Chronic Overlapping Pain Conditions in people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a sample from the Multi-site Clinical Assessment of ME/CFS (MCAM) study

Abstract Background Chronic overlapping pain conditions (COPCs), pain-related conditions that frequently occur together, may occur in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and could impact illness severity. This study aimed to identify comorbid COPCs in patients w...

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Main Authors: Elizabeth A. Fall, Yang Chen, Jin-Mann S. Lin, Anindita Issa, Dana J. Brimmer, Lucinda Bateman, Charles W. Lapp, Richard N. Podell, Benjamin H. Natelson, Andreas M. Kogelnik, Nancy G. Klimas, Daniel L. Peterson, Elizabeth R. Unger, for the MCAM Study Group
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Language:English
Published: BMC 2024-10-01
Series:BMC Neurology
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Online Access:https://doi.org/10.1186/s12883-024-03872-0
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author Elizabeth A. Fall
Yang Chen
Jin-Mann S. Lin
Anindita Issa
Dana J. Brimmer
Lucinda Bateman
Charles W. Lapp
Richard N. Podell
Benjamin H. Natelson
Andreas M. Kogelnik
Nancy G. Klimas
Daniel L. Peterson
Elizabeth R. Unger
for the MCAM Study Group
author_facet Elizabeth A. Fall
Yang Chen
Jin-Mann S. Lin
Anindita Issa
Dana J. Brimmer
Lucinda Bateman
Charles W. Lapp
Richard N. Podell
Benjamin H. Natelson
Andreas M. Kogelnik
Nancy G. Klimas
Daniel L. Peterson
Elizabeth R. Unger
for the MCAM Study Group
author_sort Elizabeth A. Fall
collection DOAJ
description Abstract Background Chronic overlapping pain conditions (COPCs), pain-related conditions that frequently occur together, may occur in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and could impact illness severity. This study aimed to identify comorbid COPCs in patients with ME/CFS and evaluate their impact on illness severity. Methods We used data from 923 participants in the Multi-Site Clinical Assessment of ME/CFS study, conducted in seven U.S. specialty clinics between 2012 and 2020, who completed the baseline assessment (595 ME/CFS and 328 healthy controls (HC)). COPCs included chronic low back pain (cLBP), chronic migraine/headache (cMHA), fibromyalgia (FM), interstitial cystitis/irritable bladder (IC/IB), irritable bowel syndrome (IBS), temporomandibular disorder (TMD). Illness severity was assessed through questionnaires measuring symptoms and functioning. Multivariate analysis of variance and analysis of covariance models were used for analyses. Log-binomial regression analyses were used to compute prevalence of COPCs and prevalence ratios (PR) between groups with 95% confidence intervals. Both unadjusted and adjusted results with age and sex are presented. Results 76% of participants with ME/CFS had at least one COPCs compared to 17.4% of HC. Among ME/CFS participants, cMHA was most prevalent (48.1%), followed by FM (45.0%), cLBP (33.1%), and IBS (31.6%). All individual COPCs, except TMD, were significantly more frequent in females than males. The unadjusted PR (ME/CFS compared to HC) was highest for FM [147.74 (95% confidence interval (CI) = 20.83-1047.75], followed by cLBP [39.45 (12.73-122.27)], and IC/IB [13.78 (1.88-101.24)]. The significance and order did not change after age and sex adjustment. The COPC comorbidities of cLBP and FM each had a significant impact on most health measures, particularly in pain attributes (Cohen’s d effect size 0.8 or larger). While the impact of COPC comorbidities on non-pain attributes and quality of life measures was less pronounced than that on pain, statistically significant differences between ME/CFS participants with and without COPCs were still evident. Conclusions More than 75% of ME/CFS participants had one or more COPCs. Multiple COPCs further exacerbated illness severity, especially among females with ME/CFS. Assessment and management of COPCs may help improve the health and quality of life for patients with ME/CFS.
