Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue SyndromeVan Den Eede F.a, c, d · Moorkens G.b · Van Houdenhove B.e · Cosyns P.a, c · Claes S.J.d, e
Departments of aPsychiatry and bInternal Medicine, University Hospital Antwerp, Edegem, cCollaborative Antwerp Psychiatric Research Institute, University of Antwerp, dDepartment of Molecular Genetics VIB8, Flanders Interuniversity Institute for Biotechnology, University of Antwerp, Antwerp, and eDepartment of Psychiatry, University Hospital Gasthuisberg, Leuven, Belgium
Filip Van Den Eede, PhD
Department of Psychiatry, University Hospital Antwerp (UZA)
BE–2650 Edegem (Belgium)
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There is evidence for a hypofunction of the hypothalamic-pituitary-adrenal (HPA) axis in a proportion of the patients with chronic fatigue syndrome (CFS), despite the negative studies and methodological difficulties. In this review, we focus on challenge studies and on the role of the HPA axis in the pathogenesis of CFS. Mild hypocortisolism, blunted adrenocorticotropin response to stressors and enhanced negative feedback sensitivity to glucocorticoids are the main findings. Several underlying mechanisms have been proposed. Currently, it is a matter of debate whether these disturbances have a primary role in the pathogenesis of CFS. However, even if the HPA axis dysfunctions are secondary to other factors, they are probably a relevant factor in symptom propagation in CFS.
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