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"Presence of pain explains differences in brain of CFS patients

NL93

Senior Member
Messages
155
Location
The Netherlands
From Radboud Nijmegen. Apparently brain differences between CFS and healthy people have to do with pain. And, wait for it, they will do a study to see if CBT reverses it.

https://goo.gl/GY0r0v

Google translate
Pain explains differences in the brains of chronic fatigue patients

In some patients with chronic fatigue syndrome (CFS), show changes in the brains. Researchers at the Radboud University Nijmegen Medical Centre and describe the AMC in the scientific journal Biological Psychiatry that these changes are not so much related to the fatigue itself, but with the presence of pain. Patients with CFS, also known as ME, are not only seriously tired, but also have numerous other complaints. For example, many patients with CFS pain or they can concentrate less. Earlier research into the brain of patients with CFS suggests that patients have less gray matter than healthy non weary people. located in the gray matter are the nerve cells that process information. However, how these brain changes associated with the various complaints is not yet known.

big brain
Researchers from Dutch Knowledge Chronic Fatigue from the Radboud University Nijmegen Medical Centre, the Donders Institute and AMC collected brain scans of a large group of patients with CFS. It examined changes in the gray matter in the so-called dorsolateral prefrontal cortex, a portion of the brains that among other things is important for the processing of pain signals. Earlier research has shown that the amount of gray matter in this brain region is often associated with pain, reduced physical activity, or decreased responsiveness. All symptoms which are common in CFS patients.

Pain explains brain change Surprisingly, it was not fatigue, but pain to best explain the variations in brain volume. Patients who reported pain had much less gray matter in the dorsolateral prefrontal cortex and a lower vitality of the nerve cells in this area of the brain. Unlike previous studies, the researchers found no difference in the amount of gray matter when the whole group of CFS patients compared with healthy people without fatigue.

More than fatigue
Researcher Marieke van der Schaaf: "The relationship between brain volume and pain is also common in other diseases found. In the search for brain abnormalities in patients with CFS is therefore important to have not only on the role of fatigue, but also of pain. "In a follow-up study, the researchers will see if the gray fabric recovers after treatment with cognitive behavioral therapy , which aims to reduce pain and fatigue.
 

Nielk

Senior Member
Messages
6,970
Umm, but the IOM report dropped pain from the SEID diagnostic criteria because it is not found in a high enough percentage of patients. Pain is common, and can be severe, but its not ubiquitous.

The problem with the IOM decisions of what to include in their criteria is that most of the studies it relied on we're using faulty criteria.
 

Glycon

World's Most Dangerous Hand Puppet
Messages
299
Location
ON, Canada
Based on this informal google-translated summary I don't know what to make of any of it. (E.g., how drastic a reduction in gray matter are we talking?) I am concerned, however, that the talk of "explaining" doesn't make any sense. Also, it starts out by saying that changes are not related to fatigue, but then proceeeds to speak of the association with reduced physical activity.
 

Dolphin

Senior Member
Messages
17,567
Source: Biological Psychiatry

Preprint

Date: August 31, 2016

URL: http://www.sciencedirect.com/science/article/pii/S0006322316327378



Prefrontal structure varies as function of pain symptoms in patients with Chronic Fatigue Syndrome

-----------------------------------------------------------

Marieke E. van der Schaaf(a,b,*), Floris P. De Lange(b), Iris C.

Schmits(a), Dirk E.M. Geurts(b,e,f), Karin Roelofs(a), Jos W.M.

van der Meer(d), Ivan Toni(a), Hans Knoop(a,c) a Radboud University Medical Center, Expert Centre for Chronic Fatigue, Nijmegen, The Netherlands b Radboud University Nijmegen, Donders Institute for Brain, Cognition, and Behaviour, Centre for Neuroimaging, Nijmegen, The Netherlands c Academic Medical Centre (AMC), University of Amsterdam, Department of Medical Psychology, Amsterdam, the Netherlands d RadboudUniversity Medical Centre, Department of Internal Medicine, Nijmegen The Netherlands e Radboud University Medical Center, Department of Psychiatry, Nijmegen The Netherlands f South London and Maudsley NHS Foundation Trust, Adult Personality Disorder Service, London

* Address correspondence to ME van der Schaaf, PhD, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.

Tel.: (+31) (0)24 3668236

Email: marieke.vandershcaaf@donders.ru.nl


Received 24 March 2016

Revised 22 July 2016

Accepted 26 July 2016

Available online 31 August 2016



Abstract


Background

Chronic fatigue syndrome (CFS) is characterized by severe fatigue persisting for at least 6 months and leading to considerable impairment in daily functioning. Neuroimaging studies of CFS patients have revealed alterations in prefrontal brain morphology. However, it remains to be determined whether these alterations are specific for fatigue or whether they relate to other common CFS symptoms, e.g.

chronic pain, lower psychomotor speed, and reduced physical activity.


