J Neurol Neurosurg Psychiatry 64:362-367 doi:10.1136/jnnp.64.3.362
  • Paper

Muscle fibre characteristics and lactate responses to exercise in chronic fatigue syndrome

  1. Russell J M Lanea,
  2. Michael C Barrettb,
  3. David Woodrowb,
  4. Jill Mossb,
  5. Robert Fletcherb,
  6. Leonard C Archardc
  1. aDivision of Neuroscience and Psychological Medicine, bDivision of Diagnostic and Investigative Sciences, cDivision of Biochemical Sciences, Imperial College School of Medicine, Charing Cross Hospital, London, UK
  1. Dr RJM Lane, West London Neurosciences Centre, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK. email r.lane{at}
  • Received 26 February 1997
  • Revised 27 August 1997
  • Accepted 28 August 1997


OBJECTIVES To examine the proportions of type 1 and type 2 muscle fibres and the degree of muscle fibre atrophy and hypertrophy in patients with chronic fatigue syndrome in relation to lactate responses to exercise, and to determine to what extent any abnormalities found might be due to inactivity.

METHODS Quadriceps needle muscle biopsies were obtained from 105 patients with chronic fatigue syndrome and the proportions of type 1 and 2 fibres and fibre atrophy and hypertrophy factors were determined from histochemical preparations, using a semiautomated image analysis system. Forty one randomly selected biopsies were also examined by electron microscopy. Lactate responses to exercise were measured in the subanaerobic threshold exercise test (SATET).

RESULTS Inactivity would be expected to result in a shift to type 2 fibre predominance and fibre atrophy, but type 1 predominance (23%) was more common than type 2 predominance (3%), and fibre atrophy was found in only 10.4% of cases. Patients with increased lactate responses to exercise did have significantly fewer type 1 muscle fibres (p<0.043 males, p<0.0003 females), but there was no evidence that this group was less active than the patients with normal lactate responses. No significant ultrastructural abnormalities were found.

CONCLUSION Muscle histometry in patients with chronic fatigue syndrome generally did not show the changes expected as a result of inactivity. However, patients with abnormal lactate responses to exercise had a significantly lower proportion of mitochondria rich type 1 muscle fibres.


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