The putative role of viruses, bacteria, and chronic fungal biotoxin exposure in the genesis of intractable fatigue accompanied by cognitive and physical disability Morris, Gerwyn, Berk, Michael, Walder, Ken and Maes, Michael 2015, The putative role of viruses, bacteria, and chronic fungal biotoxin exposure in the genesis of intractable fatigue accompanied by cognitive and physical disability, Molecular neurobiology, vol. 53, no. 4, pp. 2550-2571, doi: 10.1007/s12035-015-9262-7. Attached Files Name Description MIMEType Size Downloads Title The putative role of viruses, bacteria, and chronic fungal biotoxin exposure in the genesis of intractable fatigue accompanied by cognitive and physical disability Author(s) Morris, Gerwyn Berk, Michael orcid.org/0000-0002-5554-6946 Walder, Ken orcid.org/0000-0002-6758-4763 Maes, Michael Journal name Molecular neurobiology Volume number 53 Issue number 4 Start page 2550 End page 2571 Total pages 22 Publisher Humana Press Place of publication Clifton, N.J. Publication date 2015-06-17 ISSN 1559-1182 Keyword(s) Chronic fatigue syndrome Cognition Depression Immune Inflammation Neurology Oxidative stress Psychiatry Toll-like receptor Summary Patients who present with severe intractable apparently idiopathic fatigue accompanied by profound physical and or cognitive disability present a significant therapeutic challenge. The effect of psychological counseling is limited, with significant but very slight improvements in psychometric measures of fatigue and disability but no improvement on scientific measures of physical impairment compared to controls. Similarly, exercise regimes either produce significant, but practically unimportant, benefit or provoke symptom exacerbation. Many such patients are afforded the exclusionary, non-specific diagnosis of chronic fatigue syndrome if rudimentary testing fails to discover the cause of their symptoms. More sophisticated investigations often reveal the presence of a range of pathogens capable of establishing life-long infections with sophisticated immune evasion strategies, including Parvoviruses, HHV6, variants of Epstein-Barr, Cytomegalovirus, Mycoplasma, and Borrelia burgdorferi. Other patients have a history of chronic fungal or other biotoxin exposure. Herein, we explain the epigenetic factors that may render such individuals susceptible to the chronic pathology induced by such agents, how such agents induce pathology, and, indeed, how such pathology can persist and even amplify even when infections have cleared or when biotoxin exposure has ceased. The presence of active, reactivated, or even latent Herpes virus could be a potential source of intractable fatigue accompanied by profound physical and or cognitive disability in some patients, and the same may be true of persistent Parvovirus B12 and mycoplasma infection. A history of chronic mold exposure is a feasible explanation for such symptoms, as is the presence of B. burgdorferi. The complex tropism, life cycles, genetic variability, and low titer of many of these pathogens makes their detection in blood a challenge. Examination of lymphoid tissue or CSF in such circumstances may be warranted. Language eng DOI 10.1007/s12035-015-9262-7 Field of Research 110899 Medical Microbiology not elsewhere classified Socio Economic Objective 920111 Nervous System and Disorders HERDC Research category C1 Refereed article in a scholarly journal Copyright notice ©2015, Humana Press Persistent URL http://hdl.handle.net/10536/DRO/DU:30074310 Document type: Journal Article Collections: Faculty of Health School of Medicine Related Links Link Description Connect to published version Go to link with your DU access privileges     Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved. Versions Version Filter Type Fri, 10 Jul 2015, 14:55:33 EST Sat, 11 Jul 2015, 05:02:49 EST Mon, 13 Jul 2015, 08:40:19 EST Mon, 13 Jul 2015, 08:49:42 EST Wed, 22 Jul 2015, 15:54:47 EST Thu, 10 Sep 2015, 06:10:15 EST Wed, 21 Oct 2015, 10:12:23 EST Tue, 27 Oct 2015, 12:20:29 EST Mon, 18 Jul 2016, 15:38:53 EST Tue, 13 Feb 2018, 11:19:10 EST Tue, 13 Feb 2018, 11:20:11 EST Filtered Full Citation counts:   Cited 17 times in TR Web of Science Cited 15 times in Scopus Search Google Scholar Access Statistics: 686 Abstract Views, 4 File Downloads  -  Detailed Statistics Created: Wed, 22 Jul 2015, 15:54:47 EST

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