Study shows why exercise magnifies exhaustion for cfs patients

[Aurator]

Is anyone able to say whether there is anything revelatory in this recent study? The title suggests new biological insights were gained, but the summary in the link seems to be saying that self-reported fatigue scores were all that was relied on.

http://news.ufl.edu/archive/2015/03...on-for-chronic-fatigue-syndrome-patients.html

 

[Denise]

@Aurator - I haven't read the release or the article (paywall) but fwiw - here is the abstract:

Pain. 2015 Feb 5. [Epub ahead of print]

Evidence for Sensitized Fatigue Pathways in Patients with Chronic Fatigue Syndrome.
Staud R1, Mokthech M, Price DD, Robinson ME.

Author information
Abstract
Patients with Chronic Fatigue Syndrome (CFS) frequently demonstrate intolerance to physical exertion that is often reported as increased and long-lasting fatigue. As no specific metabolic alterations have been identified in CFS patients we hypothesized that sensitized fatigue pathways become activated during exercise corresponding with increased fatigue.After exhausting handgrip-exercise, muscle-metabolites were trapped in the forearm tissues of 39 CFS patients and 29 NC by sudden occlusion for up to 5min. A non-occlusive condition of similar duration was used as control. Repeated fatigue and pain ratings were obtained before and after exercise. Mechanical and heat hyperalgesia were assessed by quantitative sensory testing (QST).All subjects fulfilled the 1994 Fukuda-Criteria for CFS. NC and CFS subjects exercised for 6.6 (2.4) and 7.0 (2.7) min (p>.05). Forearm occlusion lasted for 4.7 (1.3) and 4.9 (1.8) min in NC and CFS subjects, respectively (p>.05). Whereas fatigue ratings of CFS subjects increased from 4.8 (2.0) to 5.6 (2.1) VAS units during forearm occlusion, they decreased from 5.0 (1.8) to 4.8 (2.0) VAS units during the control condition without occlusion (p=.04). A similar time course of fatigue ratings was observed in NC (p>.05) although their ratings were significantly lower than those of CFS subjects (p<.001). QST-testing demonstrated heat and mechanical hyperalgesia in CFS subjects.Our findings provide indirect evidence for significant contributions of peripheral tissues to the increased exercise related fatigue in CFS patients consistent with sensitization of fatigue pathways. Future interventions that reduce sensitization of fatigue pathways in CFS patients may be of therapeutic benefit.

http://www.ncbi.nlm.nih.gov/pubmed/25659069

 

[Valentijn]

Is anyone able to say whether there is anything revelatory in this recent study? The title suggests new biological insights were gained, but the summary in the link seems to be saying that self-reported fatigue scores were all that was relied on.

http://news.ufl.edu/archive/2015/03...on-for-chronic-fatigue-syndrome-patients.html

They're saying our brain pathways which signal fatigue are overactive. They blocked circulation while pumping a hand-held device, and did the same thing with the other arm, without the block. "Fatigue" patients reported more muscle fatigue in the blocked arm.

Then they go on to make a bunch of unsubstantiated guesses, and treat them as fact. It was also run by a psych department, and they think that CFS is all about fatigue, so it's probably a bad cohort.

 

[waiting]

"As no specific metabolic alterations have been found in CFS patients..."

Van Ness et al have repeatedly shown metabolic abnormalities in their 2-day CPET studies -- that have been replicated by Vermoulen and by Keller.

 

[Bob]

I haven't read the full paper - so I'm not sure if they measured blood metabolites and found them to be increased in CFS patients - but if they didn't measure metabolites, then all this study demonstrates is that fatigued individuals experience more fatigue after exercise than healthy individuals.

I quote from the news article:
"“We found that the fatigued individuals reported more fatigue than the non-fatigued individuals during the exercise, and also found that they had more pain compared to the non-fatigued individuals,” Staud said."

I repeat the crucial conclusion of the lead investigator:
"We found that the fatigued individuals reported more fatigue than the non-fatigued individuals..."

lol, how much did they get paid to come to that conclusion?!?

 

[Mij]

the hungry people felt better after eating than the non hungry people lol

 

[Sidereal]

What a joke.

 

[Valentijn]

I haven't read the full paper - so I'm not sure if they measured blood metabolites and found them to be increased in CFS patients - but if they didn't measure metabolites, then all this study demonstrates is that fatigued individuals experience more fatigue after exercise than healthy individuals.

It doesn't look like they drew any blood or measured metabolities. They just assume that they successfully blocked them by inflating a blood pressure cuff.

 

[A.B.]

Our findings provide indirect evidence for significant contributions of peripheral tissues to the increased exercise related fatigue in CFS patients consistent with sensitization of fatigue pathways.

Fatigue is consistent with the sensitization of fatigue pathways. It's also consistent with every other explanation.

