Browsing by Author "Newton, Julia L."

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    Autonomic phenotypes in chronic fatigue syndrome (CFS) are associated with illness severity: A cluster analysis
    (2020-08-05) Slomko, Joanna; Estevez-Lopez, Fernando; Kujawski, Sławomir; Zawadka-Kunikowska, Monika; Tafil-Klawe, Małgorzata; Klawe, Jacek J.; Morten, Karl J.; Szrajda, Justyna; Murovska, Modra; Newton, Julia L.; Zalewski, Paweł
    In this study we set out to define the characteristics of autonomic subgroups of patients with Chronic Fatigue Syndrome (CFS). The study included 131 patients with CFS (Fukuda criteria). Participants completed the following screening symptom assessment tools: Chalder Fatigue Scale, Fatigue Impact Scale, Fatigue Severity Scale, Epworth Sleepiness Scales, the self-reported Composite Autonomic Symptom Scale. Autonomic parameters were measured at rest with a Task Force Monitor (CNS Systems) and arterial stiffness using an Arteriograph (TensioMed Kft.). Principal axis factor analysis yielded four factors: fatigue, subjective and objective autonomic dysfunction and arterial stiffness. Using cluster analyses, these factors were grouped in four autonomic profiles: 34% of patients had sympathetic symptoms with dysautonomia, 5% sympathetic alone, 21% parasympathetic and 40% had issues with sympathovagal balance. Those with a sympathetic-dysautonomia phenotype were associated with more severe disease, reported greater subjective autonomic symptoms with sympathetic over-modulation and had the lowest quality of life. The highest quality of life was observed in the balance subtype where subjects were the youngest, had lower levels of fatigue and the lowest values for arterial stiffness. Future studies will aim to design autonomic profile-specific treatment interventions to determine links between autonomic phenotypes CFS and a specific treatment.
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    Changes in the allostatic response to whole-body cryotherapy and static-stretching exercises in chronic fatigue syndrome patients vs. Healthy individuals
    (2021-07) Kujawski, Sławomir; Bach, Anna M.; Słomko, Joanna; Pheby, Derek F.H.; Murovska, Modra; Newton, Julia L.; Zalewski, Paweł; Institute of Microbiology and Virology
    This study represents a comparison of the functional interrelation of fatigue and cognitive, cardiovascular and autonomic nervous systems in a group of Chronic Fatigue Syndrome (CFS) patients compared with those in healthy individuals at different stages of analysis: at baseline and after changes induced by whole-body cryotherapy (WBC) combined with a static-stretching (SS) program. The study included 32 patients (Fukuda criteria) and 18 healthy controls. Fatigue, cogni-tive, cardiovascular and autonomic function and arterial stiffness were measured before and after 10 sessions of WBC with SS. In the patients, a disturbance in homeostasis was observed. The network relationship based on differences before and after intervention showed comparatively higher stress and eccentricity in the CFS group: 50.9 ± 56.1 vs. 6.35 ± 8.72, p = 0.002, r = 0.28; and 4.8 ± 0.7 vs. 2.4 ± 1, p < 0.001, r = 0.46, respectively. Before and after intervention, in the CFS group increased fatigue was related to baroreceptor function, and baroreceptor function was in turn related to aortic stiffness, but no such relationships were observed in the control group. Differences in the network structure underlying the interrelation among the four measured criteria were observed in both groups, before the intervention and after ten sessions of whole cryotherapy with a static stretching exercise.
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    Effect of different types of intermittent fasting on biochemical and anthropometric parameters among patients with metabolic-associated fatty liver disease (MAFLD)—A systematic review
    (2022-01-01) Różański, Gracjan; Pheby, Derek; Newton, Julia L.; Murovska, Modra; Zalewski, Paweł; Słomko, Joanna; Institute of Microbiology and Virology
    Metabolic-associated fatty liver disease (MAFLD), previously called non-alcoholic fatty liver disease (NAFLD), is the most common chronic liver disease worldwide. It is characterised by excessive fat accumulation in hepatocytes. Currently, no pharmacological therapy is effective for this disease, so non-pharmacological alternatives such as diet, supplementation or physical activity are being sought. For this reason, we reviewed the available databases to analyse the studies con-ducted to date using different modifications of intermittent fasting among patients with MAFLD. Eight studies using this dietary strategy were included in this review. The results obtained in the different trials are varied and do not allow a clear determination of the effect of the different types of intermittent fasting on anthropometric and biochemical parameters among patients with MAFLD. However, this type of diet seems to show some therapeutic potential, but further studies are needed.
