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London criteria
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== History == === The first version === The first version of the London criteria was formulated by [[Elizabeth Dowsett]], [[Ellen Goudsmit]], Anne MacIntyre and [[Charles Shepherd]] in 1993. A shortened version was published a year later in the report from the National Task Force on ME.<ref name="Londoncriteria"/> The criteria focused on post-exertional muscle fatigue, neurocognitive impairment and fluctuation of symptoms, usually precipitated by physical or mental exercise. Autonomic and immunological symptoms were regarded as secondary. According to [[Charles Shepherd]], the London criteria were developed "in order to try and persuade researchers to carry out research into [[Melvin Ramsay|Ramsay]]-described ME. This was obviously at a time when the medical profession had decided to rename and redefine ME as CFS and (if possible) put a very thick red line through the term ME."<ref name="Londoncriteria"/> The criteria were written for British patients organizations and used in several studies<ref>McCue P, Martin CR, Buchanan T, Rodgers T, Scholey AB. An investigation into the psychometric properties of the Hospital Anxiety and Depression Scale in individuals with chronic fatigue syndrome. Psychol Health Med. 2003;8:425-439.</ref><ref>Perrin RN, Edwards J, Hartley P. An evaluation of the effectiveness of osteopathic treatment on symptoms associated with myalgic encephalomyelitis. A preliminary report. J Med Eng Technol. 1998;22(1)1-13.</ref> - most notably the study on brainstem blood perfusion by Costa et al. (1995)<ref>Costa DC, Tannock C, Brostoff J. Brainstem perfusion is impaired in patients with chronic fatigue syndrome. Q J Med. 2005;88:767-773.</ref>. The criteria however failed to get wider traction in the research community, as most journals and funders preferred to use the [[Centers for Disease Control|CDC]]-formulated chronic fatigue syndrome-criteria. === The updated London criteria === With the publication of the [[International Consensus Criteria]] (ICC) in 2011, alternative criteria for the diagnosis of ME became available for researchers and clinicians. The ICC were formulated by ME-experts from 12 different countries, using a Delphi-type process. Although the ICC have been validated in research<ref>{{Cite journal | last = Johnston | first = Samantha | last2 = Staines | first2 = Donald | last3 = Marshall-Gradisnik | first3 = Sonya | date = May 2016 | title = Epidemiological characteristics of chronic fatigue syndrome/myalgic encephalomyelitis in Australian patients|url=https://pdfs.semanticscholar.org/104e/47348a0d51cf0970b8d15f3ec387aa943f5d.pdf | journal=Clinical Epidemiology | pages = 97|doi=10.2147/clep.s96797|issn=1179-1349|volume=|via= | authorlink2 = Donald Staines | authorlink3 = Sonya Marshall-Gradisnik}}</ref>, several criticisms have arisen about its use. [[Leonard Jason]] for example noted that it is not clear if all five elements of what the ICC calls post-exertional neuroimmune exhaustion (PENE) should be present or not. A 2013 paper by [[Abigail Brown|Brown]] et al. demonstrated that the ICC identifies a patient group with more psychiatric disorders than the [[Fukuda criteria|Fukuda]] (CFS) criteria.<ref>{{Cite journal|last = Brown | first = Abigail A. | last2 = Jason | first2 = Leonard A. | last3 = Evans | first3 = Meredyth A. | last4 = Flores | first4 = Samantha | date = 2013-03-01 | title = Contrasting Case Definitions: The ME International Consensus Criteria vs. the Fukuda et al. CFS Criteria|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4215640/|journal=North American Journal of Psychology|volume=15|issue=1|pages=103–120|issn=1527-7143|pmc=|pmid=25364305|via= | author-link = Abigail Brown | authorlink2 = Leonard Jason | authorlink3 = Meredyth Evans}}</ref> By utilizing a wide array of symptoms in the diagnosis of ME, the ICC seems to capture a different set of patients than those originally described by [[Melvin Ramsay|Ramsay]]. Furthermore, [[Paresis|muscle weakness]] after minimal exercise is not explicitly mentioned in the ICC-description of PENE.<ref>{{Cite journal | last = McManimen | first = Stephanie L. | last2 = Sunnquist | first2 = Madison L. | last3 = Jason | first3 = Leonard A. | date = 2016-08-01 | title = Deconstructing post-exertional malaise: An exploratory factor analysis|url=https://www.ncbi.nlm.nih.gov/pubmed/27557649|journal=Journal of Health Psychology|pages=1359105316664139|doi=10.1177/1359105316664139|issn=1461-7277|pmc=|pmid=27557649|volume=|via= | author-link = Stephanie McManimen | authorlink2 = Madison Sunnquist | authorlink3 = Leonard Jason}}</ref> The London criteria were updated in 2009<ref name="Goudsmit2009">{{Cite journal|last = Goudsmit | first = Ellen | first2 = Charles | last3 = Dancey | first3 = Christine | first4 = Sandra | date = 2009-01-01 | title = ME: Chronic fatigue syndrome or a distinct clinical entity?|url=https://www.researchgate.net/publication/234101217_ME_Chronic_fatigue_syndrome_or_adistinct_clinical_entity|journal=Health Psychology Update|volume=18|pages=26–33|via= | last2 = Shepherd | last4 = Howes}}</ref> and once more in 2014<ref name="London2014" />, to provide research criteria that capture the clinical picture of ME as described by Ramsay and the pre-CFS literature. This updated version of the London Criteria added "impaired circulation compatible with autonomic dysfunction" as a major criterium and recommends the use of the Profile of Fatigue Related Symptoms (PFRS)<ref name="Ray1992">{{Cite journal|last = Ray|first = Colette | last2 = Weir | first2 = William R.C. | authorlink2 = William Weir | last3 = Phillips | first3 = Sarah | last4 = Cullen | first4 = Sarah | date = Oct 1992 | title = Development of a measure of symptoms in chronic fatigue syndrome: The profile of fatigue-related symptoms (PFRS)|url=https://www.tandfonline.com/doi/abs/10.1080/08870449208404293|journal=Psychology & Health|language=en|volume=7|issue=1|pages=27–43|doi=10.1080/08870449208404293|issn=0887-0446|via=|pmid= | pmc= }}</ref> in making the diagnosis of ME. Authors of the 2014 version were [[Ellen Goudsmit]], [[Charles Shepherd]] and [[Sandra Howes]].
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