{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T12:02:17Z","timestamp":1783684937369,"version":"3.55.0"},"reference-count":38,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T00:00:00Z","timestamp":1708646400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Individuals with Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS) often experience autonomic symptoms. In the present study, we evaluated 193 adults seeking treatment for ME\/CFS, who were recruited from an outpatient clinic. The participants completed a head-up tilt table test to assess two common types of orthostatic intolerance, namely, postural orthostatic tachycardia syndrome (POTS) and orthostatic hypotension (OH). During the tilt test, 32.5% of the participants demonstrated POTS or OH. The participants with either of these two common types of orthostatic intolerance were found to have more problems with sleep and post-exertional malaise as assessed by the DePaul Symptom Questionnaire; these patients also reported more physical and health function limitations. The implications of the findings are discussed.<\/jats:p>","DOI":"10.3390\/jpm14030238","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T04:31:23Z","timestamp":1708662683000},"page":"238","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Head-Up Tilt Table Test as a Measure of Autonomic Functioning among Patients with Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9972-4425","authenticated-orcid":false,"given":"Leonard A.","family":"Jason","sequence":"first","affiliation":[{"name":"Department of Psychology, DePaul University, Chicago, IL 60614, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"McGarrigle","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Kentucky, Lexington, KY 40508, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruud C. W.","family":"Vermeulen","sequence":"additional","affiliation":[{"name":"CFS Medical Center, 1114AA Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"key":"ref_1","first-page":"95","article-title":"Chronic fatigue following infections in adolescents","volume":"25","author":"Katz","year":"2013","journal-title":"Infect. Dis. Immun."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1093\/qjmed\/hcm057","article-title":"Symptoms of autonomic dysfunction in chronic fatigue syndrome","volume":"100","author":"Newton","year":"2007","journal-title":"QJM"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1111\/eci.12256","article-title":"Malfunctioning of the autonomic nervous system in patients with chronic fatigue syndrome: A systematic literature review","volume":"44","author":"Nijs","year":"2014","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"6127340","DOI":"10.1155\/2016\/6127340","article-title":"Cerebral blood flow, heart rate, and blood pressure patterns during the tilt test in common orthostatic syndromes","volume":"2016","author":"Novak","year":"2016","journal-title":"Neurosci. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"280","DOI":"10.3389\/fphys.2014.00280","article-title":"Sympathetic Dysfunction in Vasovagal Syncope and the Postural Orthostatic Tachycardia Syndrome","volume":"5","author":"Lambert","year":"2014","journal-title":"Front. Physiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1111\/joim.12022","article-title":"Clinical characteristics of a novel subgroup of chronic fatigue syndrome patients with postural orthostatic tachycardia syndrome","volume":"273","author":"Lewis","year":"2013","journal-title":"J. Intern. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1111\/joim.12021","article-title":"Syndromes of orthostatic intolerance: A hidden danger","volume":"273","author":"Fedorowski","year":"2012","journal-title":"J. Intern. Med."},{"key":"ref_8","first-page":"1386","article-title":"Update on the theory and management of orthostatic intolerance and related syndromes in adolescents and children. Expert Rev","volume":"10","author":"Stewart","year":"2012","journal-title":"Cardiovasc. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/j.clinthera.2019.02.010","article-title":"Associations between autonomic and orthostatic self-report and physician ratings of orthostatic intolerance in youth","volume":"41","author":"Schultz","year":"2019","journal-title":"Clin. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2861","DOI":"10.1016\/j.mayocp.2021.07.004","article-title":"Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management","volume":"96","author":"Bateman","year":"2021","journal-title":"Mayo Clin. Proc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1186\/1479-5876-12-104","article-title":"Inability of myalgic encephalomyelitis\/chronic fatigue syndrome patients to reproduce VO\u2082peak indicates functional impairment","volume":"12","author":"Keller","year":"2014","journal-title":"J. Transl. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1016\/S0140-6736(86)91665-X","article-title":"Head-up tilt: A useful test for investigating unexplained syncope","volume":"1","author":"Kenny","year":"1986","journal-title":"Lancet"},{"key":"ref_13","first-page":"69","article-title":"Consensus statement on thedefinition of orthostatic hypotension, neurally mediated syncope andthe postural tachycardia syndrome","volume":"21","author":"Freeman","year":"2011","journal-title":"Auton. Neurosci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"330","DOI":"10.3389\/fped.2018.00330","article-title":"The development of the DePaul Symptom Questionnaire: Original, expanded, brief, and pediatric versions","volume":"6","author":"Jason","year":"2018","journal-title":"Front. Pediatr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1080\/21641846.2014.978110","article-title":"Test-retest reliability of the DePaul Symptom Questionnaire","volume":"3","author":"Jason","year":"2015","journal-title":"Fatigue Biomed. Health Behav."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1080\/09638288.2022.2043462","article-title":"Evaluating Case Diagnostic Criteria for Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS): Toward an empirical case definition","volume":"45","author":"Conroy","year":"2023","journal-title":"Disabil. Rehabil."