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Central Sensitization in Neurological, Psychiatric, and Pain Disorders: A Multicenter Case-Controlled Study, Suzuki et al, 2021

Discussion in 'Psychosomatic research - ME/CFS and Long Covid' started by Andy, Mar 2, 2021.

  1. Andy

    Andy Committee Member

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    Open access, https://www.hindawi.com/journals/prm/2021/6656917/

     
  2. ME/CFS Skeptic

    ME/CFS Skeptic Senior Member (Voting Rights)

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    Only read the abstract, but this looks like a good example of the inappropriate use of questionnaires.

    I could make a diabetes questionnaire with nonspecific symptoms that occur in patients with diabetes such as thirst, fatigue etc.

    I then offer the diabetes questionnaire to a group of CFS patients

    "Our results suggest that CFS patients have diabetes".
     
    Last edited: Mar 2, 2021
    Dolphin, Chezboo, Michelle and 14 others like this.
  3. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    More questionnaire junk. 'Central sensitisation' needs actual neurological evidence.
     
    Chezboo, Milo, Michelle and 10 others like this.
  4. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    Are there any health conditions causing chronic pain that doctors haven't decided is a mental health problem?

    Edit : Just wanted to point out this was intended to be a serious question. :)
     
    Last edited: Mar 2, 2021
  5. spinoza577

    spinoza577 Senior Member (Voting Rights)

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    I might be wrong, but in my understanding, "central senzitation" does not imply in itself any mental causation.

    Therefore, the paper might be of interest.
     
  6. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    Who cares? We're pointing out the methodology sucks.
     
    Michelle, Mithriel, FMMM1 and 2 others like this.
  7. Amw66

    Amw66 Senior Member (Voting Rights)

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    CSS will follow on from FND as an additional diagnosis
    The subverting of language by whatever means is usually the first step.
     
  8. spinoza577

    spinoza577 Senior Member (Voting Rights)

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    Admittedly, I don´t see the point.

    Why would it be inappropriate to compare fever from a cold with fever from, say, dengue fever?

    Why should this not lead to any further knowledge, whatever it might be?


    So, in "CSS" it may turn out some day that the dopamine system is affected, or whatever.
     
    Mithriel, Peter Trewhitt and MEMarge like this.
  9. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    But they're not actually measuring any real evidence of "CSS" they're just using questionnaires and pretending this is evidence.
     
    MEMarge, Cheshire, Hutan and 8 others like this.
  10. Daisybell

    Daisybell Senior Member (Voting Rights)

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    Well the questionnaire is the Central Sensitisation Inventory - how much more evidence do you need that CSS exists??? :banghead:
    It’s amazing that you can put together a list of symptoms that commonly co-occur, give the list a label and hey presto, you have a diagnosis - even better you can then add a hypothesis for the diagnosis and people will quote your paper as the basis for all sorts of studies into your new diagnosis. Then it is beyond doubt...
     
    Michelle, Arnie Pye, MEMarge and 6 others like this.
  11. spinoza577

    spinoza577 Senior Member (Voting Rights)

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    I still don´t see the point.

    Should it be as unscientific forbidden to ask ppl how it feels?


    I would agree though, that it cannot not compete with objective knowledge like, say, about neurotransmitters. But this alone doesn´t say much as well.
     
    Last edited: Mar 4, 2021
    MEMarge likes this.
  12. Sphyrna

    Sphyrna Established Member (Voting Rights)

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    To be fair, this is the precise criticism I see medics make of ME *constantly.*
    Difference is, they don't know that ME has a distinct (generally postviral) aetiology, symptomology, and trajectory, and we do not make any claims of identifying any underlying disease process with our clinical diagnosis, whereas CSS is just to fibro what impaired connectivity is to FND.
    Or, what serotonin imbalance was to depression, before they figured out themselves they needed something a bit more sophisticated than that one.
     
