Comparison of a 20 degree and 70 degree tilt test in adolescent myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients
- Resource Type
- article
- Authors
- C. (Linda) M. C. van Campen; Peter C. Rowe; Frans C. Visser
- Source
- Frontiers in Pediatrics, Vol 11 (2023)
- Subject
- orthostatic intolerance
cerebral blood flow
tilt-table testing
myalgic encephalomyelitis
adolescents
20 degree
Pediatrics
RJ1-570
- Language
- English
- ISSN
- 2296-2360
IntroductionDuring a standard 70-degree head-up tilt test, 90% of adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) develop an abnormal reduction in cerebral blood flow (CBF). A 70-degree test might not be tolerated by young ME/CFS patients because of the high incidence of syncopal spells. This study examined whether a test at 20 degrees would be sufficient to provoke important reductions in CBF in young ME/CFS patients.MethodsWe analyzed 83 studies of adolescent ME/CFS patients. We assessed CBF using extracranial Doppler measurements of the internal carotid and vertebral arteries supine and during the tilt. We studied 42 adolescents during a 20 degree and 41 during a 70 degree test.ResultsAt 20 degrees, no patients developed postural orthostatic tachycardia (POTS), compared to 32% at 70 degrees (p = 0.0002). The CBF reduction during the 20 degree tilt of −27(6)% was slightly less than during the reduction during a 70 degree test [−31(7)%; p = 0.003]. Seventeen adolescents had CBF measurements at both 20 and 70 degrees. The CBF reduction in these patients with both a 20 and 70 degrees test was significantly larger at 70 degrees than at 20 degrees (p