Possibilities of the EcoMedic digital platform in diagnostics functional disorders

Introduction. Studying the influence of chemical sensitivity on functional disorders by means of digital diagnostic technologies is a significant medical and social problem.

Aim. To study the possibility of the EcoMedic digital platform in the diagnosis of functional disorders with multiple chemical sensitivity (MCH).

Materials and methods. Questionnaires were administered using the QEESI questionnaire to 468 outpatients undergoing preventive medical examination (232 men, mean age 34.2 ± 9.3 years and 236 women mean age 42.9 ± 13.8 years). Data were collected using the developed digital platform EcoMedic. Statistical processing was performed using MedCalc statistical programme.

Results. The frequency of MCH was 211 patients (45.1%). The most frequent complaints in MCH were gastrointestinal (n = 174, 82.4%); second were cognitive symptoms (n = 158, 75.1%); dall neurological (n = 149, 71.1%); musculoskeletal (n = 144, 68.5%); neuromuscular (n = 139, 66.4%); respiratory and mucosal (n = 130, 62.1%); cutaneous (n = 124, 59.1%); affective (n = 118, 56.4%). In MCH, symptom frequency across all 10 symptom groups was significantly higher than in controls (p < 0.0001). In MCH, the frequency of symptoms in all 10 groups of symptoms was significantly higher than in patients without MCH (p < 0.0001). The frequency of overlapping of 3 regions of the MCH scales simultaneously in the group of patients with MCH was higher than without MCH (60.2% vs 3.1%, χ² = 186.065, p = 0.000). The proportion of people with thresholds for severity of symptoms or impact on daily life according to only one of the scales in the group of patients with HCV was significantly lower (9% vs 32.6%, χ² = 37.853, p = 0.001).

Conclusions. The EcoMedic digital platform has prospects for scaling technologies to diagnose patients with HCV and conduct scientific and practical studies of functional symptoms.

1. Diukova GM, Golubev VL, Pogromov AP, Mnatsakanyan MG. Functional disorders: pathogenesis and systematic of clinical presentation. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2016;116(12):137-144. (In Russ.) https://doi.org/10.17116/jnevro2016116121137-144.

2. Diukova GM, Zamergrad MV, Golubev VL, Adilova SM, Makarov SA. Functional (psychogenic) vertigo. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2017;117(6):91-98. (In Russ.) https://doi.org/10.17116/jnevro20171176191-98.

3. Miller CS, Palmer RF, Kattari D, Masri S, Ashford NA, Rincon R et al. What initiates chemical intolerance? Findings from a large population-based survey of U.S. adults. Environ Sci Eur. 2023;35(1):65. https://doi.org/10.1186/s12302-023-00772-x.

4. Molot J, Sears M, Anisman H. Multiple chemical sensitivity: It's time to catch up to the science. Neurosci Biobehav Rev. 2023;151:105227. https://doi.org/10.1016/j.neubiorev.2023.105227.

5. Miller CS, Prihoda TJ. The Environmental Exposure and Sensitivity Inventory (EESI): a standardized approach for measuring chemical intolerances for research and clinical applications. Toxicol Ind Health. 1999;15(3-4): 370-385. https://doi.org/10.1177/074823379901500311.

6. Hauge CR, Rasmussen A, Piet J, Bonde JP, Jensen C, Sumbundu A, Skovbjerg S. Mindfulness-based cognitive therapy (MBCT) for multiple chemical sensitivity (MCS): Results from a randomized controlled trial with 1 year follow-up. J Psychosom Res. 2015;79(6):628-634. https://doi.org/10.1016/j.jpsychores.2015.06.010.

7. Rossi S, Pitidis A. Multiple Chemical Sensitivity: Review of the State of the Art in Epidemiology, Diagnosis, and Future Perspectives. J Occup Environ Med. 2018;60(2):138-146. https://doi.org/10.1097/jom.0000000000001215.

8. Steinemann A. National Prevalence and Effects of Multiple Chemical Sensitivities. J Occup Environ Med. 2018;60(3):e152-e156. https://doi.org/10.1097/jom.0000000000001272.

9. Andersson L, Claeson AS, Dantoft TM, Skovbjerg S, Lind N, Nordin S. Chemosensory perception, symptoms and autonomic responses during chemical exposure in multiple chemical sensitivity. Int Arch Occup Environ Health. 2016;89(1):79-88. https://doi.org/10.1007/s00420-015-1053-y.

10. Pall ML, Satterlee JD. Elevated nitric oxide/peroxynitrite mechanism for the common etiology of multiple chemical sensitivity, chronic fatigue syndrome, and posttraumatic stress disorder. Ann N Y Acad Sci. 2001;933:323-329. https://doi.org/10.1111/j.1749-6632.2001.tb05836.x.

11. Dupas D, Dagorne MA. Multiple chemical sensitivity: A diagnosis not to be missed. Rev Mal Respir. 2013;30(2):99-104. https://doi.org/10.1016/j.rmr.2012.06.016.

12. De Luca C, Scordo MG, Cesareo E, Pastore S, Mariani S, Maiani G et al. Biological definition of multiple chemical sensitivity from redox state and cytokine profiling and not from polymorphisms of xenobiotic-metabolizing enzymes. Toxicol Appl Pharmacol. 2010;248(3):285-292. https://doi.org/10.1016/j.taap.2010.04.017.

13. Ziem G, McTamney J. Profile of patients with chemical injury and sensitivity. Environ Health Perspect. 1997;105(Suppl 2):417-436. https://doi.org/10.1289/ehp.97105s2417.