    Michelle, Mithriel, MEMarge and 2 others like this.
  13. spinoza577

    spinoza577 Senior Member (Voting Rights)

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    I clearly say: No, this is not already a subverting of language.

    You can come up with the idea that in a variety of symptoms any so far unknown dysfunction of nerves takes place and give it a label. This is in fact science in its progress.

    You also can come up with a description of symptoms and put them together with a term, which interprets them as a "senzitisation in the CNS".


    This is perfectly fine, so far. If you put critic on this, you make it easy for your enemies not to be taken seriously.


    The problem arises when you come up with the interpretation, that symptoms and the guessed dysfunction or (more specifically) the guessed senzitation would be psychologically caused, without that there is any good evidence for nor that it is even of more likely possibility over physiological causes. But if you are doing premature critics, you will have shot you arrow already.
     
    Last edited: Mar 4, 2021
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  14. spinoza577

    spinoza577 Senior Member (Voting Rights)

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    To my knowledge, the causes of any diseases her, interpreted as FND or CSS, is not known.

    Only b/c ME/CFS begins in about 66% of cases apparently with a trigger, it´s not excluded that eg depression is not a physiologically caused disease, or at least has physiological components (which may be in disabling depression major contributers, at least).


    So you make no point in favour of ME/CFS.
     
    Peter Trewhitt likes this.
  15. Cheshire

    Cheshire Moderator Staff Member

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    The difference is that no reliable scientist says that we know the physiopathology of ME, whereas this is the assumption for Central Sensitization.
     
  16. Sphyrna

    Sphyrna Established Member (Voting Rights)

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    I was making a point in favour of demarcating clinical constructs in absence of understood pathology via the clinical picture, but I also believe that inferring a *hypothetical* pathology from the same examination is ass-backwards.
    I didn't claim that it doesn't. I brought up the serotonin hypothesis as an example of an explanatory model that is embryonic at best, and holds equally little predictive value and explanatory power in theory as well as in clinical practice. Just like the other models I mentioned.
    Unlike many medics who merely pay lip service to the idea of abolishing mind-body dualism, I'm actually interested in multi-pronged approaches.
    The problem is that the brain-behaviour divide isn't exactly trivial to bridge, and I don't think that applying one explanatory model to multiple conditions, when it hasn't even borne fruit for *any* of them, is the key.

    I'd like for anyone to look at my friend with fibro and myself and tell me we are suffering from two manifestations of the same condition. The only similarities are the demographic and absence of a biomarker that is easily detectable via standard bloodwork. Yet, I always see medics equating FND/Fibro/ME/what-have-you, and I just want to tell them to stop.
     
    Last edited: Mar 4, 2021
  17. Amw66

    Amw66 Senior Member (Voting Rights)

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    Not my idea.i recall Mike Ekzakker flagged this up a couple of years ago, how the term was being bastardised to shift agendas

    I didn't bookmark the reference, but it seemed pertinent.
    CSS seems to have taken off since in BPS world
     
  18. spinoza577

    spinoza577 Senior Member (Voting Rights)

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    I don´t disagree for sure.
     
  19. spinoza577

    spinoza577 Senior Member (Voting Rights)

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    Without hypothesis no science. Ok, here its more about the clinical picture which is given an underlying hypothetical vague mechanism, but I daresay, or I find, the guess is reasonable or at least reasonable enough.

    I agree, and there is all in all not much fantasy or imagination at work. As we could learn from Einstein, without fantasy, no good science.

    Here I disagree and say, it´s a fruitful approach to search for similarities, even if they may turn out then not to take place.
     
    Sphyrna likes this.
  20. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    It can be problematic if researchers have never bothered to ask patients if they believe the questionnaires are relevant or of high quality. (which an unfortunate flaw of most questionnaire based studies)

    If it is about how patients feel, I'd prefer a qualitative study, not a bunch of questionnaires that have not been properly validated by the patient group themselves.
     
    Michelle, FMMM1, Milo and 7 others like this.

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