Static & Kinetic Disequilibrium are Central Neural Signs in ME/CFS- Therapeutic Effect of Repetitive Transcranial Magnetic Stimulation, 2025, Miwa

Dolphin

Dolphin

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https://www.imrpress.com/journal/JIN/24/4/10.31083/JIN25488

Static and Kinetic Disequilibrium are Central Neural Signs in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome-Therapeutic Effect of Repetitive Transcranial Magnetic Stimulation
info@miwa-naika.com (Kunihisa Miwa)
J. Integr. Neurosci. 2025, 24(4), 25488; https://doi.org/10.31083/JIN25488
Submitted: 1 July 2024 | Revised: 8 January 2025 | Accepted: 8 February 2025 | Published: 24 April 2025

Abstract

Background:
Chronic fatigue syndrome is primarily caused by myalgic encephalomyelitis (ME)-associated dysfunction of the central nervous system. Postural instability or disequilibrium is a typical neural sign and is classified as static or kinetic.

Methods:
A total of 160 ME patients (53 males and 107 females) with a mean age of 37 ± 12 years were enrolled in this study. They underwent both the Romberg test for static disequilibrium and the tandem gait test with turn and return for kinetic disequilibrium.

Results:
Static disequilibrium was found in 40 (25%) patients who showed instability when standing with both feet together and eyes either open (n = 7, 4%) or closed (n = 33, 21%). Kinetic disequilibrium was found in 71 (44%) patients, with 57 (36%) being positive for the straight tandem gait test. Fourteen (9%) patients were negative for the straight tandem gait test, but showed a positive result after turning and returning. Almost all patients with static disequilibrium also had kinetic disequilibrium (39/40, 98%). Patients with static and/or kinetic disequilibrium had a significantly higher prevalence of orthostatic intolerance, diagnosed as failure to complete the 10-min standing test, compared with patients without disequilibrium. They also had a significantly higher median performance status score (0–9) for restricted activities of daily living. Both types of disequilibria were recovered in 11 (85%) of 13 patients treated with repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex and primary motor area in the brain, suggesting a central vestibular origin.

Conclusions:
Static disequilibrium related to orthostatic intolerance, and kinetic disequilibrium related to gait disturbance are both prevalent in patients with ME and are important central neural signs that restrict activities of daily living. rTMS treatment effectively alleviated these disequilibria.

Clinical Trial registration:
The study has been registered on https://jrct.mhlw.go.jp/ (registration number: jRCT1042240065; registration date: July 30, 2024).

Keywords
myalgic encephalomyelitis
chronic fatigue syndrome
disequilibrium
orthostatic intolerance
rTMS (repetitive transcranial magnetic stimulation)

https://twitter.com/user/status/1917561084522713368
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Dolphin said:
Chronic fatigue syndrome is primarily caused by myalgic encephalomyelitis (ME)-associated dysfunction of the central nervous system.
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This intro makes no sense.
Dolphin said:
They underwent both the Romberg test for static disequilibrium
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Described here, and critiqued for:
  • Not Quantitative
  • Low diagnostic sensitivity and specificity
  • Low power to determine lesions, predict the risk of falling, and reflect the discomfort and ability to perform daily activities.[13][14]
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Dolphin said:
and the tandem gait test with turn and return
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Seems to suffer from many of the same issues - people just started using it because: https://www.researchgate.net/public..._stumbled_into_the_neurological_exam_a_review
Dolphin said:
A total of 160 ME patients (53 males and 107 females) with a mean age of 37 ± 12 years were enrolled in this study.
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No control group.
 
I can’t cease to be baffled how many researchers get funding to conduct research on a condition they can’t even get the most basic facts right about.

(To be fair, there’s a lot of misinformation running around, but you’re a researcher, it’s literally part of your job to be able to see if something is evidenced or not)
 
jnmaciuch said:
I understand the frustration that prompted this, but I think this is a bit too pointed towards one nationality when plenty of other countries also churn out disappointing study after disappointing study, no? Certainly not a phenomenon where Japan is far and above the worst offender.
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I don’t necessarily have a problem with calling out a nation for producing bad research. But agree that it’s a little dubious given honestly Japan seems at worst average. You see very little BPS studies coming from there comparatively to western europe. Mainly low quality biomedical.

But less than 5% of ME papers are anywhere near good quality biomedical. So it kind of feels like a double standard. We should be criticsing *gestures vaguely everywhere*.
 
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