Exercise-induced changes in cerebrospinal fluid miRNAs in Gulf War Illness, Chronic Fatigue Syndrome and sedentary control subjects, 2017, Baraniuk

As I recall, there were a couple fMRIs that participants had as part of the study protocol. I wonder if a second study from Baraniuk's team will be forthcoming more specific to the fMRI results.

START appears to be simply POTS triggered by exercise - did any CFS subjects satisfy START requirements?

Since we seem to share the same CSF values as controls, could what he be demonstrating is a new metric for at least a form of PEM (maybe two)? Afterall, the differences appear to have been triggered by exertion/exercise.
 
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The strongest factor associated with the belief that they had Gulf War syndrome, it turned out, was knowing someone else who had it.
How utterly fatuous. You could say the same thing about people who believe they have cholera. The fact that they know other people who have cholera (perhaps they all live near each other and get their water from the same well) is just a social factor. Any cluster outbreak of anything can be blamed on psychosocial factors in this way - it happens to people in the same vicinity at the same time, so a lot of them probably knew each other. Camelford? Obviously mass hysteria.
 
Can someone comment as to the relevance of the results in relation to the potential patophysiology of ME?

They mention neurotoxicity in relation to GWI, but do not delve into any conclusions regarding ME.

The authors seem to have done quite a bit of work on GWI and so probably feel more comfortable making comments about possible mechanisms in GWI, but I don't think these results say anything yet about pathophysiology. At best they give hints about areas which would be worth further investigation.

Setting aside the question of criteria used to define the CFS group, the value of the study is the measurement of objective differences in CSF composition resulting from exercise challenge, both between patient groups and controls and among the different patient groups.

Determining the significance of those differences will need a lot more study.

As for the miRNAs being detected, this is a relatively new field and there is still a lot to learn about them.

The authors choose to comment on the role of relatively few of those observed to change, presumably reflecting paucity of information.

Two, miR-328 and miR-608, are diminished by exercise in all subjects (ie patients and controls), suggesting that these might play some general role in the effects of exercise on the brain. The latter targets cholinesterase.

Three, miR-let-7i-5p, miR-93-3p and miR-200A-5p, are diminished after exercise in GWI and CFS patients but not in sedentary controls. The first one targets IL6 and contributes to regulation of acetylcholine receptors.

Twelve miRNAs were uniquely diminished in CFS. They comment on only a few of these. miR-186-3p targets the enzyme which cleaves the amyloid protein precursor protein, miR-19b-3p targets the transcription factor STAT3 (both these may play some role in Alzheimers), miR-92a-3p targets the tumour suppressor gene BCL2L11 and miR-126-5p targets several adhesion molecules and so reduces transendothelial migration (which may be relevant to immune cell influx into the brain).

These are simply observations, we can't yet draw any conclusions about mechanism.

ETA Forgot to say the BCL2 family of proteins regulate apoptosis.
 
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Subjects cycled at 70% of age predicted maximum heart rate for 25 min followed by stepwise increases in bicycle resistance to reach 85% predicted heart rate.

These must have been very mild patients. I have spanned a breadth of disease severity throughout the last 5 years, and at no point could I have sustained cycling at 70% of maximum age predicted heart rate for 25 minutes. Even at my best I would have been absolutely devastated by such a harsh exercise test; I can't imagine having attempted that without permanently destroying my health.

So, if we're seeing these changes in patients that must be very mild, I wonder the extent of changes that might be seen in the remainder of the spectrum.
 
30 minutes on an eliptical trainer at 70% three years ago is the last exercise I ever did. Took me well over a month to recover, and I don't think I've ever recovered to the point I was before that. According to my diary I could do a full day's work in my office in the weeks before that exercise, I'm lucky to do a couple of hours now, some days nothing at all.

Since then I have flatly refused to get on an exercise bike for a cardiologist. No way would I do that again until they find the cure for ME. It would take weeks to recover and could set me back permanently.

EDIT: And I'm mild.
 
These must have been very mild patients. I have spanned a breadth of disease severity throughout the last 5 years, and at no point could I have sustained cycling at 70% of maximum age predicted heart rate for 25 minutes. Even at my best I would have been absolutely devastated by such a harsh exercise test; I can't imagine having attempted that without permanently destroying my health.

So, if we're seeing these changes in patients that must be very mild, I wonder the extent of changes that might be seen in the remainder of the spectrum.
I think of my wife as mild/moderate, and I'm absolutely certain she could get nowhere near this. 70% would be a real stress for her at best I think, even for a few seconds, and she would really pay for it. Trying to sustain it would, I'm sure, result in her rapidly winding down to much much less than 70% whilst still trying her best, and pay for it even more of course - perhaps dearly.
 
seems we are not the only ones in the fanclub:
https://docs.wixstatic.com/ugd/47b066_01d68b1309ae457b81df1e06e6beae1e.pdf
p234 onwards Charge Sheet 7: Wessely, GWI & Somatoformia

"the Pentagon hired Simon Wessely to not only trash the sick veterans, but people with ME/CFS, too"

That looks like the sort of activism we want to stay far away from. A lot of the alternative Lyme stuff can be dodgy, and there you've also got anti-vaccination stuff, claims about MMR being linked with autism... this is the sort of thing used to discredit Wessely's critics.
 
Basic question here: why do the sample sizes vary so much in the non-exercise and post-exercise groups? Are they completely different groups or was data missing for some? I thought everyone did exercise test? For example, "non-exercise" gulf war: n=22. Post-exercise, n=64 (22+42). For CFS, non-exercise group n=43; post-exercise, n=16.
 
Basic question here: why do the sample sizes vary so much in the non-exercise and post-exercise groups? Are they completely different groups or was data missing for some? I thought everyone did exercise test? For example, "non-exercise" gulf war: n=22. Post-exercise, n=64 (22+42). For CFS, non-exercise group n=43; post-exercise, n=16.
Got a response now elsewhere:
Their methods section is kind of a mess but my read was theythey have two broad groups, one tested after sleep, one after exercise.

What they haven't done is give the same person two lumbar punctures, before and after exercise. (so far as I can tell) Perhaps because of the nature of that procedure?

The sample sizes are different in the different broad groups. The reason they have so many post-exercise GWI patients is, I suspect, they are trying to get a good sample size on each of their two hypothesised groupings, START and STOPP (first one has tachycardia, second one doesn't).
Makes sense now I re-read abstract
Lumbar punctures were performed in GWI, CFS and control subjects after (i) overnight rest (nonexercise) or (ii) submaximal bicycle exercise.

though I think the full text is more confusing
All subjects had submaximal bicycle exercise stress tests on 2 consecutive days with magnetic resonance imaging before and afterwards, followed by a lumbar puncture25.
 
Chronic fatigue syndrome is not imagined but a genuine illness: Study
http://www.worldnews.easybranches.c...t-imagined-but-a-genuine-illness-study-435307

Patients with Gulf War Illness, Chronic Fatigue Syndrome Show Distinct Molecular Changes After Exercise
By Traci Pedersen
https://psychcentral.com/news/2017/...-molecular-changes-after-exercise/128630.html

Brain chemistry study shows chronic fatigue syndrome, Gulf War illness as unique disorders
http://www.psypost.org/2017/11/brai...drome-gulf-war-illness-unique-disorders-50162
 
A while ago, a US doctor did research on GWS which showed biomedical abnormalities. I can't remember the details but it was reported in the New Scientist. They had the usual "comment" from SW. They asked the American about his view that GWS was psychological and she said "Simon who?"

I loved it :laugh:
 
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