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New research appears to provide some long-awaited insight into a complex and devastating condition called myalgic encephalomyelitis, also known as chronic fatigue syndrome. The National Institutes of Health-led study found several potentially important differences in the brain and immune systems of people with ME/CFS compared to healthy controls. Researchers say these findings could help point toward possible future treatments.
ME/CFS is a debilitating disease. Its Speciality According to the Centers for Disease Control and Prevention, characterized by three main symptoms: greatly reduced ability to perform daily tasks and chronic fatigue (lasting at least six months) – fatigue that is not induced by strenuous exertion or is not relieved by rest. meets; Worsening of symptoms after an activity that did not previously tire one, also known as post-exertion sickness; And sleep problems. Sufferers will also often experience a number of other health problems, such as brain fog, increased blood pressure upon standing, chronic pain, and digestive problems.
The term chronic fatigue syndrome was first coined in the 1980s, although a similar disease had been reported in the early 20th century. For most of its history, the public and some doctors have viewed ME/CFS solely as a psychological disorder, and as a result patients have struggled to receive recognition and care (this is one reason advocates of chronic fatigue prefer the term myalgic encephalomyelitis instead). Recently, the medical establishment has come to a consensus view ME/CFS as a physical illness, however, the answer is not simple.
ME/CFS is believed to be primarily an infectious condition, resulting from the body’s passive response to a pathogen. It appears that there are several pathogens that are more likely to cause ME/CFS than others, such as Epstein-Barr virus. And some experts argue that at least a subset of long-lasting COVID cases are effectively ME/CFS cases caused by the coronavirus. But only a small percentage of people appear to develop ME/CFS (up to 2.5 million Americans may live with it, according to an estimate from the National Academy of Medicine). And scientists have not yet been able to figure out how the condition emerges after infection, nor establish biomarkers that would allow us to easily diagnose it. There are no approved treatments for this.
This new research, published In Nature Communications on Wednesday, what may be one of the most comprehensive analyzes of ME/CFS patients has been conducted to date. It was led by scientists at the National Institutes of Health, as part of an initiative launched in 2016 to study the condition. The researchers recruited volunteers suspected of having ME/CFS and ultimately selected 17 patients to undergo a series of medical examinations, such as spinal fluid collections, brain scans, skin biopsies and blood tests. These patients were then matched with healthy controls.
The researchers found that compared to the baseline of controls, there were clear biological differences in ME/CFS patients. For example, patients were more likely to have reduced brain activity in the temporal-parietal junction area of the brain. They were also found to have low levels of neurotransmitters called catecholamines, as well as altered levels of certain immune cells and possible signs of immune exhaustion.
“People with ME/CFS have very real and disabling symptoms, but their biological basis has been extremely difficult to uncover,” said Walter Koroshetz, director of NIH’s National Institute of Neurological Disorders and Stroke (NINDS). statement, “This in-depth study of a small group of people found several factors that likely contribute to their ME/CFS.”
While the team took a deep dive into the physiology of these patients, the findings are still based on a small sample size (one unexpected factor in this was the Covid-19 pandemic in 2020, which halted further recruitment). It is therefore possible that these results may not be generalizable to the broader population of ME/CFS patients. But researchers say their work is already providing some important clues about how the condition actually causes people’s symptoms.
They found no apparent differences in the way the muscles of people with CFS/ME worked that might explain, for example, people’s unusual fatigue when performing physical tasks. But they found strange patterns of brain activity in people’s motor cortex during these tasks. It is possible, the authors argue, that the immune and other disruptions seen in ME/CFS cause dysfunction in brain regions that inadvertently influence our perception of the body’s ability to heal itself. This dysfunction can lead to a long-term reduction in people’s physical activity, leading to other physical changes This makes it difficult for them to do normal work.
“We have identified a physiological focal point for fatigue in this population,” lead author Brian Wallit, an associate research physician at NINDS, said in a statement. “Rather than physical exhaustion or lack of motivation, fatigue may arise from a mismatch between what one thinks one can achieve and what one’s body performs.”
If Valit and his team’s hypothesis is correct, it may be possible to reverse these changes by attacking the root causes of ME/CFS, such as drugs that can clear the foreign antigens that are sending the immune system into overdrive. However, they also found differences between men and women with ME/CFS. So it’s possible that truly treating this condition will require a combination of treatments based on a person’s individual biology. However, for now, these findings will open new avenues of research and possibly provide hope for ME/CFS patients in the near future.
“Now researchers can test whether these findings apply to a larger patient group and move toward identifying treatments that target the main drivers of the disease,” Koroshetz said.
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