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    Effects of whole-body cryotherapy and static stretching are maintained 4 weeks after treatment in most patients with chronic fatigue syndrome
    (2023-05-01) Kujawski, Sławomir; Zalewski, Paweł; Godlewska, Beata R.; Cudnoch-Jędrzejewska, Agnieszka; Murovska, Modra; Newton, Julia L.; Sokołowski, Łukasz; Słomko, Joanna; Institute of Microbiology and Virology
    In the previous study, whole-body cryotherapy (WBC)+static stretching (SS) has been shown 25 to reduce the severity of some symptoms in Chronic Fatigue Syndrome (CFS) noted just after 26 the therapy. Here we consider the effects of treatment and explore the sustainability of 27 symptom improvements at four weeks (one-month) follow-up. Twenty-two CFS patients were 28 assessed one month after WBC+SS programme. Parameters related to fatigue (Chalder 29 Fatigue Questionnaire (CFQ), Fatigue Impact Scale (FIS), Fatigue Severity Scale (FSS)), 30 cognitive function (Trial Making test part A and B (TMT A and TMT B and its difference 31 (TMT B-A)), Coding) hemodynamic, aortic stiffness (aortic systolic blood pressure (sBP 32 aortic)) and autonomic nervous system functioning were measured. TMT A, TMT B, TMT B33 A and Coding improved at one month after the WBC+SS programme. WBC+SS had a 34 significant effect on the increase in sympathetic nervous system activity in rest. WBC+SS had 35 a significant, positive chronotropic effect on the cardiac muscle. Peripheral and aortic systolic 36 blood pressure decreased one month after WBC+SS in comparison to before. Effects of 37 WBC+SS on reduction of fatigue, indicators of aortic stiffness and symptoms severity related 38 to autonomic nervous system disturbance and improvement in cognitive function were 39 maintained at one month. However, improvement in all three fatigue scales (CFQ, FIS and 40 FSS) was noted in 17 of 22 patients. In addition, ten patients were treated initially but they 41 were not assessed at 4 weeks, and are thus not included in the 22 patients who were examined 42 on follow-up. The overall effects of WBC+SS noted at one month post-treatment should be 43 interpreted with caution.
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    The Impact of a Structured Exercise Programme upon Cognitive Function in Chronic Fatigue Syndrome Patients
    (2019-12-19) Zalewski, Paweł; Kujawski, Sławomir; Tudorowska, Malwina; Morten, Karl; Tafil-Klawe, Małgorzata; Klawe, Jacek J.; Strong, James; Estévez-López, Fernando; Murovska, Modra; Newton, Julia L.; The European Network on ME/CFS (EUROMENE)
    Background: Cognitive function disturbance is a frequently described symptom of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). In this study, the effects of a structured exercise programme (SEP) upon cognitive function in ME/CFS patients was examined. Methods: Out of the 53 ME/CFS patients initiating SEP 34 (64%) completed the 16 week programme. Cognitive function was assessed using a computerized battery test consisting of a Simple Reaction Time (SRT) (repeated three times) and Choice Reaction Time (CRT) measurements, a Visual Attention Test (VAT) and a Delayed Matching to Sample (DMS) assessment. Results: Statistically significant improvement was noted in the third attempt to SRT in reaction time for correct answers, p = 0.045, r = 0.24. Moreover, significant improvement was noted in VAT reaction time, number of correct answers and errors committed, p = 0.02, omega = 0.03, p = 0.007, r = 0.34 and p = 0.004, r = 0.35, respectively. Non-significant changes were noted in other cognitive tests. Conclusions: A substantial number of participants were unwilling or unable to complete the exercise programme. ME/CFS patients able to complete the SEP showed improved visual attention both in terms of reaction time and correctness of responses and processing speed of simple visual stimuli
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    Post-exertional malaise may be related to central blood pressure, sympathetic activity and mental fatigue in chronic fatigue syndrome patients
    (2021-05-26) Kujawski, Sławomir; Słomko, Joanna; Hodges, Lynette; Pheby, Derek F.H.; Murovska, Modra; Newton, Julia L.; Zalewski, Paweł; Institute of Microbiology and Virology
    Post-exertional malaise (PEM) is regarded as the hallmark symptom in chronic fatigue syndrome (CFS). The aim of the current study is to explore differences in CFS patients with and without PEM in indicators of aortic stiffness, autonomic nervous system function, and severity of fatigue. One-hundred and one patients met the Fukuda criteria. A Chronic Fatigue Questionnaire (CFQ) and Fatigue Impact Scale (FIS) were used to assess the level of mental and physical fatigue. Aortic systolic blood pressure (sBPaortic) and the autonomic nervous system were measured with the arteriograph and Task Force Monitor, respectively. Eighty-two patients suffered prolonged PEM according to the Fukuda criteria, while 19 did not. Patients with PEM had higher FIS scores (p = 0.02), lower central systolic blood pressure (p = 0.02) and higher mental fatigue (p = 0.03). For a one-point increase in the mental fatigue component of the CFQ scale, the risk of PEM increases by 34%. For an sBPaortic increase of 1 mmHg, the risk of PEM decreases by 5%. For a one unit increase in sympathovagal balance, the risk of PEM increases by 330%. Higher mental fatigue and sympathetic activity in rest are related to an increased risk of PEM, while higher central systolic blood pressure is related to a reduced risk of PEM. However, none of the between group differences were significant after FDR correction, and therefore conclusions should be treated with caution and replicated in further studies.
