INCREASED CONCENTRATIONS OF HOMOCYSTEINE IN THE CEREBROSPINAL-FLUID IN PATIENTS WITH FIBROMYALGIA AND CHRONIC-FATIGUE-SYNDROME

Twelve outpatients, all women, who fulfilled the criteria for both fib romyalgia and chronic fatigue syndrome were rated on 15 items of the C omprehensive Psychopathological Rating Scale (CPRS-15). These items we re chosen to constitute a proper neurasthenic subscale. Blood laborato ry levels were generally normal. The most obvious finding, was that, i n all the patients, the homocysteine (HCY) levels were increased in th e cerebrospinal fluid (CSF). There was a significant positive correlat ion between CSF-HCY levels and fatiguability, and the levels of CSF-B1 2 correlated significantly with the item of fatiguability and with CPR S-15. The correlations between vitamin B12 and clinical variables of t he CPRS-scale in this study indicate that low CSF-B12 values are of cl inical importance. Vitamin B12 deficiency causes a deficient remethyla tion of HCY and is therefore probably contributing to the increased ho mocysteine levels found in our patient group. We conclude that increas ed homocysteine levels in the central nervous system characterize pati ents fulfilling the criteria for both fibromyalgia and chronic fatigue syndrome.