As one of the lefties on this forum, I was less than thrilled with a diagnostic test which doesn't work on left-handers. I can also report that my typically idiosyncratic neurological organization may mean that my impairment is different from that experienced by most patients. My verbal skills remain good when measured as reading and writing, though I went through a period of one year when I did not read a book at all. I regained my ability to read and write through long, hard practice.
Verbal skills measured via speaking are significantly impaired. I don't "think on my feet", though this may be a consequence of orthostatic intolerance. It is hard to make sense when you are wondering if you will pass out in a few seconds. This generally fits a pattern of impaired performance intelligence.
My dyscalculia was severe, and stopped me from doing any professional work. This is a problem when your degrees and work experience are all in mathematical subjects. I have learned some ways to work around this problem, but the things I am able to do, compared to what I could do before my problems became severe, suggest a serious reduction in working memory. At one time my abilities were "off the charts" with one person who tested me unwilling to believe the evidence of longer "digit span" than she had ever seen. (My own experience included holding up to 36 digits heard once over a radio in working memory. Nobody testing digit span even thought this possible. They stopped testing around 16 digits.) At present I have trouble with ordinary telephone numbers.
Thinking about the Stanford results and
Shoemaker's work on structural brain abnormalities, I just realized this connects with the recent discovery of
a lymphatic system in the brain,
where it had not been expected, as well as
T-cell recruitment to inflamed endothelial tissue which should be limited by feedback from immune cells already in those tissues. Other people have talked about "leaky capillaries in the brain", and attempts by hormonal regulation of fluid balance to compensate for resulting cerebral edema by lowering overall volume. This would result in all the problems associated with hypovolemia, and orthostatic intolerance in particular.
I would also point to parallels with
leaky gut syndrome. Both
the gut and the brain are boundaries for the immune system, and immune malfunctions there could produce all the clinical signs we are talking about. A third immune system boundary is in the sinuses and lungs. I believe a high percentage of ME/CFS patients have chronic sinusitis, though usually this stays at a moderate level which does not cause serious medical concern. Most of the problem takes place where doctors have trouble seeing it, and few people are going to go to the trouble of imaging soft tissue unless the problem is life-threatening.
Chemokines, both pro and anti inflammatory, are definitely involved in regulation of T-cell recruitment, but traditional chemokines may not be the whole story. The work on endothelial tissue cited above shows a previously unknown peptide, PEPITEM, produced by B-cells acting to inhibit T-cell recruitment, with defects in this process producing chronic inflammation. This now reminds me of previous work on
vasoactive intestinal peptide and
similar biochemicals. Please note that abnormalities in this type of regulation are closely connected with a wide range of weird problems present in ME/CFS patients, directly affecting the hypothalamus, pituitary, brain and gut. It could also explain diffuse neurological problems.