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Center for Clinical and Epidemiological Research (CCER)

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Previous Projects of Chronic Pain and Chronic Fatigue Programs

Chronic Fatigue Syndrome Cooperative Research Center

This Center was originally funded by the National Institutes of Health in 1994 and renewed in 1999. The center funding ended on July 31, 2005. The centers consisted of three core groups (administrative, biostatistical and clinical cores) and at least four research projects. Our projects are briefly described below.

Phase 1 Monozygotic twins with Chronic Fatigue Syndrome

The Chronic Fatigue Syndrome and Fibromyalgia Twin Registry was the source for a sample of identical twins discordant for chronic fatigue syndrome (one has chronic fatigue syndrome, the other is free of fatigue). Using the information from the Chronic Fatigue Syndrome and Fibromyalgia Twin Registry as well as medical records, 22 pairs of chronic fatigue syndrome-discordant monozygotic twins (identical) were selected for a 6-day evaluation that included tests of sleep, tests of exercise capacity, neuropsychological assessment, SPECT imaging, a psychiatric and life events interview, and tests of viral replication and the immune system. This study is referred to as Phase 1. Data from the twin pairs who completed the evaluation demonstrate remarkably disrupted sleep, poor performance on the several cognitive tests, and severely impaired exercise capacity in both twins, as well as intriguing differences in immune function and perceptual style. Additionally, the preliminary analysis of data from Phase 1 led to the follow-up evaluation described next as Phase 2. Dr. Buchwald was the lead investigator on this project.

Phase 2 Monozygotic Twins with Chronic Fatigue Syndrome--Predisposition or Perception?

This study invited all twin pairs who completed Phase 1 to return to Seattle (24-30 months later) for  a further intensive study that included repeating several of the Phase 1 tests and new tests aimed at differences in perception. Originally we planned to examine 10 pairs of twins in which both members were healthy to clarify the interpretation of the abnormalities documented in the healthy member of the discordant pairs. However, we found that a 6-day evaluation was not feasible for the healthy twins. Dr. Buchwald was the lead investigator on this project.
View Phase 2 CFS Twins Abstract.

A Population-Based Twin Study of Chronic Fatigue Syndrome

The purpose of this study, led by Dr. Patrick Sullivan (currently of University of North Carolina at Chapel Hill), was to attempt to shed light on a number of basic questions about chronic fatigue syndrome through screening the population-based Mid-Atlantic Twin Registry at the Virginia Commonwealth University for the lifetime presence of chronic fatigue syndrome-like illness (and several overlapping conditions such as fibromyalgia and major depression). A sample of twins were interviewed about chronic fatigue syndrome symptoms, psychiatric disorders, stressful life events, and medical history. We planned for medical review and an in-person evaluation but Virginia Commonwealth University experienced problems with their internal review board and this study was halted. Limited data are being analyzed presently.
View Population-Based CFS Twin Study Abstract.

Children of Chronic Fatigue Syndrome Patients

This study was led by Dr. Mark Smith of University of Washington and Children’s Hospital. The primary purpose was to compare the fatigue status, functional performance, and psychological health of children who have one parent with chronic fatigue syndrome with that of children of parents without chronic fatigue syndrome. A secondary goal was to examine the relationship between parental chronic fatigue syndrome and a selected set of vulnerability markers in children.
View Children of CFS Abstract.

Patient-Partner Interactions--Perpetuators of Illness?

This project, led by Dr. Joan Romano from the Department of Psychiatry at the UW, evaluated interactions between chronic fatigue syndrome patients and their partners to evaluate whether responses of partners influence illness behavior of chronic fatigue syndrome patients, and possibly to identify factors that perpetuate functional disability in chronic fatigue syndrome. Findings from this study could pave the way for developing psychosocial treatments involving both the patient and partner to decrease the impact of chronic fatigue syndrome on patient functional disability.
View Patient-Partner Interactions in CFS Abstract.

Chiari I Malformation and Syrengomyelia in Identical Twins Discordant for Chronic Fatigue Syndrome

This project, which was funded by the American Syrengomyelia Alliance Project and led by Dr. Buchwald, was designed to establish the relationship of hindbrain anomalies and cervical cord problems to chronic fatigue syndrome. The specific aim was to determine the frequency of hindbrain and spine abnormalities such as chiari 1 malformation and syrengomyelia among monozygotic twins with chronic fatigue syndrome and their healthy co-twins.
View Chiari I in CFS Abstract.

Complementary and Alternative Treatment Projects

Efficacy of Reiki in the Treatment of Fibromyalgia and Chronic Fatigue

This study, led by Drs. Dedra Buchwald and Nassim Assefi from the Department of Medicine at the University of Washington and funded by the National Center for Complementary and Alternative Medicine at the National Institutes of Health, examined whether Reiki, which is a Japanese form of energy medicine conveyed by light touch and at a distance, is a helpful treatment for fibromyalgia and its associated symptoms.
View Reiki for Fibromyalgia Abstract.

Efficacy of Acupuncture in the Treatment of Fibromyalgia

This study was also led by Drs Buchwald and Assefi and funded by the National Center for Complementary and Alternative Medicine. The study was designed to examined whether acupuncture is a helpful treatment for fibromyalgia. Acupuncture is a form of Traditional Chinese Medicine that has been used for at least 2,500 years. While the National Institutes of Health Expert Consensus Statement states, "Musculoskeletal conditions such as fibromyalgia and myofascial pain are conditions for which acupuncture may be beneficial," we do not understand what part of acupuncture works. Acupuncture treatments usually involve the insertion of thin needles just beneath the skin at defined acupuncture points, with the goal of restoring a balance of vital energy. However, other forms of stimulating acupuncture points (such as non-insertive needling, laser stimulation and acupressure) are also thought to be potentially beneficial.
View Acupuncture for Fibromyalgia Abstract.