Methods

We used magnetic resonance imaging to quantify grey matter volume

(GMV) and N-acetylaspartate/creatine ratio (NAA/Cr) in a group of 89 female CFS patients. Building on previous reports, we tested whether GMV and NAA/Cr in the dorsolateral prefrontal cortex (DLPFC) are associated with fatigue severity, pain, psychomotor speed, and physical activity, while controlling for depressive symptoms. We also considered GMV and NAA/Cr differences between CFS patients and 26 gender-, age-, and education-matched healthy controls (HC).


Results

Presence of pain symptoms was the main predictor of both GMV and NAA/Cr in the left DLPFC of CFS patients. More pain was associated with reduced grey matter volumes and NAA/Cr, over and above effects of fatigue, depressive symptoms, physical activity and psychomotor speed.

In contrast to previous reports and despite a large representative sample, global GMV did not differ between the CFS and HC groups.


Conclusions

CFS, as diagnosed by CDC-criteria, is not a clinical entity reliably associated with reduced GMV. Individual variation in the presence of pain, rather than fatigue, is associated with neuronal alterations in the DLPFC of CFS patients.


KeyWords: Voxel-based morphometry; Magnetic resonance spectroscopy; Dorsolateral prefrontal cortex; N-acetylaspartate; Grey matter volume; Chronic Fatigue syndrome


--------
 

NL93

Senior Member
Messages
155
Location
The Netherlands
Yay... I don't have much trouble with pain, so my brain is probably A-ok!



Booo... there's a good chance it's BS.

Yes everything that comes from them is BS. For years they were babbling about CBT helping 70% of patients. Van Der Meer recently babbled to a Dutch newspaper about CFS being a setting error in the brain, that can be reversed with CBT, or some bullshit like that. And Knoop recently babbled to a newspaper as well, same BS. They were defending PACE. And the patient survey showing 60% of patients got worse with their treatments was ignored.

I am just so mad they are planning another study into the effect of CBT! Such a waste of money. Promising research and treatments hardly get any money, and these clowns can do another study on CBT, which we already know, doesn't work.

Realize the google translation is very poor, didn't have much time and energy to properly translate. :)
 

Effi

Senior Member
Messages
1,496
Location
Europe
Van Der Meer recently babbled to a Dutch newspaper about CFS being a setting error in the brain, that can be reversed with CBT, or some bullshit like that.
We talked about this in another thread. It's the guy who likes to 'foezel' but doesn't like to admit it:
But Emeritus Professor Jos van der Meer, expert in the field of CFS, warns of the consequences of disclosure of research data. 'Put everything on the internet, there is always someone who discovers something you do every study a mistake, in this fixed too. It will go to details and I predict that it be enlarged in order to pay the entire study to the dump. ' On the availability of data from clinical trials is much to do, Van der Meer know. 'There is a widespread view that any conditions should be attached.'
Coyne also wrote an article about this guy last week: https://jcoynester.wordpress.com/20...ence-warns-of-sharing-data-with-your-enemies/

And Knoop recently babbled to a newspaper as well, same BS.
A Dutch newspaper already reacted to the results of this survey. It starts out ok, but as per usual they give the BPS crew ample opportunity to deny everything...
http://www.trouw.nl/tr/nl/39681/nbs...eniging-ME-CVS-raadt-gedragstherapie-af.dhtml
Trouw said:
"Behavioral and existing movement therapy are so far the only proven effective treatments for this disease. People have fewer symptoms, a minority even heal completely," Hans Knoop reacts by Dutch Knowledge Centre for Chronic fatigue.

In that center, attached to the Nijmegen Radboud University Nijmegen Medical Centre, according to the psychologist, more than half of the patients benefit from cognitive behavioral therapy. "You can see that reflected in research and it is a safe therapy. Apparently the patient organisation has spoken with other people, especially those who are dissatisfied.."

"Do not be silly'
Knoop 'regrets' that the patients' organisation discourages CBT/GET therapy. Some of the patients feel misunderstood, he notes. "They hear quite often: anyway just start moving, don't be silly. Or one has the idea that when you go in behavioral therapy, this means that the disease is your own fault.

But that is not correct: this is a serious condition that a large group of people severely limited in life. The estimates range from 30,000 to more than 100,000 Dutch. And it is a condition that also has a physical component in addition to behavioral factors. That we will certainly not deny, we include that in our own research. "
 

valentinelynx

Senior Member
Messages
1,310
Location
Tucson
Humph. I presented a Pain Grand Rounds during my fellowship on the long term adverse effects of untreated chronic pain. Loss of gray matter is one of the most important consequences. However, at the time of my presentation, I believe that not enough had been done to control for the effect of decreased activity, which also decreases gray matter volume. Bottom line: there is nothing specific to ME/CFS about decreased gray matter.

One common error made by researchers is not adequately surveying the existing literature prior to coming up with conclusions. Especially if the literature is outside of their narrow research focus.