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Abstract
Here, a novel hypothesis for chronic fatigue syndrome (CFS) is proposed. CFS may be
a neurophysiological disorder focussing on the amygdala. During a 'traumatic' neurological
event often involving acute psychological stress combined with a viral infection or
other chemical or physiological stressor, a conditioned network or 'cell assembly'
may be created in the amygdala. The unconscious amygdala may become conditioned to
be chronically sensitised to negative symptoms arising from the body. Negative signals
from the viscera or physiological, chemical and dietary stressors, become conditioned
stimuli and the conditioned response is a chronic sympathetic outpouring from the
amygdala via various brain pathways including the hypothalamus. This cell assembly
then produces the CFS vicious circle, where an unconscious negative reaction to symptoms
causes immune reactivation/dysfunction, chronic sympathetic stimulation, leading to
sympathetic dysfunction, mental and physical exhaustion, and a host of other distressing
symptoms and secondary complications. And these are exactly the symptoms that the
amygdala and associated limbic structures are trained to monitor and respond to, perpetuating
a vicious circle. Recovery from CFS may involve projections from the medial prefrontal
cortex to the amygdala, to control the amygdala's expressions. I shall firstly discuss
predisposing, precipitating, and perpetuating factors involved in the possible etiology
of chronic fatigue syndrome (CFS), followed by the patient's experience of the illness.
Finally, I shall look at a suggested explanation for the symptoms of CFS.
Copyright 2002 Elsevier Science Ltd.