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spelling doaj-art-c609e5ef527946d89b732ed65a5de97e2025-08-20T02:17:56ZengBMCBMC Neurology1471-23772024-10-0124111110.1186/s12883-024-03872-0Chronic Overlapping Pain Conditions in people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a sample from the Multi-site Clinical Assessment of ME/CFS (MCAM) studyElizabeth A. Fall0Yang Chen1Jin-Mann S. Lin2Anindita Issa3Dana J. Brimmer4Lucinda Bateman5Charles W. Lapp6Richard N. Podell7Benjamin H. Natelson8Andreas M. Kogelnik9Nancy G. Klimas10Daniel L. Peterson11Elizabeth R. Unger12for the MCAM Study GroupDivision of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and PreventionDivision of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and PreventionDivision of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and PreventionDivision of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and PreventionDivision of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and PreventionBateman Horne CenterHunter-Hopkins CenterRichard N. Podell MedicalDepartment of Neurology, Icahn School of Medicine at Mount SinaiBasis DiagnosticsInstitute for Neuro Immune Medicine, Nova Southeastern UniversitySierra Internal MedicineDivision of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and PreventionAbstract Background Chronic overlapping pain conditions (COPCs), pain-related conditions that frequently occur together, may occur in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and could impact illness severity. This study aimed to identify comorbid COPCs in patients with ME/CFS and evaluate their impact on illness severity. Methods We used data from 923 participants in the Multi-Site Clinical Assessment of ME/CFS study, conducted in seven U.S. specialty clinics between 2012 and 2020, who completed the baseline assessment (595 ME/CFS and 328 healthy controls (HC)). COPCs included chronic low back pain (cLBP), chronic migraine/headache (cMHA), fibromyalgia (FM), interstitial cystitis/irritable bladder (IC/IB), irritable bowel syndrome (IBS), temporomandibular disorder (TMD). Illness severity was assessed through questionnaires measuring symptoms and functioning. Multivariate analysis of variance and analysis of covariance models were used for analyses. Log-binomial regression analyses were used to compute prevalence of COPCs and prevalence ratios (PR) between groups with 95% confidence intervals. Both unadjusted and adjusted results with age and sex are presented. Results 76% of participants with ME/CFS had at least one COPCs compared to 17.4% of HC. Among ME/CFS participants, cMHA was most prevalent (48.1%), followed by FM (45.0%), cLBP (33.1%), and IBS (31.6%). All individual COPCs, except TMD, were significantly more frequent in females than males. The unadjusted PR (ME/CFS compared to HC) was highest for FM [147.74 (95% confidence interval (CI) = 20.83-1047.75], followed by cLBP [39.45 (12.73-122.27)], and IC/IB [13.78 (1.88-101.24)]. The significance and order did not change after age and sex adjustment. The COPC comorbidities of cLBP and FM each had a significant impact on most health measures, particularly in pain attributes (Cohen’s d effect size 0.8 or larger). While the impact of COPC comorbidities on non-pain attributes and quality of life measures was less pronounced than that on pain, statistically significant differences between ME/CFS participants with and without COPCs were still evident. Conclusions More than 75% of ME/CFS participants had one or more COPCs. Multiple COPCs further exacerbated illness severity, especially among females with ME/CFS. Assessment and management of COPCs may help improve the health and quality of life for patients with ME/CFS.https://doi.org/10.1186/s12883-024-03872-0Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS)MultimorbidityChronic low back pain (cLBP)Chronic migraine/Headache (cMHA)Fibromyalgia (FM)Interstitial cystitis/Irritable bladder (IC/IB)
spellingShingle Elizabeth A. Fall
Yang Chen
Jin-Mann S. Lin
Anindita Issa
Dana J. Brimmer
Lucinda Bateman
Charles W. Lapp
Richard N. Podell
Benjamin H. Natelson
Andreas M. Kogelnik
Nancy G. Klimas
Daniel L. Peterson
Elizabeth R. Unger
for the MCAM Study Group
Chronic Overlapping Pain Conditions in people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a sample from the Multi-site Clinical Assessment of ME/CFS (MCAM) study
BMC Neurology
Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS)
Multimorbidity
Chronic low back pain (cLBP)
Chronic migraine/Headache (cMHA)
Fibromyalgia (FM)
Interstitial cystitis/Irritable bladder (IC/IB)
title Chronic Overlapping Pain Conditions in people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a sample from the Multi-site Clinical Assessment of ME/CFS (MCAM) study
title_full Chronic Overlapping Pain Conditions in people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a sample from the Multi-site Clinical Assessment of ME/CFS (MCAM) study
title_fullStr Chronic Overlapping Pain Conditions in people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a sample from the Multi-site Clinical Assessment of ME/CFS (MCAM) study
title_full_unstemmed Chronic Overlapping Pain Conditions in people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a sample from the Multi-site Clinical Assessment of ME/CFS (MCAM) study
title_short Chronic Overlapping Pain Conditions in people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a sample from the Multi-site Clinical Assessment of ME/CFS (MCAM) study
title_sort chronic overlapping pain conditions in people with myalgic encephalomyelitis chronic fatigue syndrome me cfs a sample from the multi site clinical assessment of me cfs mcam study
topic Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS)
Multimorbidity
Chronic low back pain (cLBP)
Chronic migraine/Headache (cMHA)
Fibromyalgia (FM)
Interstitial cystitis/Irritable bladder (IC/IB)
url https://doi.org/10.1186/s12883-024-03872-0
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