Dr Neil Harrison: Webinar on neuroimaging (MRI, fMRI, SPECT and PET scans

[Sasha]

Under Cognitions and Priming, he notes: "Our brains predict a degree of inflammation in the body and compare this to the signal that arrives. If these two signals do not match, it could be felt as fatigue. These are the things we are currently looking to see whether there is in those who experienced the most fatigue or chronic fatigue, a large difference between absolute levels and levels predicted by the brain."

"Then the question would be whether there is a difference in the way their brains processing inflammatory stimulus."

He seems to be suggesting pwME are interpreting things that aren't real. Maybe I am expressing that poorly. Regardless, these are potentially loaded observations.

He leaves me concerned.

He seems to be talking about brains predicting things in this section, not any kind of conscious processing. Our brains do all sorts of things that aren't subject to conscious influence.

 

[duncan]

Agreed. So we unconsciously are misinterpreting reality. Still not good. And I think dead wrong, to boot.

I'd like to ask him to differentiate this from an autoimmune disorder.

 

[Sasha]

Agreed. So we unconsciously are misinterpreting reality. Still not good. And I think dead wrong, to boot.

No, we're talking about two different things, duncan. There are brain functions that are widely agreed to be not amenable to conscious thought - there is no "we" who are "misinterpreting", just brains, not thoughts or minds - so there are no false beliefs, no ideas that can be argued against or influenced.

An analogy might be how the brain causes optical illusions - it's our brains that do that, not our minds/ideas, and we don't have any access to the processes that drive those illusions.

 

[duncan]

Oh, I get it's a step removed from false illness beliefs, but I fear it's not a big step. It's still putting out there that what we feel is not based on anything overtly real; or rather, our brains are misinterpreting reality. We are deluded, just not consciously so.

I think that is wrong, and I think this is not the message we want conveyed.

 

[Sasha]

Oh, I get it's a step removed from false illness beliefs, but I fear it's not a big step. It's still putting out there that what we feel is not based on anything overtly real; or rather, our brains are misinterpreting reality. We are deluded, just not consciously so.

I think that is wrong, and I think this is not the message we want conveyed.

Here's the passage that you quoted again:

Under Cognitions and Priming, he notes: "Our brains predict a degree of inflammation in the body and compare this to the signal that arrives. If these two signals do not match, it could be felt as fatigue. These are the things we are currently looking to see whether there is in those who experienced the most fatigue or chronic fatigue, a large difference between absolute levels and levels predicted by the brain."

So he's making it clear that there is (he believes) inflammation in the brain and he's asking why inflammation would lead to the perception of fatigue - and he's positing a process in the brain that might lead to that perception. I don't see that as saying that that means that the fatigue isn't "real". Fatigue is a sensation and all sensations are produced in the brain, ultimately, wherever they originate. It doesn't mean that the chemical signals that produce them aren't real or don't arise from organic pathology.

 

[duncan]

I interpret that differently. I think he is saying there is a communication snafu.

Plus, he is a "behavior" man. Also potentially not a good thing if you are hoping for an explanation of ME that is psych-free.

 

[Sasha]

I interpret that differently. I think he is saying there is a communication snafu.

I don't think that follows from what he said. If your brain expects no inflammation and yet there is inflammation, he's saying that that mismatch between the brain's prediction and actuality manifests itself as a sensation of fatigue. That wouldn't be a communication snafu.

Plus, he is a "behavior" man.

He thinks that what goes on in the brain - high cytokine levels, for example - can affect behaviour. Isn't that a reasonable position?

Also potentially not a good thing if you are hoping for an explanation of ME that is psych-free.

A psych explanation of ME would be one in which our silly ideas make us think we're ill when we're not. He doesn't seem to be saying anything remotely like that.

Have you read this on sickness behaviour?

https://en.wikipedia.org/wiki/Sickness_behavior

No-one seems to be suggesting that that's psychological and it's a well-recognised, immune-driven set of behaviours observed in animals, not just people.

I know that as PWME we don't want any suggestion that our psychology could be causing our illness but I don't think that means that we need to claim that the immune system can't affect the brain or that the brain can't affect behaviour.

 

[Scarecrow]

Plus, he is a "behavior" man. Also potentially not a good thing if you are hoping for an explanation of ME that is psych-free.

I'd far rather have a psychiatrist interested in neurology and the immune system (not unlike Mady Hornig incidentally) study ME than a neurologist who thinks we are some variation of mad or bad.

Edit: Fortunately, we're beneath most neurologists. They just fob us off on the sort of psychiatrists it might be better for us to avoid.

 

[BurnA]

to see whether there is in those who experienced the most fatigue or chronic fatigue, a large difference between absolute levels and levels predicted by the brain."

What does the above quoted mean. What is absolute fatigue and how is it measured ? What is brain predicted fatigue and how is it measured ?

 

[duncan]

One of these days I have to figure out how to copy parts of posts.

@BurnA: Good question.

@Scarecrow, psychs don't belong examining ME.

@Sasha, behavior assessment is necessary with animals. With humans, not so much. Besides, it's kinda like objectifying or profiling - both of which I find repugnant.

