Possible involvement of the autonomic nervous system in cervical muscles of patients with ME/CFS, Matsui et al, 2020/1

[John Mac]

Full title: Involvement of Cervical Muscle Lesions and Autonomic Nervous System in Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS)
(Thread title changed to the title of the published version)

Background:
Patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) sometimes coincide with stiffness of cervical muscles.
This study examined the effect of local modulation of the cervical muscles on ME/CFS and the underlying mechanism.

Methods:
In total, 1,226 inpatients with ME/CFS who were resistant to outpatient care were enrolled in this study for 11 years.
All patients underwent daily physical therapies to the cervical muscles during hospitalization. Self-rated records documenting the presence and absence of ME/CFS and the representative eight disorders that frequently accompany it at admission and discharge were compared.
The pupil diameter was also measured to examine involvement of autonomic nervous system function.

Results:
The recovery rate of ME/CFS after local therapy was 55.5%, and did not differ significantly by sex, age strata, and hospitalization period.
The recovery rates of the eight disorders were variable (36.6－86.9%); however, those of ME/CFS in the disorder subpopulations were similar (52.3－55.8%).
The recovery rates of all disorders showed strong associations with that of ME/CFS (p<0.001). The pupil diameter was decreased at discharge, and the change was significantly higher in the ME/CFS-recovered patients than ME/CFS-unrecovered patients in the total population and the subpopulations stratified by sex, age, and hospitalization period.

Conclusions:
Local therapy to the cervical muscles led to recovery in more than half of patients with ME/CFS, at least partly through amelioration of the autonomic nervous system.
There may be a causal relationship between recoveries of ME/CFS and these related whole-body disorders.

https://www.researchsquare.com/article/rs-100155/v1

 

[John Mac]

 

[John Mac]

 

[alktipping]

based on self report forms . the fact that they where in a hospital and medical records are so reliable i would take this with a bucketful of salt .

 

[NelliePledge]

What % of the general population has stiffness of cervical muscles. Very common among people who work sat in front of a computer screen.

 

[Andy]

A huge bucketful of salt needed with this study I reckon.

Fukuda criteria, no mention of PEM at all.
Other than eye-pupil diameter measurement, no objective measurements.
Study was retrospectively registered.

In my opinion, this study most likely tells us that 55% (the percentage of participants who 'recovered' from ME/CFS having stayed in hospital for up to 120 days and had regular cervical muscle massage) of people assessed as having ME/CFS actually didn't.

 

[Hutan]

Or staying in hospital required a lot less effort than their normal life did, so some of the people felt quite a lot better at the end of the hospital stay?

 

[Milo]

A hot mess?

In principle, hospitalization was decided by consent between patients and physicians independent of the severity of ME/CFS. The main reason for hospitalization was persistent symptoms that required more intensive treatments as well as detailed examinations of other organs. Discharge was also decided by consent between patients and physicians independent of the ME/CFS recovery by the definition above [13], mainly due to considerable improvement of symptoms of ME/CFS or related whole-body disorders. Patients who were hospitalized for 5-120 days were enrolled.

 

[Milo]

Here is what the first 2 sentences say, under ‘background’:

Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) is a serious, chronic, and complex disease that occasionally affects the lives of patients due to debilitating fatigue [1–4]. It is accompanied by various symptoms throughout the body, such as headache, cervical stiffness, vertigo, cardiovascular and gastrointestinal disorders, fever of unknown etiology, and psychological disorders

occasionally affects the lives...? Oh really?
And the list of symptoms...
cervical stiffness... really? Which criteria do they go by?
vertigo... would be uncommon, why name it up front, could it be you selected it because it fits what you are trying to say?
fever of unknown etiology... not for years on end, and it would need to be described... by fever do you mean over 38.3 C and over? Or would it also be 37.5 C? Or could it also be that the patient reports feeling like a fever is coming?
psychological disorders... well that would be quite wide. What do you think the authors have in mind? Somatization? Conversion disorder? bodily distress syndrome? Anxiety related to symptoms? Depression?

The narrative used matters a lot. In my view i am not sure that the authors understand what the disease is all about. It is also a problem that the disease is defined by a bunch of symptoms.

 

[Andy]

Merged thread - Paper now published

Full title: Possible involvement of the autonomic nervous system in cervical muscles of patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS)

Abstract

Background
Patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) sometimes present with stiffness of the cervical muscles. To investigate the pathophysiology of ME/CFS, this observational study compared patients with versus without recovery from ME/CFS through local modulation of the cervical muscles.

Methods
Over a period of 11 years, a total of 1226 inpatients with ME/CFS who did not respond to outpatient care were enrolled in this study. All patients received daily cervical muscle physical therapy during hospitalization. Self-rated records documenting the presence or absence of ME/CFS, as well as the representative eight symptoms that frequently accompany it at admission and discharge, were compared. Pupil diameter was also measured to examine autonomic nervous system function involvement.

Results
The recovery rate of ME/CFS after local therapy was 55.5%, and did not differ significantly by sex, age strata, and hospitalization period. The recovery rates of the eight symptoms were variable (36.6–86.9%); however, those of ME/CFS in the symptom subpopulations were similar (52.3–55.8%). The recovery rates of all symptoms showed strong associations with that of ME/CFS (p < 0.001). The pupil diameter was more constricted in the ME/CFS-recovered patients than in the ME/CFS-unrecovered patients in the total population and the subpopulations stratified by sex, age, and hospitalization period.

Conclusions
There was a strong association between the recovery of ME/CFS and other related whole-body symptoms. The recovery of ME/CFS may be partly linked to amelioration of the autonomic nervous system in the cervical muscles.

Open access, https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-021-04293-7

 

[rvallee]

This seems very random and uninterpretable.