Abnormalities in response to vasopressin infusion in chronic fatigue syndrome

Several neuroendocrine studies have suggested hypoactivation of the hypotha lamic-pituitary-adrenal axis in chronic fatigue syndrome. One possible dete rminant of this neuroendocrine abnormality, as well as the primary symptom of fatigue, is reduced hypothalamic secretion of corticotropin-releasing ho rmone (CRH). Because CRH and vasopressin secreted from the hypothalamus act synergistically at the pituitary to activate ACTH secretion, the ACTH resp onse to peripheral infusion of vasopressin can provide an indirect measure of hypothalamic CRH secretion. We measured the ACTH and cortisol response t o a one hour infusion of arginine vasopressin in 19 patients with chronic f atigue syndrome and 19 age and sex matched healthy volunteers. Patients wit h chronic fatigue syndrome had a reduced ACTH response to the vasopressin i nfusion and a more rapid cortisol response to the infusion. These results p rovide further evidence of reduced hypothalamic CRH secretion in patients w ith chronic fatigue syndrome. (C) 2001 Elsevier Science Ltd. All rights res erved.