A University of Leicester research team has discovered a vision-related abnormality that could help diagnose ME/CFS.
The abnormality, called "pattern glare," produces distortions, such as curving, wavering, and colors, when viewing stripes. Pattern glare has been associated with migraines and Irlen Syndrome (a visual processing disorder). It can lead to headaches, photophobia, and eyestrain.
This is not the first study to find a correlation between visual disturbances and ME/CFS. In May 2014, an Australian group found a greater occurrence of Irlen Syndrome in ME/CFS patients (Loew et al. "Symptoms of Meares-Irlen/Visual Stress Syndrome in subjects diagnosed with Chronic Fatigue Syndrome.")
A previous Australian study found significant variations in blood lipids as well as urine amino and organic acids in ME/CFS patients with Irlen Syndrome. They proposed that ocular symptoms might be caused by activation of the immune system due to "some infective agent." (Robinson et al. "A biochemical analysis of people with chronic fatigue who have Irlen Syndrome: Speculation concerning immune system dysfunction.")
Coincidentally, I had an eye exam shortly before the University of Leicester study was published. On viewing a cross-hatch pattern, I remarked that it had blue horizontal stripes, and purple vertical stripes. "It's black and white," said the technician.
Both of my children have pattern glare - one has migraines, and the other Irlen Syndrome.
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Visual stress could be a symptom of Chronic Fatigue
Syndrome, research suggests
Press Release: University of Leicester, November 24, 2015.
People suffering from Chronic Fatigue Syndrome (CFS) could experience higher
levels of visual stress than those without the condition, according to new
research from the University of Leicester.
CFS, also known as Myalgic Encephalomyelitis (ME), is a condition
that causes persistent exhaustion that affects everyday life and doesn't go
away with sleep or rest. Diagnosis of the condition is difficult as its
symptoms are similar to other illnesses.
A research team from the University of Leicester led by Dr Claire
Hutchinson from the Department of Neuroscience, Psychology and Behaviour has
examined patients with and without CFS and has found that those suffering from
the condition are more vulnerable to pattern-related visual stress, which
causes discomfort and exhaustion when viewing repetitive striped patterns, such
as when reading text.
The results of the study, which is published in the journal Perception,
could help in the diagnosis of CFS, as the findings suggest that there are
visual system abnormalities in people with ME/CFS that may represent an
identifiable and easily measurable behavioural marker of the condition.
Dr Hutchinson explained: "Diagnosis of ME/CFS is
controversial. With the exception of disabling fatigue, there are few
definitive clinical features of the condition and its core symptoms, overlap
with those often prevalent in other conditions. As a result, ME/CFS is often a
diagnosis of exclusion, being made as a last resort and possibly after a
patient has experienced a series of inappropriate treatments of misdiagnosed
disorders.
"It is imperative therefore that research focuses on
identifying significant clinical features of CFS/ME with a view to elucidating
its underlying pathology and delineating it from other illnesses. Doing so will
help researchers and healthcare professionals gain important insights into the
condition, aid diagnosis and, in the longer term, inform evidence-based
therapeutic interventions."
The study assessed vulnerability of ME/CFS patients to
pattern-related visual stress using a standardised test called the pattern
glare test, in which people report the number of visual distortions they
experience when looking at three repetitive striped patterns of different
levels of detail.
During the study twenty patients with CFS and twenty
patients without the condition were recruited.
Participants viewed 3 patterns, the spatial frequencies (SF)
of which were either 0.3 (low-SF), 2.3 (mid-SF) and 9.4 (high-SF) cycles per
degree (c/deg). They then reported the number of distortions they experienced
when viewing each pattern.
Patients with ME/CFS reported more distortions on the
intermediate striped pattern (Pattern 2) than people without the condition.
Dr Hutchinson added: "The existence of pattern-related
visual stress in ME/CFS may represent an identifiable and easily measurable
behavioural marker of ME. This could, in conjunction with other diagnostic
tests, help delineate it from other conditions."
The work was funded by ME Research UK who provided funding
for a 1-year MPhil studentship, awarded to Rachel Wilson, who was supervised by
Drs Claire Hutchinson and Kevin Paterson from the University of Leicester's
Department of Neuroscience, Psychology and Behaviour.
Dr Neil Abbot, Research & Operations Director at ME
Research UK, added: "Around three-quarters of people with ME/CFS report a
range of eye and vision-related symptoms that interfere with their everyday
lives, yet there has been very little scientific investigation of the problem.
"Dr Claire Hutchinson and her team have previously
confirmed the existence of eye movement difficulties in ME/CFS patients, and
that symptoms, including eye pain, can be severe. Her new report in Perception extends
these findings and raises the possibility that vision anomalies, including
pattern-related visual stress, may have a diagnostic role in the disease."
Citation:
Wilson RL, Paterson KB, Hutchinson CV. Increased Vulnerability to
Pattern-Related Visual Stress in Myalgic Encephalomyelitis. Perception
2015 Nov 3.
The objective of this study was to determine vulnerability to pattern-related visual stress in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). A total of 20 ME/CFS patients and 20 matched (age, gender) controls were recruited to the study. Pattern-related visual stress was determined using the Pattern Glare Test. Participants viewed three patterns, the spatial frequencies (SF) of which were 0.3 (low-SF), 2.3 (mid-SF), and 9.4 (high-SF) cycles per degree (c/deg). They reported the number of distortions they experienced when viewing each pattern. ME/CFS patients exhibited significantly higher pattern glare scores than controls for the mid-SF pattern. Mid-high SF differences were also significantly higher in patients than controls. These findings provide evidence of altered visual perception in ME/CFS. Pattern-related visual stress may represent an identifiable clinical feature of ME/CFS that will prove useful in its diagnosis. However, further research is required to establish if these symptoms reflect ME/CFS-related changes in the functioning of sensory neural pathways.
