Research and articles concerning GBS and fatigue
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AnonymousJanuary 20, 2008 at 11:13 pm
[B]Research and articles concerning GBS and fatigue[/B]
Last updated: Jan 20 2008.
The knowledge related to this disease and fatigue is limited, but research continues. I estimate 30,000 people in the US are dealing with residuals related to GBS, many suffering with fatigue. The truth of the matter is that those those of us afflicted with GBS and subsequent residuals are a tiny minority when compared to major diseases. Rare neurological disorders are placed on the back burner and it is hard to find what research is out there.
Here are some links to research and articles related to fatigue and GBS. I hope they might provide some insight. If you find other research papers related to this subject please e-mail me at [email]rocker@woh.rr.com[/email] or post them below. From time to time I will update the few lead posts (had to take additional slots because of the Forum limit on text in a post), which will then include, I hope, links posted below the lead posts updated by participants (YOU!). I will try and make it a “Definitive thread” on research and article links for GBS related to fatigue. PLEASE REPORT BROKEN LINKS BELOW and if you find additional links to the same reports at a different location please place them in a thread below with reference to the article title!
Hugs,
Rocker
PS I will try to collate and sort this data down the road so that it can be searched alphabetically. In the mean time, please use your web browser search tool to find specific words if you are looking for a specific study or topic.
PPS Sorry for the lack of active hyperlinks…Omit the [URL][/URL] when you cut and paste the link! To do so, highlight everything other than the brackets, by left clicking and dragging your mouse across the letters and symbols, then right click while pointing at the highlighted text. Select copy, then go to the top of your web browser- the address field- and highlight what is in this field. Then, right click with your mouse over the highlighted field and select Paste. Once the field is propagated with this new address, select go! It’s easy, although somewhat tedious 🙁
[B][SIZE=”4″]Research[/SIZE][/B]
-Understanding Guillain-Barré syndrome and central nervous system involvement.
Recognition is growing that recovery is not as smooth and free of symptoms as previously thought. Following “recovery” some people endure long-term residual symptoms, such as fatigue and pain.[url]http://www.ncbi.nlm.nih.gov/pubmed/16175926?ordinalpos=13&itool=EntrezSystem2.PEntrez .Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum[/url]
-Residual fatigue is independent of antecedent events and disease severity in Guillain-Barré syndrome.
Severe fatigue, expressed as a mean Fatigue Severity Scale (FSS) score of 5.0 or more, was present in 60% of all patients. It was more frequently present in females and in patients over 50 years (p < 0.01). There was no significant relationship between fatigue severity and the level of functional disability at nadir, antecedent events or infections, clinical variables, and time to follow-up after GBS. [url]http://www.ncbi.nlm.nih.gov/pubmed/16998652?ordinalpos=5&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum[/url] [url]http://www.springerlink.com/content/a428850007783122/[/url] -Nerve conduction studies in relation to residual fatigue in Guillain-Barré syndrome found "No correlations were found between the electrophysiological findings and the fatigue scores,muscle strength, or functional scores. " [url]http://www.ncbi.nlm.nih.gov/pubmed/16845568?ordinalpos=6&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum[/url] -Fatigue in immune-mediated polyneuropathies. European Inflammatory Neuropathy Cause and Treatment (INCAT) Group. RESULTS: "Severe" fatigue (FSS scores > or =95th percentile values in controls) was present in 80% of the patients. Fatigue was not significantly related to general strength, sensory deficits, f-score, and duration of symptoms. Severe fatigue was reported in 81% to 86% of patients with normal strength or sensation. Eighty percent of the patients (controls, 12%) reported their fatigue being among the three most disabling symptoms. CONCLUSION: Fatigue is a major symptom in patients with immune-mediated polyneuropathies and may persist for years after apparent recovery. The Fatigue Severity Scale seems appropriate for assessing fatigue in these patients because good internal consistency, reliability, and validity were demonstrated.[url]http://www.ncbi.nlm.nih.gov/pubmed/10563607?ordinalpos=27&itool=EntrezSystem2.PEntrez .Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum[/url]
[url]http://www.neurology.org/cgi/content/abstract/53/8/1648[/url]
-Conduction velocity distribution in neurologically well-recovered but fatigued Guillain-Barré syndrome patients.