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    Prediction of discontinuation of structured exercise programme in chronic fatigue syndrome patients.
    (2020-10-26) Kujawski, Sławomir; Cossington, Jo; Słomko, Joanna; Dawes, Helen; Strong, James W. L.; Estevez-Lopez, Fernando; Murovska, Modra; Newton, Julia L.; Hodges, Lynette; Zalewski, Paweł
    Purpose: The purpose of this study was to assess differences in the physiological profiles of completers vs. non-completers following a structured exercise programme (SEP) and the ability to predict non-completers, which is currently unknown in this group. Methods: Sixty-nine patients met the Fukuda criteria. Patients completed baseline measures assessing fatigue, autonomic nervous system (ANS), cognitive, and cardiovascular function. Thirty-four patients completed a home-based SEP consisting of 10–40 min per day at between 30 and 80% actual HR max. Exercise intensity and time was increased gradually across the 16 weeks and baseline measures were repeated following the SEP. Results: Thirty-five patients discontinued, while 34 completed SEP. For every increase in sympathetic drive for blood pressure control as measured by the taskforce, completion of SEP decreased by a multiple of 0.1. For a 1 millisecond increase in reaction time for the simple reaction time (SRT), the probability for completion of SEP also decreases by a multiple of 0.01. For a one beat HRmax increase, there is a 4% increase in the odds of completing SEP. Conclusion: The more sympathetic drive in the control of blood vessels, the longer the reaction time on simple visual stimuli and the lower the HRmax during physical exercise, then the lower the chance of SEP completion in ME/CFS.
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    Relationship between cardiopulmonary, mitochondrial and autonomic nervous system function improvement after an individualised activity programme upon chronic fatigue syndrome patients
    (2021-04-01) Kujawski, Sławomir; Cossington, Jo; Słomko, Joanna; Zawadka-Kunikowska, Monika; Tafil-Klawe, Małgorzata; Klawe, Jacek J.; Buszko, Katarzyna; Jakovljevic, Djordje G.; Kozakiewicz, Mariusz; Morten, Karl J.; Dawes, Helen; Strong, James W.L.; Murovska, Modra; Oosterwijck, Jessica Van; Estevez-Lopez, Fernando; Newton, Julia L.; Hodges, Lynette; Zalewski, Paweł; Institute of Microbiology and Virology
    Background: The therapeutic effects of exercise from structured activity programmes have recently been questioned; as a result, this study examines the impact of an Individualised Activity Program (IAP) on the relationship with cardiovascular, mitochondrial and fatigue parameters. Methods: Chronic fatigue syndrome (CFS) patients were assessed using Chalder Fatigue Questionnaire (CFQ), Fatigue Severity Score (FSS) and the Fatigue Impact Scale (FIS). VO2peak, VO2submax and heart rate (HR) were assessed using cardiopulmonary exercise testing. Mfn1 and Mfn2 levels in plasma were assessed. A Task Force Monitor was used to assess ANS functioning in supine rest and in response to the Head-Up Tilt Test (HUTT). Results: Thirty-four patients completed 16 weeks of the IAP. The CFQ, FSS and FIS scores decreased significantly along with a significant increase in Mfn1 and Mfn2 levels (p = 0.002 and p = 0.00005, respectively). The relationships between VO2 peak and Mfn1 increase in response to IAP (p = 0.03) and between VO2 at anaerobic threshold and ANS response to the HUTT (p = 0.03) were noted. Conclusions: It is concluded that IAP reduces fatigue and improves functional performance along with changes in autonomic and mitochondrial function. However, caution must be applied as exercise was not well tolerated by 51% of patients.