14. Van den Bergh O, Devriese S, Winters W, Veulemans H, Nemery B, Eelen P, Van de Woestijne KP. Acquiring symptoms in response to odors: a learning perspective on multiple chemical sensitivity. Ann N Y Acad Sci. 2001;933:278-290. https://doi.org/10.1111/j.1749-6632.2001.tb05831.x.

15. Meggs WJ. Hypothesis for induction and propagation of chemical sensitivity based on biopsy studies. Environ Health Perspect. 1997;105(Suppl 2): 473-478. https://doi.org/10.1289/ehp.97105s2473.

16. Meggs WJ. Neurogenic inflammation and sensitivity to environmental chemicals. Environ Health Perspect. 1993;101(3):234-238. https://doi.org/10.1289/ehp.93101234.

17. Mazzatenta A, Pokorski M, Cozzutto S, Barbieri P, Veratti V, Di Giulio C. Non-invasive assessment of exhaled breath pattern in patients with multiple chemical sensibility disorder. Adv Exp Med Biol. 2013;756:179-188. https://doi.org/10.1007/978-94-007-4549-0_23.

18. Aguilar-Aguilar E, Marcos-Pasero H, de la Iglesia R, Espinosa-Salinas I, Ramfrez de Molina A, Reglero G, Loria-Kohen V. Characteristics and determinants of dietary intake and physical activity in a group of patients with multiple chemical sensitivity. Endocrinol Diabetes Nutr (Engl Ed). 2018;65(10):564-570 . https://doi.org/10.1016/j.endinu.2018.07.009.

19. Cullen MR, Redlich CA. Significance of individual sensitivity to chemicals: elucidation of host susceptibility by use of biomarkers in environmental health research. Clin Chem. 1995;41(12):1809-1813. https://doi.org/10.1093/clinchem/41.12.1809.

20. Micarelli A, Viziano A, Bruno E, Micarelli E, Alessandrini M. Vestibular impairment in Multiple Chemical Sensitivity: Component analysis findings. J Vestib Res. 2016;26(5-6):459-468. Available at: https://pubmed.ncbi.nlm.nih.gov/28262643.

21. Azuma K, Uchiyama I, Katoh T, Ogata H, Arashidani K, Kunugita N. Prevalence and Characteristics of Chemical Intolerance: A Japanese Population-Based Study. Arch Environ Occup Health. 2015;70(6):341-353. https//doi.org/10.1080/19338244.2014.926855.

22. Simon GE, Daniell W, Stockbridge H, Claypoole K, Rosenstock L. Immunologic, psychological, and neuropsychological factors in multiple chemical sensitivity. A controlled study. Ann Intern Med. 1993;119(2):97-103. https://doi.org/10.7326/0003-4819-119-2-199307150-00001.

23. Staudenmayer H. Clinical consequences of the EI/MCS “diagnosis”: Two paths. Pt 2Regul. Toxicol Pharmacol. 1996;24:S96-S110. https://doi.org/10.1006/rtph.1996.0084.

24. Jimenez XF, Shirvani N, Hogue O, Karafa M, Tesar GE. Polyallergy (Multiple Chemical Sensitivity) is Associated with Excessive Healthcare Utilization, Greater Psychotropic Use, and Greater Mental Health/Functional Somatic Syndrome Disorder Diagnoses: A Large Cohort Retrospective Study. Psychosomatics. 2019;60(3):298-310. https//doi.org/10.1016/j.psym.2018.07.016.

25. Bornschein S, Hausteiner C, Zilker T, Forstl H. Psychiatric and somatic disorders and multiple chemical sensitivity (MCS) in 264 ‘environmental patients'. Psychol Med. 2002;32(8):1387-1394. https//doi.org/10.1017/s0033291702006554.

26. Katerndahl DA, Bell IR, Palmer RF, Miller CS. Chemical intolerance in primary care settings: prevalence, comorbidity, and outcomes. Ann Fam Med. 2012;10(4):357-365. https//doi.org/10.1370/afm.1346.

27. Chanana P, Kumar A. GABA-BZD Receptor Modulating Mechanism of Panax quinquefolius against 72-h Sleep Deprivation Induced Anxiety like Behavior: Possible Roles of Oxidative Stress, Mitochondrial Dysfunction and Neuroinflammation. Front Neurosci. 2016;10:84. https://doi.org/10.3389/fnins.2016.00084.

28. Herken H, Akyol O, Yilmaz HR, Tutkun H, Savas HA, Ozen ME et al. Nitric oxide, adenosine deaminase, xanthine oxidase and superoxide dismutase in patients with panic disorder: alterations by antidepressant treatment. Hum Psychopharmacol. 2006;21(1):53-59. https://doi.org/10.1002/hup.742.

29. Herken H, Gurel A, Selek S, Armutcu F, Ozen ME, Bulut M et al. Adenosine deaminase, nitric oxide, superoxide dismutase, and xanthine oxidase in patients with major depression: impact of antidepressant treatment. Arch Med Res. 2007;38(2):247-252. https//doi.org/10.1016/j.arcmed.2006.10.005.

30. Steckert AV, Valvassori SS, Moretti M, Dal-Pizzol F, Quevedo J. Role of oxidative stress in the pathophysiology of bipolar disorder. Neurochem Res. 2010;35(9):1295-1301. https://doi.org/10.1007/s11064-010-0195-2.