 

[Cheshire]

Sensitization is the new "explain all" justification, when you're too lazy to make real research...

 

[A.B.]

Sensitization is the new "explain all" justification, when you're too lazy to make real research...

One could say that sensitization is all in the head.

 

[Cheshire]

One could say that sensitization is all in the head.

Yes, just as vague as the chemical imbalance.
Emerges because one overfocuses on symptoms.
Curable by... exercice and CBT!

 

[Jonathan Edwards]

They do not seem to have done the necessary controls. Maybe PWME find having a cuff on more unpleasant than healthy controls?

 

[Sherlock]

Thanks, Aurator. I've added that study to my Kaatsu (blood flow restriction training) thread:
http://forums.phoenixrising.me/index.php?threads/kaatsu-blood-flow-restriction-training.34510/

Btw, they also did do:

Mechanical and heat hyperalgesia were assessed by quantitative sensory testing (QST).

which is from the abstract:
http://www.ncbi.nlm.nih.gov/pubmed/25659069

 

[Valentijn]

They do not seem to have done the necessary controls. Maybe PWME find having a cuff on more unpleasant than healthy controls?

It certainly does get a lot more painful when my swelling is worse. During my Cranberry Episode it was quite agonizing just to have a band around my arm so that blood could be drawn from the back of my hand.

 

[*GG*]

@Aurator - I haven't read the release or the article (paywall) but fwiw - here is the abstract:

Pain. 2015 Feb 5. [Epub ahead of print]

Evidence for Sensitized Fatigue Pathways in Patients with Chronic Fatigue Syndrome.
Staud R1, Mokthech M, Price DD, Robinson ME.

Author information
Abstract
Patients with Chronic Fatigue Syndrome (CFS) frequently demonstrate intolerance to physical exertion that is often reported as increased and long-lasting fatigue.

As no specific metabolic alterations have been identified in CFS patients we hypothesized that sensitized fatigue pathways become activated during exercise corresponding with increased fatigue.After exhausting handgrip-exercise, muscle-metabolites were trapped in the forearm tissues of 39 CFS patients and 29 NC by sudden occlusion for up to 5min.

A non-occlusive condition of similar duration was used as control. Repeated fatigue and pain ratings were obtained before and after exercise. Mechanical and heat hyperalgesia were assessed by quantitative sensory testing (QST).All subjects fulfilled the 1994 Fukuda-Criteria for CFS. NC and CFS subjects exercised for 6.6 (2.4) and 7.0 (2.7) min (p>.05).

Forearm occlusion lasted for 4.7 (1.3) and 4.9 (1.8) min in NC and CFS subjects, respectively (p>.05). Whereas fatigue ratings of CFS subjects increased from 4.8 (2.0) to 5.6 (2.1) VAS units during forearm occlusion, they decreased from 5.0 (1.8) to 4.8 (2.0) VAS units during the control condition without occlusion (p=.04).

A similar time course of fatigue ratings was observed in NC (p>.05) although their ratings were significantly lower than those of CFS subjects (p<.001). QST-testing demonstrated heat and mechanical hyperalgesia in CFS subjects.

Our findings provide indirect evidence for significant contributions of peripheral tissues to the increased exercise related fatigue in CFS patients consistent with sensitization of fatigue pathways. Future interventions that reduce sensitization of fatigue pathways in CFS patients may be of therapeutic benefit.

http://www.ncbi.nlm.nih.gov/pubmed/25659069

Just breaking this up, for ease of reading

GG

 

[alex3619]

"As no specific metabolic alterations have been found in CFS patients..."

Van Ness et al have repeatedly shown metabolic abnormalities in their 2-day CPET studies -- that have been replicated by Vermoulen and by Keller.

Not to mention the Lights' studies. They have shown specific biochemical alterations linked to fatigue and pain signalling. Their research is much higher quality.

As @Valentijn points out, they make a lot of assumptions. They may or may not be right. Its not a great study. However I have not read the full paper so I cannot be sure of much as the abstract may not accurately reflect the actual study. That happens a lot.

 

[aimossy]

They do not seem to have done the necessary controls. Maybe PWME find having a cuff on more unpleasant than healthy controls?

I do find it a lot more uncomfortable than it ever was when well. I can't handle much restriction or pressure for long. Limbs feel congested.

Does anyone as an aside remember which thread JE and Alex and a few others were talking about cortisol receptors? I had a weird experience with a cortisol lowering drug that some might find interesting.

 

[alex3619]

@aimossy, I recall the discussion but not the thread. There is pending research that, if validated, will change a lot of the discussion about ME or SEID biochemistry.

 

[aimossy]

Thanks, I will wait till I come across that type of discussion again then @alex3619 I don't want to derail this thread further.