CFS/ME research

Royal Free London chronic fatigue syndrome/ME research project: the PACE trial

The Royal Free London fatigue team has been involved with chronic fatigue syndrome/ME research projects, such as the PACE trial which involved:

  • testing and comparing the effectiveness of four of the main Royal Free CFS/ME treatments available for sufferers from; adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and standardised specialist medical care. 
  • trial participants being randomly allocated to one of the treatments for a 12-month programme involving appointments with specialist doctors and therapists
  • over 600 participants in the 5-year trial, aged 18 and over, in Scotland and England
  • analysing and publicising of the results. These were presented in The Lancet ‘Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial’ Read about the PACE trial in the Lancet article.

Cytokine responses to exercise and activity in patients with chronic fatigue syndrome/ME

This purpose of the PACE trial was to better understand the possible causes of chronic fatigue syndrome. Some of the findings were as follows:

  • A common symptom is to feel worse after a small amount of activity. 
  • If this symptom is apparent during an infection, immune hormones called cytokines may cause it.  An example of a cytokine is interferon. 
  • Chronic fatigue syndrome/ME can be brought on by infections. 
  • Exercise in general can cause a release of cytokines, especially in inactive people 
  • The study investigates whether physical activity increases cytokine levels and the activity of their genes in people with CFS/ME, more than in healthy sedentary people, and whether this ties in with the increased symptoms after activity. 

Cognitive behaviour therapy and graded exercise therapy can safely be added to standardised specialist medical care to moderately improve outcomes for chronic fatigue syndrome/ME, but adaptive pacing therapy is not an effective addition.