TGI Friday! Our weekly round-up of recently published research abstracts | 23 May 2014

Journal of Oral & Facial Pain and Headache, Spring 2014.

Topical review: the enigma of fibromyalgia.

Jin H, Patil PM, Sharma A.
Affiliations not available


Fibromyalgia is a syndrome characterized by chronic widespread pain, stiffness, nonrestorative sleep, fatigue, and comorbid conditions.

Recognition of the condition and its associated medications and challenges, along with knowledge of treatment modifications and precautions in drug prescription, can ensure safe and effective delivery of oral health care in fibromyalgia patients. The ever-evolving research into the condition makes it necessary for the oral health care provider to be informed about the current state of the literature and treatment standards regarding the management of fibromyalgia patients.

This article reviews the epidemiology, etiology, pathophysiology, and clinical presentation of fibromyalgia, as well as therapeutic advances. Also highlighted are issues that are important to the oral health care provider, including orofacial manifestations and oral health care considerations for patients with fibromyalgia.

Applied Neuropsychology: Adult, Volume 21, Issue 2, 2014. Epub 2013 Aug 13.

Neuropsychological impairment in female patients with chronic fatigue syndrome: a preliminary study.

Pilar Santamarina-Perez(a*), Francisco Jose Eiroa-Orosa(bce), Amanda Rodriguez-Urrutia(b), Adil Qureshi(b) & Jose Alegre(d)
a) Department of Child and Adolescent Psychiatry and Psychology, Institut Clínic de Neurociències, Hospital Clínic Universitari, Barcelona, Spain
b) Department of Psychiatry, University Hospital Vall d’Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain
c) Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
d) Chronic Fatigue Unit, Department of Internal Medicine, University Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
e) Section of Clinical & Health Psychology, School of Health in Social Sciences, The University of Edinburgh, Edinburgh, United Kingdom


This study examines neuropsychological impairments associated with chronic fatigue syndrome (CFS) and explores their association with related clinical factors.

Sixty-eight women with CFS were assessed with a neuropsychological battery. Raw scores were adjusted for age and gender and were converted to T scores according to normative data extracted from a local sample of 250 healthy subjects.

Neuropsychological dysfunction was calculated using summary impairment indexes (proportion of test scores outside normal limits-T score <40-for each cognitive domain). Finally, a linear regression was calculated to identify predictors of cognitive deficit, including intrinsic factors of the disease (level of fatigue and length of illness) and extrinsic factors (emotional factors, age, and education). Approximately 50% of scores showed impairment in attention and motor functioning, and nearly 40% showed impairment in speed information processing and executive functioning. Fatigue predicted attention and executive functioning impairment, and emotional factors predicted verbal memory dysfunction. According to our findings, cognitive dysfunction in CFS could be explained by pathophysiological processes of the disease. One implication of this would be the need to identify homogeneous subgroups of patients with CFS by taking into account common factors, which, in turn, would help to identify more specific cognitive profiles, which could then serve to implement appropriate therapeutic measures accordingly.

From The Journal of Immunology, 1 May 2014.

Investigation of humoral immune response towards persisting Epstein-Barr virus infections in multiple sclerosis and chronic fatigue syndrome using peptide microarrays (TECH1P.868)

Aaron Castro(1), Nikolaus Pawlowski(1), Ulf Reimer(1), Janina Jansong(1), Madlen Löbel(2), Klemens Ruprecht(2) and Carmen Scheibenbogen(2)
1) JPT Peptide Technologies, Volmerstr. 5, D-12489, Berlin, Germany
2) Clinical and Experimental Multiple Sclerosis Research Center, Charité – Universitätsmedizin Berlin, Charité Campus Mitte Charitéplatz 1,
10117, Berlin, Germany


Most humans carry a considerable number of persisting viral infections, frequently in a latent state. Chronic infections may intermittently reactivate especially under immune suppression and play an important role as trigger or cofactor for autoimmune diseases and cancer. Correlation of such infections with diseases is difficult.

An analysis of antibody repertoire in chronic infection may provide information about patterns of virus reactivation.

Following primary infection the herpes virus 4 (EBV) results in persistent mostly asymptomatic latent infection. About 95% of the adult population are EBV seropositive. EBV infections are known as cofactors for various diseases such as lymphomas, multiple sclerosis and chronic fatigue syndrome.

The detailed mapping of humoral immune response in human serum samples allows a high resolution analysis of the antibody repertoire against EBV antigens.

We developed a peptide microarray platform with peptide libraries of up to 6900 members. Here we present data using a library of peptide scans through major EBV antigens from incubations with serum samples of healthy human donors, patients diagnosed with chronic fatigue syndrome or multiple sclerosis. Even though there are shared epitopes between the specimens and cohorts, different epitope patterns are observed for a number of antigens and antigen areas. The patterns of antibody responses could be of diagnostic value for multiple sclerosis and chronic fatigue syndrome.

Behavioural and Cognitive Psychotherapy, 15 May 2014.

Competences Required for the Delivery of High and Low-Intensity Cognitive Behavioural Interventions for Chronic Fatigue, Chronic
Fatigue Syndrome/ME and Irritable Bowel Syndrome

Rimes KA(1), Wingrove J(2), Moss-Morris R(1), Chalder T(1).
1) King’s College London, Institute of Psychiatry, UK
2) South London and Maudsley NHS Foundation Hospital Trust, London, UK



Cognitive behavioural interventions are effective in the treatment of chronic fatigue, chronic fatigue syndrome (sometimes known as ME or CFS/ME) and irritable bowel syndrome (IBS). Such interventions are increasingly being provided not only in specialist settings but in primary care settings such as Improving Access to Psychological Therapies (IAPT) services. There are no existing competences for the delivery of “low-intensity” or “high-intensity” cognitive behavioural interventions for these conditions.


To develop “high-intensity” and “low-intensity” competences for cognitive behavioural interventions for chronic fatigue, CFS/ME and IBS.


The initial draft drew on a variety of sources including treatment manuals and other information from randomised controlled trials. Therapists with experience in providing cognitive behavioural interventions for CF, CFS/ME and IBS in research and clinical settings were consulted on the initial draft competences and their suggestions for minor amendments were incorporated into the final versions.


Feedback from experienced therapists was positive. Therapists providing low intensity interventions reported that the competences were also helpful in highlighting training needs.


These sets of competences should facilitate the training and supervision of therapists providing cognitive behavioural interventions for chronic fatigue, CFS/ME and IBS. The competences are available online (see table of contents for this issue: or on request from the first author.