Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome

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dc.contributor.authorAzcue, N.
dc.contributor.authorPino, Rocío del
dc.contributor.authorAcera, M.
dc.contributor.authorFernández Valle, Tamara
dc.contributor.authorAyo Mentxakatorre, Naia
dc.contributor.authorPérez Concha, Tomás
dc.contributor.authorMurueta-Goyena Larrañaga, Ane
dc.contributor.authorLafuente, Jose Vicente
dc.contributor.authorPrada, A.
dc.contributor.authorLópez de Munain Arregui, Adolfo
dc.contributor.authorRuiz Irastorza, Guillermo
dc.contributor.authorMartín Iglesias, Daniel
dc.contributor.authorRibacoba Bajo, Laureano
dc.contributor.authorGabilondo, Iñigo
dc.contributor.authorGómez Esteban, Juan Carlos
dc.contributor.authorTijero Merino, Beatriz
dc.date.accessioned2025-07-24T10:49:01Z
dc.date.available2025-07-24T10:49:01Z
dc.date.issued2023-11-15
dc.date.updated2025-07-24T10:49:01Z
dc.description.abstractBackground: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and post-COVID condition can present similarities such as fatigue, brain fog, autonomic and neuropathic symptoms. Methods: The study included 87 patients with post-COVID condition, 50 patients with ME/CFS, and 50 healthy controls (HC). The hemodynamic autonomic function was evaluated using the deep breathing technique, Valsalva maneuver, and Tilt test. The presence of autonomic and sensory small fiber neuropathy (SFN) was assessed with the Sudoscan and with heat and cold evoked potentials, respectively. Finally, a complete neuropsychological evaluation was performed. The objective of this study was to analyze and compare the autonomic and neuropathic symptoms in post-COVID condition with ME/CFS, and HC, as well as, analyze the relationship of these symptoms with cognition and fatigue. Results: Statistically significant differences were found between groups in heart rate using the Kruskal–Wallis test (H), with ME/CFS group presenting the highest (H = 18.3; p ≤.001). The Postural Orthostatic Tachycardia Syndrome (POTS), and pathological values in palms on the Sudoscan were found in 31% and 34% of ME/CFS, and 13.8% and 19.5% of post-COVID patients, respectively. Concerning evoked potentials, statistically significant differences were found in response latency to heat stimuli between groups (H = 23.6; p ≤.01). Latency was highest in ME/CFS, and lowest in HC. Regarding cognition, lower parasympathetic activation was associated with worse cognitive performance. Conclusions: Both syndromes were characterized by inappropriate tachycardia at rest, with a high percentage of patients with POTS. The prolonged latencies for heat stimuli suggested damage to unmyelinated fibers. The higher proportion of patients with pathological results for upper extremities on the Sudoscan suggested a non-length-dependent SFN.en
dc.description.sponsorshipThis study has been funded by Instituto de Salud Carlos III (ISCIII) through the project PI20/01076 and co‑funded by the European Union, EITB maratoia (BIOS21/COV/006) and grants for health research projects from the Basque Government (2021111006). Azcue, N. received a pre‑doctoral research grant from the basque government (PRE_2022_2_0111)en
dc.identifier.citationAzcue, Del Pino, Acera, Fernández-Valle, Ayo-Mentxakatorre, Pérez-Concha, Murueta-Goyena, Lafuente, Prada, López de Munain, Ruiz Irastorza, Martín-Iglesias, Ribacoba, Gabilondo, Gómez-Esteban, & Tijero-Merino. (2023). Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome. Journal of Translational Medicine, 21(1). https://doi.org/10.1186/S12967-023-04678-3
dc.identifier.doi10.1186/S12967-023-04678-3
dc.identifier.eissn1479-5876
dc.identifier.urihttps://hdl.handle.net/20.500.14454/3286
dc.language.isoeng
dc.publisherBioMed Central Ltd
dc.rights© The Author(s) 2023
dc.subject.otherCognition
dc.subject.otherDysautonomia
dc.subject.otherMyalgic Encephalomyelitis/Chronic Fatigue Syndrome
dc.subject.otherPost-COVID condition
dc.subject.otherSmall fiber neuropathy
dc.titleDysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndromeen
dc.typejournal article
dcterms.accessRightsopen access
oaire.citation.issue1
oaire.citation.titleJournal of Translational Medicine
oaire.citation.volume21
oaire.licenseConditionhttps://creativecommons.org/licenses/by/4.0/
oaire.versionVoR
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