Discussion in 'Latest ME/CFS Research' started by Countrygirl, Apr 23, 2014.
I missed it too.
But we get there, if we work as a team.
(Small point on discussion earlier in the thread)
It would be good if people specified which specific currency they are referring to i.e. there are US dollars, Canadian dollars, Australian dollars, etc.
Betsy Keller presented research at the 2011 IACFS/ME conference making this very point although not just about severe patients:
Haven't read the whole paper yet, but by golly, if @alex3619 and @Valentijn are excited, then so am I!
James Baraniuk presented on 2-day exercise testing at the 2011 IACFS/ME conference
I vaguely recall talk of 3 exercise tests, possibly over five days, being presented at a previous IACFS/ME conference (i.e. not 2014 nor 2011) i.e. 2007 or 2009 I think. I don't have the abstracts for the 2007 or 2009 conferences.
@SDSue Ditto what you said
I wonder why he didn't report the CFS results?
There was probably 100% overlap between the CFS and GWS groups. The symptoms are pretty much identical, hence many GWS studies will mention that the patients also fulfill all of the criteria for Fukuda CFS.
So there might not have been any CFS patients, just CFS/GWS patients.
But he says:
I'm not sure I quite buy the logic of this point. Certainly the effect of a 2-day CPET in reducing performance is striking, and the day-2 AT levels are at the levels where normal daily activities are likely to go beyond anaerobic limits. However, I don't think you can say that normal PEM will have the same effect on AT (anaerobic threshold) as cycling to exhaustion. Most patients get PEM way below pushing to total exhaustion, one reason the illness is so hard to manage. The Light's gene expression study using moderate exercise provoked PEM, but would moderate physical exercise - or even cognitive exertion provoking PEM - also cause AT to fall in the same way as a maximal cycling test? I don't think we can say from the evidence in this paper.
I think what would be needed would be:
- initial test to establish AT; you can't measure AT on the fly so this might need to be the full max test
- at a later date retesting patients on a day they have PEM not brought on by a max test
One possibility (not sure it would work) would be say, a 70% max heart-rate CPET (ie sub-maximal) to provoke PEM and measure AT, followed by a maximal CPET next day: would the results be the same on day 2 after a sub-maximal test on day 1?
It's also worth bearing in mind that not all patients were effected - in fact, fewer than half showed a drop in day-2 AT, with the rest basically the same on both days, or even increasing slightly (most of these instead showed a drop in day-2 VO2.max). See panel A in the figure from the published paper:
I think the 2-day CPETs give us some of the most striking results seen in studying mecfs to date and need to be pursued in much bigger studies (as Betsy Keller argues in her paper), but I also think we need to be careful in interpreting the data. Particularly as to whether 2-day CPET tests reflect what happens in 'normal' PEM brought on by more typical activities.
Is that the same study? The one in @Dolphin's info says that VO2 peak/max decreased by 13.5%, whereas the published study says 13.8%, HRmax/peak decreased by 8 bpm vs. 9 bpm, and Wmax/peak by 9.4% vs. 12.5%, if I have read/understood right (brain a bit sub-optimal at moment).
IACFS/ME Conference 2014 abstract
Is that a study that has been or will be published Tom?
Since the primary author is a doctoral student, it's probably the thesis which he needs to publish to graduate. If he can't get it into a normal journal, his school probably has their own journal to publish it in.
Don't know if it's the right place to ask...
Are PwFibromyalgia experiencing PEM?
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