The largest in-depth study of people with chronic fatigue syndrome has established that the great majority have brain damage and evidence of active infection by a common virus.
The long-awaited report, to be published today, strongly supports the contention by some doctors and thousands of patients that the disorder often has physical causes rather than only psychological ones.
The study focused on the original cluster of chronic fatigue patients in the Lake Tahoe region of Northern California and Nevada who first brought the disorder to public and scientific attention in 1985. Reflecting the medical establishment's skepticism toward the syndrome, often known as "yuppie flu," the report was rejected by medical journals until enough data accumulated to show undeniable evidence of viral, immune-system and brain effects.
Nearly 4 out of 5 studied Lake Tahoe patients had evidence of brain inflammation, compared with only 1 in 5 healthy comparison subjects. Similarly, 70 percent of the chronic fatigue patients had evidence of active infection by human herpes virus-6, versus 20 percent of the control subjects.
Patients suffering from the syndrome also had evidence of immune-system abnormalities suggesting active viral infection. One of the authors of the study said the results painted "a picture of an immune system chronically at war."
The findings are welcomed by advocates for patients with chronic fatigue syndrome, who have long been frustrated by doctors' reluctance to accept the disorder as a genuine organic disease rather than as primarily a psychological disturbance.
Jan Montgomery of San Francisco, co-director of the Chronic Fatigue Immune Dysfunction Syndrome Foundation, says 1 million to 3 million Americans have the disorder. Dr. Alan L. Landay, a Chicago immunologist, said this and other ongoing research should "point us in the direction of giving the syndrome credibility in eyes of the medical community, which it's still lacking in some quarters."
The syndrome is marked by profound fatigue, usually developing suddenly after a flu-like illness, which lasts at least six months and often years. A high proportion of the Lake Tahoe patients also suffered from muscle aches, headaches, difficulty concentrating, recurrent sore throats, sleeping problems, depression, joint pain and other symptoms.
While specialists believe that one or more viruses are centrally involved in chronic fatigue syndrome, they have not solved the mystery of what causes the disabling disease.