Conventional maximal nerve conduction velocities (NCVs) did not show differences between GBS patients and healthy controls. However, in both GBS and CIDP patients the CVD was altered, showing significant narrowing of the velocity distribution with loss of the fastest- and slowest-conducting fibers. These changes were most pronounced in the subgroup of patients with the lowest fatigue scores.[url]http://www.ncbi.nlm.nih.gov/pubmed/16270305?ordinalpos=12&itool=EntrezSystem2.PEntrez .Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum[/url]
-Impairment in Guillain-Barré syndrome during the first 2 years after onset: a prospective study.
CONCLUSIONS: Recovery occurred mainly during the first year after onset. At 2 years, motor impairment and sensory impairment were each still detectable in more than 50% of patients. We conclude that residual impairment is significant, somatically widespread and, likely, persistent.[url]http://www.ncbi.nlm.nih.gov/pubmed/15546603?ordinalpos=19&itool=EntrezSystem2.PEntrez .Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum[/url]
-Fatigue and neuromuscular diseases.
CONCLUSION: This review shows that fatigue has to be taken into account in patients with neuromuscular diseases. In this context, pathophysiology of fatigue often implies the motor component but the disease evolution and the physical obligates of daily life also induce an important psychological component.[url]http://www.ncbi.nlm.nih.gov/pubmed/16780988?ordinalpos=7&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum[/url]
-Clinical neurophysiology of fatigue.
More than 60% of all neuromuscular patients suffer from severe fatigue, a prevalence resembling that of patients with MS. Except for several rare myopathies with specific metabolic derangements leading to exercise-induced muscle fatigue, most studies have not identified a prominent peripheral cause for the fatigue in this population.[url]http://www.ncbi.nlm.nih.gov/pubmed/18039594?ordinalpos=1&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum[/url]
-Analysing the favourable effects of physical exercise:
relationships between physical fitness, fatigue and functioning in Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy.CONCLUSION: Changes in fatigue, actual mobility and perceived functioning seem not to be influenced by changes in physical fitness. This study stresses the presence and importance of additional effects of a physical training program, not directly related to increasing fitness.[url]http://www.ncbi.nlm.nih.gov/pubmed/17351693?ordinalpos=2&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum[/url]
-Amantadine for treatment of fatigue in Guillain-Barre syndrome:
a randomised, double blind, placebo controlled, crossover trial. CONCLUSIONS: Amantadine was not superior to placebo. Because fatigue remains a serious complaint, other studies evaluating new treatment options are strongly recommended.[url]http://www.ncbi.nlm.nih.gov/pubmed/16361594?ordinalpos=11&itool=EntrezSystem2.PEntrez .Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum[/url]
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AnonymousJanuary 20, 2008 at 11:17 pm
[B][SIZE=”4″]Research continued[/SIZE][/B]
-Clinical neurophysiology of fatigue.
As regards neuromuscular disorders, fatigue has been reported in patients with post-polio syndrome, myasthenia gravis, Guillain-Barré syndrome, facioscapulohumeral dystrophy, myotonic dystrophy and hereditary motor and sensory neuropathy type-I. More than 60% of all neuromuscular patients suffer from severe fatigue, a prevalence resembling that of patients with MS… The reliability of the psychological and clinical neurophysiological assessment techniques available today allows a multidisciplinary approach to fatigue in neurological patients, which may contribute to the elucidation of the pathophysiological mechanisms of chronic fatigue, with the ultimate goal to develop tailored treatments for fatigue in neurological patients.[url]http://www.ncbi.nlm.nih.gov/pubmed/18039594?ordinalpos=1&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum[/url]
-Residual Problems Following Recovery from Guillain-Barre¢ Syndrome: Do Depression and Anxiety Play a Part?
