Dr Byron Hyde states that ME is a clearly defined disease caused by damage to the brain (akin to polio but in a different area). The primary area of brain damage he singles out is Brodmann 38, a part of the temporal cortex (although he finds damage in other areas as well). He believes that damage is caused by an enterovirus infection and is diagonsable via SPECT scan and gut biopsy. This strikes me as both an elegant and sobering definition given that the brain influences everything downstream. And while Dr Hyde's results have not been independently verified, he has seen thousands of patients, and meticulously documented his work. He states that the nature of the damage is microvascular and neuronal, and hence does not often show up on MRIs. This meshes fairly well with Dr Jared Younger's work on migcroglial inflammation and LDN. Some questions that have been discussed before... How can we contextualize these findings with current findings on metabolomics and autoimmunity? Are these simply the downstream results of limbic brain damage? If the brain damage is severe as he says, how do we account for temporary spontaneous recoveries where cognitive and physical function are fully restored? And some new thoughts... Do the 6 months delay in responses to Rituximab and Ampligen actually reflect the time it takes the brain to heal (once stressors have been removed)? Are there other diseases or research on damage to Brodmann 38 that give us any clues? What happens to the brain damage when you treat whatever "x-factor" has been shown in the blood (as demonstrated by Ron Davis)? Can this kind of brain damage be partially treated with things like stem cells, HBOT, and neurofeedback? Or is it more treatment resistant because there's an ongoing precipitating cause?