A compromised paraventricular nucleus within a dysfunctional hypothalamus: A novel neuroinflammatory paradigm for ME/CFS, 2018, Mackay, Tate.

I mean the easiest way is always to find an animal knockout model. If the PVN is really this inflamed and destroyed, create a mouse without a paraventricular nucleus and see how it performs. In fact, i just looked up some studies injecting some lipopolysaccharide into the PVN. The impact was manageable to make it short. Was a nice read, but a lot of hypothetical assumptions without any backup for now for anything. And like always it will probably end there because no funding to go deeper. He says that PEM comes from stress from exercise
(Kinda funny, when i was training and running the marathon i never felt stress, quite the opposite. A lot of stress relieve. Eustress.)
which again overloads the PVN, activates glia cells, pumps out pro-inflammatory cytokines followed by fatigue. Not one disease in my life ever created such a fatigue i feel right now with Cfs. I have seen tumor fatigue. They weren't as bad as me even in their worst days. So to say now it comes from the immune system down the line from some glia cells seems pretty weak. Maybe you could go with extreme activation of the PNS from an inflamed PVN. Kinda like this TED talk guy with adrenal medulla hyperplasia. I mean he could easily go as a Cfs patient.

https://www.youtube.com/watch?v=w4s0uNy8Q2g

I mean you can bend and stretch every medical theory till it fits your purpose. Seems weak for now without any real medical background to back up his claims.