Multimodal and Simultaneous Assessments of Brain and Spinal Fluid Abnormalities in CFS,... Effects of Psychiatric Comorbidity, 2017, Natelson et al

Not yet. Sadly the cited-bys are reviews and "may help withs".

 

This is the neuropsychological testing used:

"All subjects underwent a battery of neuropsychological tests, which included the b Adult Reading Test, a measure used to estimate overall intellectual ability prior to illness onset7; the Gordon Vigilance and Distractibility Test, computer administered measures to evaluate sustained and focused attention as well as processing speed8; the WAIS IV Digit Span forward and backward, assessments of simple attention and working memory9; and the Rey-Osterrieth complex figure test, a measure of visuo-constructional ability and visual memory10."

I've not seen the Gordon testing being used before in pwME. Seems an odd choice to use something new. It is used for ADHD assessment mainly. Digit Span is commonly OK ish in pwME. And the R-O doesn't necessarily get at the cognitive issues pwME face. Far better tests exist (for example PASAT - auditory information processing, working memory, time pressure etc) and it's a mystery why they were not used here.....

 

Except the patients were scanned supine. The result might be quite different and stronger if they were in an upright MRI. This is one of the things we've been missing up until now -> #alltestsarenormal.

[15] is Increased ventricular lactate in chronic fatigue syndrome. III. Relationships to cortical glutathione and clinical symptoms implicate oxidative stress in disorder pathophysiology (2012, NMR in Biomedicine) —

 

Jarred Younger presented some preliminary unpublished lactate data during the ME/CFS Research Roadmap series. It seemed to have a similar distribution to what they found in this paper; that there is overlap between HC and ME/CFS but a higher average and some patients with very clearly abnormal levels. This could reflect some patients being in PEM, as I'm pretty sure PEM was not specifically induced for either study. Not sure when it is planned to be published though.

 

All of those are routinely handed out to pwME, sometimes in alternative to, sometimes in addition to. So it's hard to say whether there is any validity to any of those. And the standard questionnaires for this mostly have overlapping questions so even if it's not just someone's opinion, there is no way to validate either way since the instrument is basically no better than a dowsing rod.

The DSM is often presented as a step forward, but frankly it has been a huge step backward for medicine because it sometimes works explicitly by taking the mere suspicion of something as a fact, when the medical standard is solid verifiable evidence most of the time. It's like twice-removed hearsay from an unverifiable source who commented anonymously counterbalancing anything but verified timestamped video. This is not the way to do things.

 

The study itself showed that these psychiatric diagnosis had no impact on the measured parameters. What is more interesting to me are the differences between the ME and control patients.

 

Absolutely this.

 

Hey we are Type A personalities after all! Well, some are. Not really statistically different than the whole population. And it doesn't affect outcomes. But it could! Imagine a world where it could. It would obviously explain why we all just give in to the "sick role". Well, we mostly don't, and those contradict one another, but it could be the case. Add an engine and some wings and you got a fully functioning airplane, you just have to meet a few conditions that aren't met and it's a perfect model of reality. It all makes sense if you don't think about it.