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) In this old study from 2005, researchers induced catastrophic thinking in their participants and then recorded their pain intensity after immersing their hand in ice water.
Catastrophizing didn't have any influence on pain.
2) The researchers split the participants into two groups and told one of them (the catastrophizing group) that a few people who did the experiment fainted during the ice-water immersion. And the people who fainted had similar responses to the questionnaire as you.
3) Catastrophizing thoughts (negative thinking that interprets things as worse, more threatening and less controllable) were measured with the pain catastrophizing scale (PCS).
The experiment successfully increase the PCS score in the catastrophizing group.
2) The Netherlands Brain Bank has 40 years of experience.
Their ME/CFS program started in April 2024. They currently have 61 registrations and the aim is to have 200 by the end of their 5-year project.
3) They already did 10 autopsies but aim to do 50 over a period of ten years.
They submitted a manuscript on their first findings titled “Hypothalamic-pituitary-adrenal axis dysfunction in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome”.
1) 🏴 Researchers from Cardiff University followed-up on their findings on complement activation in Long Covid. In this new study, they found differences in the lectin pathway and suggest it might explain endothelial damage and persistent coagulopathy in LC.
2) The complement system consists of tiny proteins all over your body that can be activated to initiate an immune response and tagg pathogens so that you immune cells can more easily catch and destroy them.
3) The key protein is C3, but there are different pathways to activate it. In this new paper, the authors used the ELISA technique to test more markers of the so called lectin pathway in a large sample of 159 LC patients and 76 controls.
1) Reading this old hypothesis by Michael VanElzakker on how infection of the vagus nerve might cause symptoms similar to ME/CFS.
This nerve passes on info about what's happening internally in the body. So an infection there might cause constant and severe sickness symptoms.
2) The vagus nerve is like a highway from your brainstem all the way down to your abdomen, wandering (vagus means wandering in Latin) through major organs along the way.
It picks up pro-inflammatory cytokines and passes on the danger response to the brain.
3) But what if this messenger itself is infected? That's sort of the gist of the theory, that an infection at the vagus nerve would cause a constant signal that the body is severely infected by a virus or other pathogen.
1) Todd Davenport and his colleagues from the Workwell foundation published new data on 2-day exercise testing in patients with Long Covid.
These showed reductions in workload and VO2 max on the second test, similar to ME/CFS patients.
2) These cardiopulmonary exercise tests (CPET) involve riding a bike for about 10 minutes. The resistance is increased until you reach your maximum effort.
ME/CFS and Long Covid show lower values on these tests but this doesn't' fully reflect their disease or disability.
3) Researchers have noted, however, that if ME/CFS patients repeat this exercise test on consecutive days, they are unable to replicate their first values. That's strange because CPET is normally quite reliable, even in patients with for example heart or lung disease.
1) 🇧🇪 A small Belgian study reports that patients with ME/CFS and FM might have abnormalities in the opioid system.
They found that the opioid receptor genes were more often methylated, suggesting that these patients might be less sensitive to this type of pain relief.
2) This paper focuses on epigenetics: how our genes are switched on or off. This is done by adding methyl groups to specific pieces of DNA, making it less likely that a gene will be expressed.
The genetic code remains exactly the same but it becomes harder to acces and read.
3) In the current study, Andrea Polli and his colleagues looked at OPRM1, the gene that provides instructions for building µ-opioid receptors. These are the receptors for both your body’s natural painkillers (endorphins) and prescription painkillers (like morphine).