Meythaler, De Vivo, and Braswell (1997) estimate that at any one time between 25,000 and 50,000 individuals in the USA have some form of long term disability secondary to GBS. These include muscle weakness (especially limb muscles), abnormal sensations, shortness of breath, pain, and extreme fatigue.[url]http://www.hicsocial.org/Social2003Proceedings/Cecilia%20Bourke.pdf[/url]
-Supportive Care for Patients With Guillain-Barré Syndrome.
Persistent fatigue following Guillain-Barré syndrome is common and may be helped by an exercise program.[url]http://archneur.highwire.org/cgi/content/abstract/62/8/1194[/url]
-Contribution of central and peripheral factors to residual fatigue in Guillain-Barré syndrome.
Many patients with Guillain-Barré syndrome (GBS) suffer from severe residual fatigue that has an uncertain basis. We determined the relative contribution of peripheral and central factors during a 2-min fatiguing sustained maximal voluntary contraction (MVC) in 10 neurologically well-recovered GBS patients and 12 age- and sex-matched healthy controls. Physiological fatigue was defined as the decline of voluntary force during an MVC of the biceps brachii. Relative amounts of peripheral fatigue and central activation failure were determined combining voluntary force and force responses to electrical stimulation. Surface electromyography was used to determine muscle-fiber conduction velocity. During the first minute of sustained MVC, peripheral fatigue developed more slowly in patients than in controls. Central fatigue only occurred in patients. The muscle-fiber conduction velocity was higher in patients. The initial MVC, decrease of MVC, initial force response, and initial central activation failure did not significantly differ between the groups. Although peripheral mechanisms cannot be excluded in the pathogenesis of residual fatigue after GBS, these results suggest that central changes are involved. This study thus provides further insight into the factors contributing to residual fatigue in GBS patients. Muscle Nerve, 2007[url]http://www3.interscience.wiley.com/cgi-bin/abstract/114079839/ABSTRACT?CRETRY=1&SRETRY=0[/url]
-Autism & Vaccines: A New Look At An Old Story.
Likewise, clinical symptoms that follow hepatitis B vaccine complications are similar to lupus and rheumatoid arthritis, as well as optic neuritis and multiple sclerosis (Guiserix, 1996; Pope & Bell, 1998; WHO, 1990;Berkman, 1996). GBS, chronic fatigue and vascular disorders have also been reported (Shaw, 1988; Salit, 1993; Granel, 1997).[url]http://www.nvic.org/Diseases/autismsp.htm[/url]
-Physical training and fatigue, fitness, and quality of life in Guillain-Barré syndrome and CIDP.
The authors performed a 12-week study of bicycle exercise training in 20 patients with severe fatigue, 16 with relatively good recovery from GBS, and 4 with stable CIDP. Training seemed well tolerated, and self-reported fatigue scores decreased 20% (p = 0.001). Physical fitness, functional outcome, and quality of life were improved.[url]http://www.ncbi.nlm.nih.gov/pubmed/15623709?ordinalpos=17&itool=EntrezSystem2.PEntrez .Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum[/url]
[url]http://www.ncpad.org/research/fact_sheet.php?sheet=314&view=all[/url]
-The vexed question of residuals in Guillain Barre Syndrome.
“Steinberg also commented that patients might develop fatigue, particularly with sustained activity, and demonstrate poor endurance, even with normal muscle strength. This could lead to serious problems for those who worked long hours and/or had physically demanding jobs.”[url]http://www.jsmarcussen.com/gbs/print/residual3.htm[/url]
-Nerve conduction studies in relation to residual fatigue in Guillain-Barré syndrome.
