New paper: Deviant Cellular and Physiological Responses to Exercise in ME

[Countrygirl]

Deviant Cellular and Physiological Responses to Exercise in Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Frank N.M. Twisk1*, Keith J. Geraghty2

This isn't a research paper, but rather an overview of some previous papers/findings . It's theme is apt given the controversy over the PACE paper.


http://www.jacobspublishers.com/images/Physiology/J_J_Physiology_1_2_007.pdf

Abstract

Post-exertional “malaise” is a hallmark symptom of Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS). Various abnormalities, including abnormal physiological responses to exertion, can account for post-exertional “malaise” and “exercise avoidance”. Since these abnormalities are not observed in sedentary healthy controls, the abnormalities and deviant responses cannot be explained by “exercise avoidance” and subsequent deconditioning, nor by psychogenic factors. Keywords: Myalgic Encephalomyelitis; Chronic Fatigue Syndrome; Exercise Physiology; Energetics; Immune System; Oxidative And Nitrosative Stress Review Article Cite this article: Twisk and Geraghty. Deviant Cellular and Physiological Responses to Exercise in Myalgic Encephalomyelitis and Chronic Fatigue Syndrome. J J Physiology. 2015, 1(2): 007. Introduction Post-exertional “malaise”, a (prolonged) aggravation of symptoms after a minor exertion, is a discriminative symptom of Myalgic Encephalomyelitis (ME) [1-3] / Chronic Fatigue Syndrome (CFS) [4]. Several abnormalities observed in ME/CFS, such as a prolonged fall in oxygen uptake after exercise, and a post-exertional increase in metabolite-detecting (pain) receptors [5], can plausibly account for “exercise intolerance” reported by ME/CFS patients and the lack of the success of rehabilitation protocols. Since these abnormalities are not observed in sedentary controls, deconditioning (alone) cannot account for the physiological aberrations in ME/CFS after exertion. The exercise-induced abnormalities, which cannot be explained by psychogenic factors, appear strong correlates of ME/CFS. Abnormalities relating to exercise and its effect

Conclusion

Post-exertional “malaise” and “exercise intolerance” are hallmark symptoms [80] of Myalgic Encephalomyelitis (ME) [1-3] and Chronic Fatigue Syndrome (CFS) [4]. This article reviews observations which support the position that post-exertional “malaise” in ME/CFS may be linked to a number of observable deviant physiological responses to exercise, including muscle weakness and myalgia, a substantial fall of oxygen uptake after exercise, an increase in metabolite-detecting (pain) receptors, increased acidosis, abnormal immune responses, and orthostatic intolerance. Such findings go some way to explain why many ME/CFS sufferers either avoid exercise or report negative effects of exercised-based rehabilitation protocols, such as graded exercise therapy (GET). The physiological abnormalities induced by ME/CFS cannot be simply explained by a sedentary life style and deconditioning [81], or psychogenic factors [82]. While we acknowledge the importance of physical activity in illness rehabilitation, our findings cast doubt on the efficacy of exercise protocols as a therapeutic approach. More research into exercise-induced cellular and physiological abnormalities in ME/CFS is needed to better understanding the illness and its impact on patients, and to develop appropriate treatment.

 

[ScottTriGuy]

"Deviant"

Not often that word is used in biomedical science - more like psych science.

Anyway, already knew I was deviant. This is just proof.

 

[adreno]

Aberrant would be a better word in this context.

 

[Sea]

Aberrant would be a better word in this context.

Perhaps English not being his first language makes word choice a little trickier

 

[Keith Geraghty]

aberrant would have been a possible alterntive adjective for our paper title, however given its use in 'psychosomatic studies' relating to aberrant thought processes, we felt it better to use deviant physiological responses.

we are working on a longer and more detailed paper, and hope to test some of our hypotheses in forthcoming work in this area.

The current paper includes some interesting observations regarding responses in ME/CFS following exercise.

 

[Dolphin]

Free full text: http://www.jacobspublishers.com/images/Physiology/J_J_Physiology_1_2_007.pdf

Jacobs Journal of Physiology

Deviant Cellular and Physiological Responses to Exercise in Myalgic Encephalomyelitis and Chronic Fatigue Syndrome

Frank N.M. Twisk1*, Keith J. Geraghty2

1 ME-de-patiënten Foundation, Limmen, Netherlands

2 Institute of Population Health, School of Community Based Medicine, University of Manchester, United Kingdom.

*Corresponding author: Frank N.M. Twisk, MBA BEd BEc, ME-de-patiënten Foundation, Zonnedauw 15, Limmen, Netherlands, Tel: +31-72-505 4775; Email: frank.twisk@hetnet.nl

Received: 09-20-2015 Accepted: 10-26-2015 Published: 11-07-2015

Copyright: © 2015 Twisk and Geraghty

Abstract

Post-exertional “malaise” is a hallmark symptom of Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS). Various abnormalities, including abnormal physiological responses to exertion, can account for post-exertional “malaise” and “exercise avoidance”. Since these abnormalities are not observed in sedentary healthy controls, the abnormalities and deviant responses cannot be explained by “exercise avoidance” and subsequent deconditioning, nor by psychogenic factors.

