Submaximal exercise testing with near-infrared spectroscopy in Myalgic Encephalomyelitis/CFS

[user9876]

Thanks for the opinions and views. I think you are right that the wording can be read as dismissive, and that's not the intention. We'll be more sensitive to such issues as we work more in the field. We're working in this area because we want to contribute to finding the causes of a debilitating illness. Every person who has contributed to the study comes with a story that makes me convinced that there is something yet to be discovered. Please stay tuned as we work through the sequencing data which will tell us more about the role of gene expression and of microbial agents. What we hope people get out of the study is that the sub-maximal exercise testing approach has not proved too useful. That's why we're working with maximal exercise testing to learn more about gene expression associated with post-exertional malaise. You may also be reassured that our further work on full exercise testing uses healthy but deconditioned controls. This kind of feedback is a helpful reminder of why we got engaged in the first place. My best. David Patrick, MD, FRCPC, MHSc

Welcome to the forum,

Reading your paper I think perhaps you missed an opportunity. Your testing seemed to be based on exercise muscles and measure blood flow and oxygen. This doesn't really tell us anything about PEM which I would see as a longer term effect where symptoms are worsened after a delay. What would have been interesting is to repeat the test over a number of days to see if there was an effect at the muscle level due to the exercise of those muscles. My guess is not because I would see PEM as a systemic disturbance in the way the body is regulated with a much wider feedback loop. But I think this is worth testing - I guess that is can you see localized effects on repeated exercise based on the exercised muscles.

In terms of the discussion in the paper it would have been good to see it related to work by say Julia Newton looking at muscle cells exercised outside of the body. Do your results fit together or are they contradictory. Same with the gene expression work of the Lights or the 2 day testing done by Snell. I think what is interesting is how these pieces may or may not fit together and whether they suggest subgroups. I think Newtons paper only came out very recently and wouldn't have been in time for you to comment on in your paper. It would be good to hear your opinions on how all the different pieces fit together.