Review Diagnosis and Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, 2023, Grach et al

Discussion in 'ME/CFS research' started by Wyva, Oct 4, 2023.

  1. Wyva

    Wyva Senior Member (Voting Rights)

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    Abstract

    Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic neurologic disease often preceded by infection. There has been increased interest in ME/CFS recently because of its significant overlap with the post-COVID syndrome (long COVID or post-acute sequelae of COVID), with several studies estimating that half of patients with post-COVID syndrome fulfill ME/CFS criteria. Our concise review describes a generalist approach to ME/CFS, including diagnosis, evaluation, and management strategies.

    Open access: https://www.mayoclinicproceedings.org/article/S0025-6196(23)00402-0/fulltext
     
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  2. Hutan

    Hutan Moderator Staff Member

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    On a quick skim, it looks pretty good. As you would expect with Jaime as one of the authors, it gets the main things right such as PEM; 'don't do GET' and making the link with Long Covid.

    As with many other resources, there's a lot of recommendation of drugs and supplements for which there really is not good evidence. I think a lot of doctors just can't bear to say 'yeah, we've got nothing'. And, if you are a clinic like the Mayo, who is going to beat a path to your door and have their insurance spend big bucks if that's what you are saying?

    It doesn't add anything beyond what existing resources/summary papers say, I think, and it's not a systematic review. It's more along the lines of 'this is what we reckon'. But, if it's getting the important things right, maybe that doesn't matter. Perhaps this paper will reach and convince new audiences.
     
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  3. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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    Not too bad but the opening sentence isn't supported.

    Referencing Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: An IOM Report on Redefining an Illness (2015, JAMA) which is a viewpoint article written by the IOM chair in JAMA rather than the IOM report itself.

     
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  4. livinglighter

    livinglighter Senior Member (Voting Rights)

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    Referencing Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: An IOM Report on Redefining an Illness (2015, JAMA) which is a viewpoint article written by the IOM chair in JAMA rather than the IOM report itself.

    In medical terminology, can the Central nervous system also be referred to as a multisystem, such as Multiple system atrophy?

    I’m thinking multisystem is another term for the CNS.
     
    Last edited: Oct 4, 2023
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  5. Dakota15

    Dakota15 Senior Member (Voting Rights)

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    Sharing from Jaime Seltzer, one of the co-authors from #MEAction.

    https://twitter.com/exceedherg.../status/1711197702564856010

    Per Jaime, "It’s in the top <1% most shared of all Mayo Clinic publications. It’s the most shared paper amongst its contemporaries at Mayo Clinic Proceedings. It’s in the top 0.2% most shared research products of all time. It’s been live less than a week."
     
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  6. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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    I think that MSA implies multiple neurological systems, as opposed to a single neurological system. The disease definition involves autonomic dysfunction with either Parkinsonian or cerebellar symptoms and was derived to wrap previously individually named conditions. See Second consensus statement on the diagnosis of multiple system atrophy (2008, Neurology). So it looks as if "multiple system" is being used to reference CNS and ANS (the latter having both central and peripheral components - preganglionic/postganglionic).

    In contrast, the IOM report advocated renaming to "systemic exertion intolerance disease", where systemic is multi organ systems, encompassing eg cardiovascular, musculoskeletal, neurological, endocrine etc.

     
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  7. Grigor

    Grigor Senior Member (Voting Rights)

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    I wanted to share it but decided not to when I read the recommendations.
     
  8. ahimsa

    ahimsa Senior Member (Voting Rights)

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    I thought the figure on PEM was helpful.

    Figure 2 - PEM.jpg

    For anyone who wants to post this image on social media, here's an image description I wrote that you can add as alt text (the text read by screen readers or that is shown if the image fails to load) when you post the image:
    Image descriptions take work so I wanted to share just in case it's helpful for someone out there.

    EDIT: And right after I posted I noticed several typos! Fixing now, let me know if you see errors/typos.
     
    Last edited: Oct 10, 2023
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  9. Dolphin

    Dolphin Senior Member (Voting Rights)

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    6-minute video:
    Description: Dr. Stephanie Grach, an Assistant Professor of Medicine in the Division of General Internal Medicine at Mayo Clinic in Rochester, MN, and Jaime Seltzer, Director of Scientific and Medical Outreach at #MEAction and a researcher with Stanford School of
    Medicine in Palo Alto, CA, share insights from their Concise Review on the diagnosis and management of myalgic encephalomyelitis / chronic fatigue syndrome, also known as “ME/CFS.” They note infection-associated chronic illness is an up-and-coming area of
    research and state it is vital that medical providers learn more about how to recognize and address this disease. The Concise Review will be appearing in the October 2023 issue of Mayo Clinic Proceedings.
    Available at: https://mayocl.in/3L8Olwb

    https://www.youtube.com/watch?v=WZLY3nU0LbY




    There is also a transcript at the link

     
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  10. ahimsa

    ahimsa Senior Member (Voting Rights)

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  11. Dolphin

    Dolphin Senior Member (Voting Rights)

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