The research links chronic fatigue syndrome with a nervous system disorder called neurally mediated hypotension. In this disorder, explains Rowe, the communication between the heart and the brain is abnormal. Normally, when a patient sits or stands, the brain sends a message to the heart telling it to pump more blood throughout the body. But in patients with neurally mediated hypotension, the reverse occurs. Blood pools in the feet, and blood pressure drops precariously low.
Patients often faint.
So the investigators tested a group of chronic fatigue patients using a tilt table, a device that is also used to diagnose neurally mediated hypotension. Patients lie flat on the table for a few minutes, and then are tilted to a 70-degree upright angle for 15 minutes or longer. That's just what the Hopkins team observed in seven adolescent patients with chronic fatigue symptoms. In the March 11 Lancet , Rowe, pediatrician Hugh Calkins, and Issam Bou-Holaigah, a pediatric cardiology fellow, report that during the tilt portion of the test, all seven of the patients felt lightheaded and fatigued, and two fainted for the first time. If it is triggered enough, patients get symptoms of chronic fatigue.