},{"key":"ref_17","first-page":"41","article-title":"Identifying key symptoms differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis","volume":"4","author":"Ohanian","year":"2016","journal-title":"EC Neurol."},{"key":"ref_18","first-page":"473","article-title":"The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection","volume":"30","author":"Ware","year":"1992","journal-title":"Medcare"},{"key":"ref_19","first-page":"40","article-title":"The MOS 36-ltem short-form Health survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups","volume":"32","author":"McHorney","year":"1994","journal-title":"Medcare"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.cnp.2020.01.003","article-title":"Cerebral blood flow is reduced in ME\/CFS during head-up tilt testing even in the absence of hypotension or tachycardia: A quantitative, controlled study using Doppler echography","volume":"5","author":"Verheugt","year":"2020","journal-title":"Clin. Neurophysiol. Pract."},{"key":"ref_21","unstructured":"Institute of Medicine (2015). Beyond Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: Redefining an Illness, The National Academies Press."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1300\/J092v11n01_02","article-title":"Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols","volume":"11","author":"Carruthers","year":"2003","journal-title":"J. Chronic Fatigue Syndr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"953","DOI":"10.7326\/0003-4819-121-12-199412150-00009","article-title":"The Chronic Fatigue Syndrome: A Comprehensive Approach to its Definition and Study","volume":"121","author":"Fukuda","year":"1994","journal-title":"Ann. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1080\/21641846.2015.1051291","article-title":"Chronic Fatigue Syndrome versus Systemic Exertion Intolerance Disease","volume":"3","author":"Jason","year":"2015","journal-title":"Fatigue Biomed. Health Behav."},{"key":"ref_25","first-page":"114","article-title":"Patients Diagnosed with Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome Also Fit Systemic Exertion Intolerance Disease Criteria","volume":"5","author":"Chu","year":"2017","journal-title":"Fatigue: Biomed. Health Behav."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"20210033","DOI":"10.1515\/em-2021-0033","article-title":"Orthostatic Intolerance and neurocognitive impairment in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS)","volume":"11","author":"Gaglio","year":"2022","journal-title":"Epidemiol. Methods"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/S0165-1838(98)00177-5","article-title":"Orthostatic Intolerance in the Chronic Fatigue Syndrome","volume":"75","author":"Schondorf","year":"1999","journal-title":"J. Auton. Nerv. Syst."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/s10286-002-0014-1","article-title":"Hemodynamic and Neurohumoral Responses to Head-Up Tilt in Patients with Chronic Fatigue Syndrome","volume":"12","author":"Timmers","year":"2002","journal-title":"Clin. Auton. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1046\/j.1365-2281.1999.00154.x","article-title":"Cardiovascular Response during Head-Up Tilt in Chronic Fatigue Syndrome","volume":"19","author":"LaManca","year":"1999","journal-title":"Clin. Physiol. Funct. Imaging"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/BF01824009","article-title":"Effect of recombinant erythropoietin on anemia and orthostatic hypotension in primary autonomic failure","volume":"5","author":"Perera","year":"1995","journal-title":"Clin. Auton. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"171","DOI":"10.3389\/fcvm.2019.00171","article-title":"Cerebral Oximetry in Syncope and Syndromes of Orthostatic Intolerance","volume":"6","author":"Kharraziha","year":"2019","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1002\/ajmg.a.62705","article-title":"The prevalence and impact of orthostatic intolerance in young women across the hypermobility spectrum","volume":"188","author":"Peebles","year":"2022","journal-title":"Am. J. Med Genet. A"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/0002-9343(83)90625-3","article-title":"Vasopressin response to orthostatic hypotension: Etiologic and clinical implications","volume":"74","author":"Zerbe","year":"1983","journal-title":"Am. J. Med."},{"key":"ref_34","first-page":"95","article-title":"Relation of blood volume and blood pressure in orthostatic intolerance","volume":"315","author":"Jacob","year":"1998","journal-title":"Am. J. Med. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/pathophysiology31010001","article-title":"Similar patterns of Dysautonomia in Myalgic Encephalomyelitis\/Chronic Fatigue and Post-COVID-19 Syndromes","volume":"31","author":"Ryabkova","year":"2024","journal-title":"Pathophysiology"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Swai, J., Hu, Z., Zhao, X., Rugambwa, T., and Ming, G. (2019). Heart rate and heart rate variability comparison between postural orthostatic tachycardia syndrome versus healthy participants; a systematic review and meta-analysis. BMC Cardiovasc. Disord., 19.","DOI":"10.1186\/s12872-019-01298-y"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"100107","DOI":"10.1016\/j.bbih.2020.100107","article-title":"Autoantibodies to beta-adrenergic and muscarinic cholinergic receptors in Myalgic Encephalomyelitis (ME) patients\u2014A validation study in plasma and cerebrospinal fluid from two Swedish cohorts","volume":"7","author":"Bynke","year":"2020","journal-title":"Brain Behav. Immun. Health"},{"key":"ref_38","unstructured":"(2023, December 15). CDC Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome, Available online: https:\/\/www.cdc.gov\/me-cfs\/healthcare-providers\/diagnosis\/evaluation.html."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/3\/238\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:03:33Z","timestamp":1760105013000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/3\/238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,23]]},"references-count":38,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["jpm14030238"],"URL":"https:\/\/doi.org\/10.3390\/jpm14030238","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,23]]}}}