Journal: Behav Brain Funct. 2009 Feb 23;5(1):10. [Epub ahead of print]
Authors: Wyller VB, Eriksen HR, Malterud K.
NLM Citation: PMID: 19236717
We present an integrative model of disease mechanisms in the Chronic
Fatigue Syndrome (CFS), unifying empirical findings from different
research traditions. Based upon the Cognitive activation theory of
stress (CATS), we argue that new data on cardiovascular and
thermoregulatory regulation indicate a state of permanent arousal
responses - sustained arousal - in this condition. We suggest that
sustained arousal can originate from different precipitating factors
(infections, psychosocial challenges) interacting with predisposing
factors (genetic traits, personality) and learned expectancies
(classical and operant conditioning).
Furthermore, sustained arousal may explain documented alterations by
establishing vicious circles within immunology (Th2 (humoral) vs Th1
(cellular) predominance), endocrinology (attenuated HPA axis),
skeletal muscle function (attenuated cortical activation, increased
oxidative stress) and cognition (impaired memory and information processing).
Finally, we propose a causal link between sustained arousal and the
experience of fatigue. The model of sustained arousal embraces all
main findings concerning CFS disease mechanisms within one