This study demonstrates that fatigue in GBS is not explained by residual nerve dysfunction, using conventional NC measurements.[url]http://www.springerlink.com/content/t3t272k6752lh414/?p=64c176f5d2754d34956d02a26bdebffd&pi=3[/url]
-Fatigue in Guillain-Barre Syndrome.
Fatigue is a common symptom in patients with Guillain-Barré Syndrome and CIDP. The mechanisms of fatigue are still incompletely understood but fatigue can be one of the most disabling symptoms for GBS/CIDP patients. There are at least three different ways that fatigue can manifest itself…[url]http://www.gbs-cidp.org/newsletters/2001winter.htm[/url]
– Residual Effects Following Guillain-Barré.
The study used a validated index of fatigue severity to assess residual disability.
It included 83 patients who had suffered from GBS an average of five years previously. About 80% of these patients experienced fatigue that was considered severe enough to interfere with their life despite that fact that the majority had normal strength or only minor weakness.[url]http://www.jsmarcussen.com/gbs/print/residual1.htm[/url]
[url]http://www.angelfire.com/home/gbs/residual.html[/url]
-Treatment of Guillain-Barré syndrome and causes and treatment of residual fatigue.
The considerable percentages of (long-lasting) morbidity and mortality, as well as the residual complaints of severe fatigue, were the most important reasons to initiate this study[url]http://repub.eur.nl/publications/med_hea/mh3/294503503/[/url]
[url]http://bugsmart.com.au/content/view/27/58/[/url]
-Disability After “Recovery” From GBS.
In a recent study of 83 patients recovering from GBS, severe fatigue was reported as one of the three most disabling symptoms by over 80%. The incidence of fatigue did not correlate with age, or motor and sensory residual deficits, but fatigue was more common in women.[url]http://www.gbs-cidp.org/newsletters/2000fall.htm[/url]
-Practice parameter: Immunotherapy for Guillain–Barré syndrome: Report of the Quality Standards Subcommittee of the American Academy of Neurology.
Guillain–Barré syndrome (GBS) affects between 1 and 4 per 100,000 of the population annually throughout the world, causing respiratory failure requiring ventilation in approximately 25%, death in 4 to 15%, persistent disability in approximately 20%, and persistent fatigue in 67%. The costs in the United States have been estimated as $110,000 for direct health care and $360,000 in lost productivity per patient.[url]http://www.neurology.org/cgi/content/full/61/6/736[/url]
-Residual Problems Following Recovery from Guillain-Barre¢ Syndrome: Do Depression and Anxiety Play a Part?
Meythaler, De Vivo, and Braswell (1997) estimate that at any one time between 25,000 and 50,000 individuals in the USA have some form of long term disability secondary to GBS. These include muscle weakness (especially limb muscles), abnormal sensations, shortness of breath, pain, and extreme fatigue.[url]http://www.hicsocial.org/Social2003Proceedings/Cecilia%20Bourke.pdf[/url]
-Supportive Care for Patients With Guillain-Barré Syndrome.
Persistent fatigue following Guillain-Barré syndrome is common and may be helped by an exercise program.[url]http://archneur.highwire.org/cgi/content/abstract/62/8/1194[/url]
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AnonymousJanuary 20, 2008 at 11:20 pm
[B]Research continued[/B]
-Contribution of central and peripheral factors to residual fatigue in Guillain-Barré syndrome.
