Maintenance of Chronic Fatigue Syndrome (CFS) in Young CFS Patients Is Associated with the 5-HTTLPR and SNP rs25531 A > G Genotype

Earlier studies have shown that genetic variability in the SLC6A4 gene encoding the serotonin transporter (5-HTT) may be important for the re-uptake of serotonin (5-HT) in the central nervous system. In the present study we investigated how the 5-HTT genotype i.e. the short (S) versus long (L) 5-HTTLPR allele and the SNP rs25531 A > G affect the physical and psychosocial functioning in patients with chronic fatigue syndrome (CFS). All 120 patients were recruited from The Department of Paediatrics at Oslo University Hospital, Norway, a national referral center for young CFS patients (12–18 years). Main outcomes were number of steps per day obtained by an accelerometer and disability scored by the Functional Disability Inventory (FDI). Patients with the 5-HTT SS or SL(G) genotype had a significantly lower number of steps per day than patients with the 5-HTT L(A)L(G), SL(A) or L(A)L(A) genotype. Patients with the 5-HTT SS or SL(G) genotype also had a significantly higher FDI score than patients with the 5-HTT L(A)L(G), SL(A) or L(A)L(A) genotype. Thus, CFS patients with the 5-HTT SS or SL(G) genotype had worse 30 weeks outcome than CFS patients with the 5-HTT L(A)L(G), SL(A) or L(A)L(A) genotype. The present study suggests that the 5-HTT genotype may be a factor that contributes to maintenance of CFS.