Discussion in 'BioMedical ME/CFS News' started by Sasha, Sep 24, 2018.
Kidnapping Alex's post from another thread:
This looks really really good, although Cort does tend to be really positive on everything.
I’m curious to know why if the lactate is lower than other serious illness the disability can be as high or higher. But younger isn’t claiming to explain all of ME so maybe this is a downstream part of it. Really good he’s applying for a big grant and that we have some solid proof of stuff wrong in the brain vs spotless healthy controls
I hope this proves to be a real lead. Unfortunately, Cort Johnson does not give us a clear story and certainly not enough actual facts to make much sense of.
Lactate is not a marker of inflammation. It is a marker of a shift in metabolic pathway. And so far I thought it had only been found higher in ventricles rather than bring tissue.
Also it is unclear what a raised temperature in brain would have to do with inflammation. The raised temperature seen in inflammation in other areas is a rise towards core temperature (36.8) from normal peripheral temperatures. So the skin surface of an inflamed hand might be at 30 degrees rather than 20 because of increased blood flow. The brain is already at 36.8 so inflammation would not put the temperature up just because of blood flow. Increased cell metabolism might but that is not particularly a sign of inflammation.
We want some actual facts here. If there is enough data to put in a grant that sounds good, but it would be nice to know what the data are.
Without even following the link (as I won't give Cort traffic for reasons), this will obviously need to be replicated, in the same way that any breakthrough that might occur will need to be.
Am I right in remembering that you (?) said that the Japanese work about brain inflammation wasn't about 'heating up' inflammation as patients would normally think of it but a sort of micro-inflammation, @Jonathan Edwards? (Sorry for my layperson's vague flailing!) I'm wondering whether Jarred Younger's work and the Japanese work is actually related. I wasn't able to read Cort's long article properly.
Jarred Younger is one of the speakers at the Stanford Symposium on Saturday. Maybe we will hear more about that.
From Cort’s blog:
"Because Younger didn’t know exactly where in the brain to search in ME/CFS, that technique wouldn’t work for him. He had to develop a method that would produce a heat map and a chemical signature of the entire brain, and found a Florida researcher who developed a way to do that.
With this technique, it takes just 20 minutes in the machine to get an entire 3-D heat and chemistry map of an ME/CFS patient’s brain. After The Solve ME/CFS Initiative (SMCI) provided funding, he got to work and ultimately scanned the brains of 15 ME/CFS women and 15 age and sex matched healthy controls."
So this looks like a brand-new technique that both maps temperature and chemical make up, which is remarkable. We don’t know if it’s been validated and published. There must be something to it as Solve have funded the work.
As @Jonathan Edwards says, we don’t have enough of the story to evaluate it. Also we don’t know why Younger believes that the increase in temperature shows inflammation . And as @Andy says, it would need to be replicated. We can’t really tell until we see some data and ultimately a publication. As @Joh says, hopefully more will be revealed at the Stanford symposium. I can’t wait.
Get in touch with Jarred @Simon M , see if he'll talk to you about it, then we could get a decent write-up
Scientists, publish your studies so we can hear from you first hand! Or better, please come and discuss your finding with us!
The Japanese study shows an apparent shift in activation of some phagocytic cells. That may something that happens as part of inflammation but it may occur for other reasons - so it is not a direct indication of inflammation. Whether Younger's findings relate to the Japanese is I think so far uncertain - until we have some data at least.
He might need to keep his data quiet so as not to mess up his chances of publication.
“After hitting several dead ends, he hypothesized that because inflammation produces temperature increases, he could try and create a heat map of the brain. Looking through the literature, he realized that thermometry was already being used in the brain to assess stroke and cancer patients. It turns out that the brain’s attempts to repair the damage from stroke and cancer results in huge temperature increases. The stroke and cancer researchers, though, were just focused on small areas of the brain.
Because Younger didn’t know exactly where in the brain to search in ME/CFS, that technique wouldn’t work for him. He had to develop a method that would produce a heat map and a chemical signature of the entire brain, and found a Florida researcher who developed a way to do that.”
This is the bit about temperature
I hope that there is a study soon to replicate this and that there is an examination of other illness groups (in addition to ME and healthy controls).
if I have the energy, I would. I don’t . My probably-final blog has been stuck in the pipeline for a month as I dxon’t have the energy to produce even a fairly short one.
It’s worth noting that Maureen Hanson’s collaborative is going to do a fairly large replication (50 cases/50 controls, I think - both before & after exercise ) of the Japanese PET study from 2014 that first found neuroinformation. I think this is the work by Dr Shungu ( who Cort mentioned for his work that found elevated lactate in ventricles - which help bathe the brain in cerebrospinal fluid).
This is so interesting. I'd like to be tested for this before and after having read some long texts, as that's when I feel the brain is burning. The only thing that helps is to not read, not write, not concentrate.
I don't usually get this particular symptom after physical exertion, but it can be part of severe crashes.
This implies lactate is a secondary measure, not a primary cause of our problems.
Yes, the cause of the heat signature is only presumed to be inflammation, it might indeed be something else. The finding matches the Japanese findings in brain locations, and elevated lactate, which makes it likely something is there. However this is pre-publication so we cannot be sure of details, and have to go by what Cort wrote.
This is very encouraging, but really understanding it is going to require more research. This is however the kind of research that may advance our understanding a lot.
I wonder how it tracks with qEEG data.
I think Montoya was saying that Stanford also plans to replicate the Japanese findings.
Worth noting that a team at Oxford are also looking at lactate levels (https://www.s4me.info/threads/oxfor...ing-into-energy-status-mrs-in-cfs.2661/page-2) using similar MRS techniques I believe... though when I spoke to them as a potential candidate (turned down unfortunately) they were still looking at selection criteria, and I did worry they might end up not excluding those with MDD which might skew the results given reported changes in brain lactate in those suffering a depressive episode.
Very interesting, and exciting news. I hope the 120 subject Japanese study is published soon in an English journal.
It is encouraging to read that Jarred Younger was able to replicate some aspects of the Japanese study, and doing that using a different method.
These studies, and their replications can't come soon enough. It seems the BPS brigade may be getting more proactive with their proselytizing. This will do further damage to the community while we are waiting for more definitive biomedical studies, and replications.
A couple of paragraphs jumped out at me in Cort's blog:
Let's hope Jarred does get that money. Finding out what's happening in our brains after exertion - and coming at it from two angles, with Maureen Hanson doing the PET replication study - would be extremely interesting.
Does anybody here 1) understand Japanese and 2) have access to those papers and 3) have the time and energy to give us a summary of what they're about?
Separate names with a comma.