistical & Data Management, and Clinical Cores. Faculty Principal Investigator: Dedra S. Buchwald, M.D. Project 1: Monozygotic Twins with CFS, An evaluation of Neuropsychological, Neuroendocrine and Sleep Function Project Leader: Dedra S. Buchwald, M.D. Project 2: Immunology and Virology of CFS in Monozygotic Twins Project Leader: Lawrence Corey, M.D. Project 4: Biological and Psychosocial Factors in Post-Infectious Fatigue Project Leader: Dedra S. Buchwald, M.D. Project 5: Prognosis of Chronic Fatigue Syndrome Project Leader: Karen B. Schmaling, Ph.D.

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