1) There’s a new interesting study out by a collaboration of ME/CFS patients and scientists.
They’ve sent Freedom of Information requests to 38 NHS specialist centers for ME/CFS and asked them about their information on harms by rehabilitative therapies such as GET or CBT.
2) The results are striking. Among the ME/CFS clinics surveyed, there was an almost universal absence of criteria for detecting harm, and no clinic reported any harm to have occurred in their patients, despite acknowledging that many dropped out of treatment.
3) No clinic reported telling patients explicitly that they could be worse after therapy than before. They only said that setbacks were possible (but temporary) or that the reported harms of GET are due to the treatment being wrongly executed.
4) So patients getting worse during treatment might think that their decline is due to something else.
The authors suggest this can result in a “misinformation loop”: the clinics say GET is safe, patients believe that and do not report harm, clinics think GET is really safe...
5) Or as the authors put it more eloquently: “if clinics presume that treatments are harmless, they will inevitably fail to record harms accurately.”
Another possibility is of course that patients do report harms but that clinics do not use or record this information.
6) The solution the authors propose is a national system for collecting information from patients who think they have been harmed by rehabilitative therapies such as GET, something similar to the Yellow Card Scheme for adverse effects arising from medical drugs or devices.
1) 🇦🇺 An Australian study claims to have found impaired glymphatic function in ME/CFS.
This glymphatic system was recently discovered and is thought to be responsible for clearing the brain of waste products, especially during sleep.
But there are some big limitations...
2) First: our understanding of this 'glymphatic system' as a waste clearance system is still quite limited. It's supposed to work through the aquaporin-4 channels on astrocytes, but much of what we know is derived from rodent experiments.
3) Second: the study didn't actually measure waste products or their clearance directly. It used an MRI scan to measure how water molecules diffuse in certain areas in the brain. That was used to calculate a proxy for glymphatic activity.
1) An overview of positive developments in ME/CFS research 👇
The European Union awarded €7.5 to a ME/CFS consortium that will conduct multi-omics and test biomarkers in hundreds of patients. It will connect five biobanks across the continent.
2) In the UK, the government invested £4.75 million in SequenceME. It will measure the whole genome of thousands ME/CFS patients in high resolution so that rare mutations can be found.
3) The WE&ME Foundation launched an ambitious grant program that was co-developed by members of the Science for ME forum. It aims to fund 7 projects with a budget of €120,000-180,000 per project.
1) 🇧🇪 In Belgium, the Federal Knowledge Centre (KCE) published a 144-page report on ME/CFS.
It measured the healthcare needs and priorities of ME/CFS patients (shown in the graph below) and recommends investments in research and specialist centres for ME/CFS.
2) The KCE makes scientific reports to guide policy. This report is part of the NEED project, which aims to identify healthcare needs in multiple medical conditions. They did a survey of 749 ME/CFS patients and conducted in-depth interviews with 19.
3) The NEED project is compiling a database of these healthcare needs. For ME/CFS, they found a large impact on quality of life. Patients had a mean EQ-5D-5L utility score of only 0.36.
This questionnaire is often used for estimates of disease burden.
1) 🇯🇵 A Japanese group published their hypothesis of Long Covid.
They suspect SARSCoV-2 causes a reactivation of another virus (HHV-6B) in the olfactory bulb where it produces a protein (SITH-1) that reduces acetylcholine levels in the brain.
Let's have a closer look...
2) These researchers had previously done a mouse experiment where SARS-CoV-2 spike (S1) protein in the nasal cavity caused fatigue- and depression-like symptoms and reduced acetylcholine.
Symptoms were improved with the drug donepezil (an acetylcholinesterase inhibitor)
3) They then tested donepezil in randomized controlled trial of 110 Long Covid patients but unfortunately it did not have any significant effect on fatigue or depression. Link here:
1) 🇳🇿 A survey in New Zealand among 333 ME/CFS and Long Covid patients found that half of the respondents had experienced food insecurity in the past 12 months.
2) Food insecurity was defined as ‘sometimes’ or ‘never’ being able to afford to eat properly, or ‘sometimes’ or ‘always’ having food run out, eating less, eating less variety due to cost, relying on others for food or using food grants/banks.
3) Food insecurity was more common in young people and increased with illness severity, but among the very severe, it was actually lower (potentially due to higher support and provision in this group).
1) This review found that people with ME/CFS are profoundly impacted by stigmatisation and that it also affects their social circles, such as friends and family.
The most frequently identified issue was stigmatising experiences by healthcare professionals and physicians.
2) The review found 44 studies on the topic of stigmatisation and ME/CFS, but the majority (68%) only addressed it as a secondary or peripheral topic.
Most studies were on adult women with ME/CFS. There were hardly any studies that focused on children or the experiences of men.
3) ME/CFS patients reported stigmatisation in many areas, such as disbelief from friends and family, public authorities and work environments denying disability, and media and society conveying negative stereotypes.