Many patients with Guillain-Barré syndrome (GBS) suffer from severe residual fatigue that has an uncertain basis. We determined the relative contribution of peripheral and central factors during a 2-min fatiguing sustained maximal voluntary contraction (MVC) in 10 neurologically well-recovered GBS patients and 12 age- and sex-matched healthy controls. Physiological fatigue was defined as the decline of voluntary force during an MVC of the biceps brachii. Relative amounts of peripheral fatigue and central activation failure were determined combining voluntary force and force responses to electrical stimulation. Surface electromyography was used to determine muscle-fiber conduction velocity. During the first minute of sustained MVC, peripheral fatigue developed more slowly in patients than in controls. Central fatigue only occurred in patients. The muscle-fiber conduction velocity was higher in patients. The initial MVC, decrease of MVC, initial force response, and initial central activation failure did not significantly differ between the groups. Although peripheral mechanisms cannot be excluded in the pathogenesis of residual fatigue after GBS, these results suggest that central changes are involved. This study thus provides further insight into the factors contributing to residual fatigue in GBS patients. Muscle Nerve, 2007[url]http://www3.interscience.wiley.com/cgi-bin/abstract/114079839/ABSTRACT?CRETRY=1&SRETRY=0[/url]
-Autism & Vaccines: A New Look At An Old Story.
Likewise, clinical symptoms that follow hepatitis B vaccine complications are similar to lupus and rheumatoid arthritis, as well as optic neuritis and multiple sclerosis (Guiserix, 1996; Pope & Bell, 1998; WHO, 1990;Berkman, 1996). GBS, chronic fatigue and vascular disorders have also been reported (Shaw, 1988; Salit, 1993; Granel, 1997).[url]http://www.nvic.org/Diseases/autismsp.htm[/url]
An association between Vogt-Koyanagi-Harada disease and Guillain-Barré syndrome.
…dysesthesias of sudden onset involving her upper limbs, malaise, and fatigue. … Achilles tendon reflexes, and the diagnosis of Guillain-Barré syndrome was made…CONCLUSIONS: Vogt-Koyanagi-Harada disease may follow or occur simultaneously with Guillain-Barré;1.5 syndrome. The fact that these two autoimmune disorders occur together in some patients suggest that they may share common disease mechanisms.[url]http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VK5-42Y128D-8&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=4d7c2966fe37a89da7d18018af1acbaa[/url]
Guillain-Barré syndrome Journal: Neurological Sciences.
…5–15% of the patients die and more patients are left with a disabling motor deficit and/or fatigue. Electrophysiology and cerebrospinal fluid evaluation support the diagnosis. The treatment of GBS is multidisciplinary, and both plasma exchange and high dose immunoglobulin (IVIg) are effective in reducing both the severity of the disease and the residual deficits. Finally, steroids are not effective in GBS.[url]http://www.springerlink.com/content/53585587p18n577k/[/url]
-SAFETY OF IMMUNIZATION AND ADVERSE EVENTS FOLLOWING VACCINATION AGAINST HEPATITIS B.
A number of controversial adverse events have been purported to be associated with hepatitis B vaccines including rheumatoid arthritis, diabetes, chronic fatigue syndrome, demyelinating diseases (e.g. multiple sclerosis (MS)) and more recently lymphoblastic leukemia. There had also been a suggested possible association between Guillain–Barr� syndrome (GBS) and receipt of the first dose of plasma-derived vaccine in the US (CDC, 1991). In 1991, Guillain–Barr� syndrome was reported at a very low rate (0.5 per 100 000 vaccine recipients), with no deaths in all reported cases among adults. Current available data indicate no demonstrable association between receipt of either plasma-derived or recombinant vaccine and GBS. But the IOM review. At its 2002 review, the IOM concluded but that the evidence was inadequate to accept or reject a causal relationship between hepatitis B vaccine and first episodes of a central nervous system demyelinating disorder, acute disseminated encephalomyelitis , optic neuritis, transverse myelitis, GBS and brachial neuritis.[url]http://66.102.1.104/scholar?num=100&hl=en&lr=&newwindow=1&safe=off&q=cache:cv5kfEG47igJ:www.easl.ch/hbv2002/abstracts/2.1200.doc+Guillain-Barr%C3%A9+syndrome+AND+FATIGUE[/url]
-Connecting impairment, disability, and handicap in immune mediated polyneuropathies.