As for miscommunication - I think you need to decipher loaded terms and phrases. If there is double speak involved, if clarity is lacking, I think problems may lurk.

 

[cmt12]

No, we're talking about two different things, duncan. There are brain functions that are widely agreed to be not amenable to conscious thought - there is no "we" who are "misinterpreting", just brains, not thoughts or minds - so there are no false beliefs, no ideas that can be argued against or influenced.

An analogy might be how the brain causes optical illusions - it's our brains that do that, not our minds/ideas, and we don't have any access to the processes that drive those illusions.

Those optical illusions are the result of beneficial adaptive strategies. Chronic illnesses are not beneficial. Let's keep that difference in mind.

The idea that the brain adapts in beneficial ways is self-evident and agreed to be true. However, the idea that the brain can just malfunction independently is a hypothesis. It is a widely accepted hypothesis, no doubt, because we are biased to believe it's true since we can observe the brain, but it's still not a fact.

The brain is one of the most dynamic and complex systems in the Universe. It should not be the first option considered when hypothesizing about illnesses and should definitely not be the only option considered. There is money being dumped into Alzheimer's research centered on this brain malfunction hypothesis and anyone who is being honest and unbiased will tell you that they are not close to solving it.

So far we still have never cured any illness based on focusing on the brain as the source of the problem. I'm not attempting to make an argument here, but just want to provide a bit of a reality check if possible.

 

[Scarecrow]

What does the above quoted mean. What is absolute fatigue and how is it measured ? What is brain predicted fatigue and how is it measured ?

He's referring to the absolute levels of signals coming into the brain (e.g. cytokines) and the levels predicted by the brain. He doesn't mention 'absolute fatigue' as far as I can see.

Here's the actual transcript for that entire section:

So this is an interesting concept, and it really addresses the question of how we believe the brain may function. So there are a number of prominent theories that suggests that the brain is a predictive machine. It predicts what it expects to happen in the world and compares that to what is happening in the world. And a simple example of this could be catching a ball. In real time we place our hand in space where we think it needs to be and our brains get feedback from the hand to say where it truly is in space. And this needs to happen, if you like, in real time. In order to catch a ball, we need to be able to compare where we expect our hand to be with the feedback from where the hand actually is.

And similar ideas have been applied to, for example, the relationship between inflammation and fatigue. Our brain predicts a certain amount of inflammation within our body, and then compares that to the signal that is coming in and if there's a mismatch between those two signals, that could be perceived as fatigue.

So these are some ideas that we are currently looking at to see whether those individuals that experience the most fatigue or even chronic fatigue, have a big mismatch between absolute levels and levels predicted within the brain.

 

[duncan]

So pwME would constantly be missing the ball. None of us would ever play for the Yankees.

 

[lansbergen]

One of these days I have to figure out how to copy parts of posts.

Right mouse button. block->copy-> paste?

 

[duncan]

block->copy-> paste?

HA! Thank You, @lansbergen! I am writing this down and taping it to my computer.

 

[Mark]

If you just select a section of text, a couple of buttons should pop up, to multiquote or to reply to (i.e. quote) that section of text. click reply and that should do what you want. You can do this multiple times, to reply to various excerpts on the page.

 

[Sea]

What does the above quoted mean. What is absolute fatigue and how is it measured ? What is brain predicted fatigue and how is it measured ?

Absolute levels of inflammation not levels of fatigue

 

[Scarecrow]

So pwME would constantly be missing the ball. None of us would ever play for the Yankees.

Apparently not.

I don't understand why a mismatch would automatically imply fatigue. Perhaps the suggestion is that the signals coming into the brain are normal but the brain is erroneously predicting lower than normal levels. If the brain was predicted higher than normal levels, surely there wouldn't be a problem?

In any case, he does make it clear that it's only a theory, which I interpret in this context as only a hypothesis.

@Scarecrow, psychs don't belong examining ME.

Why not? I mean I could name a few who I wish hadn't bothered but in principle, why shouldn't a psychiatrist study ME. Should they also not study, say, bipolar disorder?

 

[BurnA]

Absolute levels of inflammation not levels of fatigue

Thanks @Sea and @Scarecrow for explaining

 

[Sasha]

@Scarecrow, psychs don't belong examining ME.

I don't see an issue if they're intelligent psychs and understand science and biology. Neuropsychiatry is a discipline where biology meets psychology - and I hope that the science is now at a point where psychiatric illnesses are now being more understood as diseases of the brain, not the result of weird thinking.

@Sasha, behavior assessment is necessary with animals. With humans, not so much. Besides, it's kinda like objectifying or profiling - both of which I find repugnant.

But we are animals - and the fact that all animals show this reaction to high levels of cytokines helps establish sickness behaviour as a biologically driven behaviour, not a psychological or cultural one.

I don't understand your comment about objectifying and profiling.

As for miscommunication - I think you need to decipher loaded terms and phrases. If there is double speak involved, if clarity is lacking, I think problems may lurk.

If "psychology" or "behaviour" or terms like these are going to be automatically treated like loaded phrases or double-speak every time anyone mentions them, then I think that in itself is a recipe for miscommunication. Again, I understand people's sensitivities but if we've got people looking at brain inflammation, that's a wholly different context.