Keywords:
Myalgic Encephalomyelitis; Chronic Fatigue Syndrome; Exercise Physiology; Energetics; Immune System; Oxidative And Nitrosative Stress

 

[Dolphin]

I thought this could be a useful resource if one wanted a list of most of the published abnormal responses to exercise.

 

[Dolphin]

This paper wasn't included for whatever reason:

Clin Physiol Funct Imaging. 2008 Nov;28(6):364-72. doi: 10.1111/j.1475-097X.2008.00822.x. Epub 2008 Jul 29.
Prefrontal cortex oxygenation during incremental exercise in chronic fatigue syndrome.
Patrick Neary J1, Roberts AD, Leavins N, Harrison MF, Croll JC, Sexsmith JR.
Author information

Abstract

This study examined the effects of maximal incremental exercise on cerebral oxygenation in chronic fatigue syndrome (CFS) subjects.

Furthermore, we tested the hypothesis that CFS subjects have a reduced oxygen delivery to the brain during exercise.

Six female CFS and eight control (CON) subjects (similar in height, weight, body mass index and physical activity level) performed an incremental cycle ergometer test to exhaustion, while changes in cerebral oxy-haemoglobin (HbO2), deoxy-haemoglobin (HHb), total blood volume (tHb = HbO2 + HHb) and O2 saturation [tissue oxygenation index (TOI), %)] was monitored in the left prefrontal lobe using a near-infrared spectrophotometer.

Heart rate (HR) and rating of perceived exertion (RPE) were recorded at each workload throughout the test.

Predicted VO2peak in CFS (1331 +/- 377 ml) subjects was significantly (P < or = 0.05) lower than the CON group (1990 +/- 332 ml), and CFS subjects achieved volitional exhaustion significantly faster (CFS: 351 +/- 224 s; CON: 715 +/- 176 s) at a lower power output (CFS: 100 +/- 39 W; CON: 163 +/- 34 W).

CFS subjects also exhibited a significantly lower maximum HR (CFS: 154 +/- 13 bpm; CON: 186 +/- 11 bpm) and consistently reported a higher RPE at the same absolute workload when compared with CON subjects.

Prefrontal cortex HbO2, HHb and tHb were significantly lower at maximal exercise in CFS versus CON, as was TOI during exercise and recovery.

The CFS subjects exhibited significant exercise intolerance and reduced prefrontal oxygenation and tHb response when compared with CON subjects.

These data suggest that the altered cerebral oxygenation and blood volume may contribute to the reduced exercise load in CFS, and supports the contention that CFS, in part, is mediated centrally.

PMID:

18671793

[PubMed - indexed for MEDLINE]

 

[Dolphin]

Conclusion:

Post-exertional “malaise” and “exercise intolerance” are hallmark symptoms [80] of Myalgic Encephalomyelitis (ME) [1-3] and Chronic Fatigue Syndrome (CFS) [4]. This article reviews observations which support the position that post-exertional “malaise” in ME/CFS may be linked to a number of observable deviant physiological responses to exercise, including muscle weakness and myalgia, a substantial fall of oxygen uptake after exercise, an increase in metabolite-detecting (pain) receptors, increased acidosis, abnormal immune responses, and orthostatic intolerance. Such findings go some way to explain why many ME/CFS sufferers either avoid exercise or report negative effects of exercised-based rehabilitation protocols, such as graded exercise therapy (GET). graded exercise therapy (GET). The physiological abnormalities induced by ME/CFS cannot be simply explained by a sedentary life style and deconditioning [81], or psychogenic factors [82]. While we acknowledge the importance of physical activity in illness rehabilitation, our findings cast doubt on the efficacy of exercise protocols as a therapeutic approach. More research into exercise-induced cellular and physiological abnormalities in ME/CFS is needed to better understanding the illness and its impact on patients, and to develop appropriate treatments."

 

[jimells]

@Keith Geraghty Thank you for taking the time to post on our forum.

Your review is most timely for me, as just yesterday I had a first appointment with a new primary care physician, Even after she observed impaired circulation in my feet and hands, and I described how my pulse goes from 60 supine to 120 standing within 10 minutes (when I'm not taking atenolol), she concluded that my illness is "mostly psychological".

I think your article is just about the right length to show to a busy physician and I will do that promptly.