Methods: Four impairment measures (fatigue severity scale, MRC sum score, “INCAT” sensory sum score, grip strength with the Vigorimeter), five disability scales (nine hole peg test, 10 metres walking test, an overall disability sum score (ODSS), Hughes functional grading scale, Rankin scale), and a handicap scale (Rotterdam nine items handicap scale (RIHS9)) were assessed in 113 clinically stable patients (83 with Guillain–Barré syndrome, 22 with chronic inflammatory demyelinating polyneuropathy, eight with a gammopathy related polyneuropathy). Conclusions: In contrast to some suggestions, support for the ICIDH model is found in the current study because significant associations were shown between its various levels in patients with immune mediated polyneuropathies. Further studies are required to examine other possible contributors to deficits in daily life and social functioning in these conditions.[url]http://jnnp.bmj.com/cgi/content/abstract/74/1/99[/url]
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AnonymousJanuary 20, 2008 at 11:24 pm
[B]Articles[/B]
-Here is a great article on Chronic fatigue. It really shows how difficult it is to define what CFS actually is, not to mention the etiology and treatment options. Rocker
[url]http://en.wikipedia.org/wiki/Chronic_fatigue_syndrome[/url]
– Article, not research. A recent study in the US has estimated a 37% decline in household productivity and a 54% reduction in workforce productivity in people with CFS. The annual total value of lost productivity in the USA was calculated to be $US9.1 billion or about $US20 000 per person with CFS (Reynolds et al. 2004).
Article Bibliography
Buchwald D, Herrell R, Ashton S, Belcourt M, Schmaling K, Sullivan P, Neale, M and Goldberg J. 2001. A twin study of chronic fatigue. Psychosomatic Medicine 63:936-943.Chaudhuri A and Behan P O. 2000. Fatigue and basal ganglia. Journal of the Neurological Sciences 179 :34-42.
Cleare A J. 2003. The neuroendocrinology of chronic fatigue syndrome. Endocrine Reviews 24(2):236-252
Fulcher K Y and White P D. 2000.Strength and physiological response to exercise in patients with chronic fatigue syndrome. Journal of Neurology, Neurosurgery and Psychiatry 69:302-307.
Kavelaars A, Kuis W, Knook L, Sinnema G and Heijnen C J. 2000. Disturbed neuroendocrine-immune interactions in chronic fatigue syndrome. Journal of Clinical Endocrinology and Metabolism 85(2):692-696.
Reid S, Chalder T, Cleare A, Hotoppf M and Wessely S. 2000. Chronic fatigue syndrome. British Medical Journal 320:292-296.
Reynolds K J, Vernon S D, Bouchery E and Reeves W C. 2004. The economic impact of chronic fatigue syndrome. Cost Effective Resoure Allocation 2:4.
Tan E M, Sugiura K and Gupta S. 2002. The case definition of chronic fatigue syndrome. Journal of Clinical Immunology 22(1):8-12.
Yirmiya R. 2000. Depression in medical illness: the role of the immune system. Western Journal Medicine 173:333-336.
END-Article, not research. Everything you wanted to know about GBS…almost.The term myalgic encephalomyelitis was replaced with the more accurate term CFS because sufferers do not have encephalomyelitis (inflammation of the muscle membranes) and many do not have myalgia (muscle pain). Stereotypes of the typical sufferer being a middle-class, middle-aged woman have also been found to be unjustified. CFS is not a new phenomenon, with cases documented worldwide for more than 50 years…Although it is in part the result of the demyelination it is not properly understood why it occurs.
[url]http://www.geocities.com/westshape/everygbs.htm[/url]
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AnonymousJanuary 29, 2008 at 5:03 pm
hey slugo,
in response to your question about college athletes..you may want to contact Tennesee Tech Coach Mike Sutton, he was diagosed with GBS and is still recovering from it. I would think since he is a coach he might have had a little more information concerning athletes and GBS. I have tried to keep up with information about him since the day he was diagnosed and the man is remarkable. It might be worth a try.Good luck
sherry
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