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2008 study finding 7 ME/CFS subtypes - Did anything further come out of this?

Seven7

Seven
Messages
3,444
Location
USA
I have been looking into subtypes myself, did not find any explanation on the topic, and this one makes no sense to me whatsoever, I belong to more of one subtype: 6,7. And to be honest for me, this looks more like progression of disease than subsets.

When I hear Specialist talking and see videos they always refer to subset or subtype but I have never been clear what they mean by it.

Note:
subtype 1 (cognitive, musculoskeletal, sleep, anxiety/depression); subtype 2 (musculoskeletal, pain, anxiety/depression); subtype 3 (mild); subtype 4 (cognitive); subtype 5 (musculoskeletal, gastrointestinal); subtype 6 (postexertional); subtype 7 (pain, infectious, musculoskeletal, sleep, neurological, gastrointestinal, neurocognitive, anxiety/depression).
 

hixxy

Senior Member
Messages
1,229
Location
Australia
Even if those subtypes aren't correct. I believe there is definitely very distinct subtypes.

For instance, I've never been bed ridden or even close to it, but I am on the very extreme end of neurological dysfunction. There are plenty of other people who are severely fatigued and bed ridden with barely any neurological problems.
 

ukxmrv

Senior Member
Messages
4,413
Location
London
Dr Kerr lost his job (they didn't extend his contract) and he has now been lost to ME and CFS research. He told a patient at the time that it was unlikely he would ever have a lab again and be able to do more. I was one of the patients in his study(ies).

I have a feeling that another group tried to carry on this research but had mixed or different results. Sorry can't remember exactly what happened.
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
Dr Kerr lost his job (they didn't extend his contract) and he has now been lost to ME and CFS research. He told a patient at the time that it was unlikely he would ever have a lab again and be able to do more.

Shocked that I had somehow missed knowing that :( .

He looked like such a promising researcher. I wish the patient group themselves, wish we could fund and pay researchers and get ME/CFS research done, that we want done, ourselves.

.......

Note:
subtype 1 (cognitive, musculoskeletal, sleep, anxiety/depression)
subtype 2 (musculoskeletal, pain, anxiety/depression); subtype 3 (mild)
subtype 4 (cognitive)
subtype 5 (musculoskeletal, gastrointestinal)
subtype 6 (postexertional)
subtype 7 (pain, infectious, musculoskeletal, sleep, neurological, gastrointestinal, neurocognitive, anxiety/depression).

I dont think all these groups would be the same thing.

Ive got to know a couple of subgroup 4 ones over the years and Im SURE they didnt have what I have or even a minor variety of whatever I do have.
(I personally thought they probably have another illness be it a deficiency or something else.. something doctors were missing rather then ME/CFS).

I do thou believe this can all manifest differently in different people.

That subgroup 6 (postexertional) thou I think would mix strongly with all the other subgroups. I havent met many of those other subgroups who also arent postexertional. (other then a few here).

umm one of those subgroups is probably a more FM group
subtype 1? FM itself may cause anxiety, sleep issues, fibrofog. My nanna would fit this group but she also has IBS. (she certainly thou hasnt got what Id call ME/CFS just FM with things which go with FM).

My sister I'd say is subgroup 3 thou I do believe she's got a minor version of what I have thou her's didnt start in a traditional way with virally symptoms, she's never got virally symptoms and never has had the kind of neuro issues I get either.

Ive changed symptom wise with those subgroups, I used to be subgroup 7 (but with post exetional) but now days dont get much musculoskeletal stuff at all. I truely dont know where I fit in all that.

Not sure where those who has MCS as the worst symptom of their illness fit either or where do those who have POTS and autonomic issues being the most major part of the illness fit.
(many who only have POTS may be getting falsely diagnosed with havin CFS as POTS gives a lot of symptoms too).

I suspect many of those subgroups thou are the same thing. I like the fact that I researcher thou tried to break down our illness and tried to find subgroups. (If different like groups were studied I think more answers would be found.
 

Little Bluestem

All Good Things Must Come to an End
Messages
4,930
I, too, am surprised to see postexertional as only a single-symptom sub-type.

What is the difference between cognitive, neurocognitive, and neurological?

I wonder if these were current symptoms or original symptoms? While I now have gastrointestinal symptoms, they are of relatively recent occurrence. My sleep problems are of longer duration, but I am not sure now far into the ME/CFS they occurred. I think maybe sleep and anxiety are part of the neurological issues, especially anxiety if Dr. Cheneys minor seizure disorder theory is correct.

But yes, it is nice that someone at least tried. It is too bad someone didnt do more to refine it.
 

hixxy

Senior Member
Messages
1,229
Location
Australia
I don't see any difference between cognitive and neurocognitive, but there is a lot that can fall under neurological that doesn't fall under neurocognitive. Such as neuromuscular problems and seizures. Cognitive is only of the thought processes.

But yes, postexertional seems like it should fall under more subtypes. There's also no mention of sensitivities of any kind either.
 

oceanblue

Guest
Messages
1,383
Location
UK
I fear this '7 sub-types' was one of the most implausible studies published in CFS. How on earth can anyone hope to find 7 sub-types from a sample of just 23? Unsurprisingly, the association between gene expression and CFS couldn't be replicated - but kudos to Kerr for trying, and publishing the negative results:

PLoS One. 2011 Mar 30;6(3):e16872.

Assessment of a 44 Gene Classifier for the Evaluation of Chronic Fatigue Syndrome from Peripheral Blood Mononuclear Cell Gene Expression.

Frampton D, Kerr J, Harrison TJ, Kellam P.

Department of Infection, Division of Infection and Immunity, University College London, London, United Kingdom.

Chronic fatigue syndrome (CFS) is a clinically defined illness estimated to affect millions of people worldwide causing significant morbidity and an annual cost of billions of dollars. Currently there are no laboratory-based diagnostic methods for CFS. However, differences in gene expression profiles between CFS patients and healthy persons have been reported in the literature. Using mRNA relative quantities for 44 previously identified reporter genes taken from a large dataset comprising both CFS patients and healthy volunteers, we derived a gene profile scoring metric to accurately classify CFS and healthy samples. This metric out-performed any of the reporter genes used individually as a classifier of CFS. To determine whether the reporter genes were robust across populations, we applied this metric to classify a separate blind dataset of mRNA relative quantities from a new population of CFS patients and healthy persons with limited success. Although the metric was able to successfully classify roughly two-thirds of both CFS and healthy samples correctly, the level of misclassification was high. We conclude many of the previously identified reporter genes are study-specific and thus cannot be used as a broad CFS diagnostic.

PMID: 21479222
[note: tossing a coin will, on average, successfully classify half of CFS patients and controls.]
 

Min

Messages
1,387
Location
UK
It was my understanding that the MRC refused Dr Kerr's research grant applications more than once, prefering to grant funding for M.E. research to the Wessely school of psychiatry. Can anyone confirm this please?
 
Messages
32
There's also this study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921262/

Microbial infections in eight genomic subtypes of chronic fatigue syndrome/myalgic encephalomyelitis

Aim
To attempt to reproduce these findings, determine the specificity of this signature to CFS/ME, and test for associations between CFS/ME subtype and infection.

...Antibody testing for Epstein–Barr virus, enterovirus, Coxiella burnetiiand parvovirus B19 revealed evidence of subtype-specific relationships for Epstein–Barr virus and enterovirus, the two most common infectious triggers of CFS/ME.

This study confirms the involvement of these genes in CFS/ME.

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