Cognitive FX clinic say neurovascular coupling dysfunction causes ME/CFS; all very interesting, but they end up prescribing CBT and other nonsense!

[Hip]

The Cognitive FX clinic in Utah has some interesting ideas about the possible cause of long COVID, but disappointingly, their treatment seems to involve the same old discredited cognitive behavioural therapy (CBT).

Cognitive FX was founded in 2014 by Dr Allen and others in order to treat post-concussion syndrome (PCS), an ME/CFS-like condition caused by a physical blow to the head. Dr Allen theorised that PCS is caused by dysfunctions of neurovascular coupling in the brain.

Neurovascular coupling is where the body dynamically alters blood flow to the brain according to neuronal activity, with blood flow increased when active neurons require more energy and nutrients.

The clinic theorise long COVID is also due to neurovascular coupling dysfunction. All very interesting, but the clinic end up treating long COVID with a variety of therapies that I doubt will have any lasting impact on the disease.

Their long COVID treatment webpage says:

A condition as complex and wide-ranging as long COVID is not going to be cured with a single treatment or medication. This is why our approach — which we call Enhanced Performance in Cognition (EPIC) Treatment — includes various multidisciplinary therapies, including vision therapy, occupational therapy, cognitive therapy, neuromuscular therapy, sensorimotor therapy, psychotherapy, and more.

The concept of neurovascular coupling (NC) dysfunction being a factor in ME/CFS remains interesting though. According to this paper, one model of NC is based on glutamate released by active neurons triggering the release of vasodilators by astrocytes:

Previously favoured models of the neurovascular coupling mechanism were centred on synaptic glutamate triggering Ca2+-dependent release of vasoactive substances by astrocytes

However, the paper goes on to find flaws in that model, and proposes that ATP released by neurons may be the signalling factor which triggers astrocytes to release the vasodilators that increase blood flow to the appropriate area of the brain:

We proposed in 2015 that (instead of glutamate) the release of purine nucleotide ATP may mediate signalling between neurones and astrocytes

This is interesting, as one ME/CFS patient (Keshav) rapidly improved in a matter of days from ATP tablets and ATP injections.

 

[hapl808]

Enhanced Performance in Cognition (EPIC) Treatment — includes various multidisciplinary therapies, including vision therapy, occupational therapy, cognitive therapy, neuromuscular therapy, sensorimotor therapy, psychotherapy, and more.

Well they have an acronym - if that's not science, I dunno what is!

The neurovascular part is interesting, but I agree it's quite weird that multidisciplinary includes vision therapy, cognitive therapy, sensorimotor therapy, psychotherapy, etc. These are all coping mechanisms - none of them are going to impact the illness itself.

How utterly disappointing.

 

[Atlas]

However, the paper goes on to find flaws in that model, and proposes that ATP released by neurons may be the signalling factor which triggers astrocytes to release the vasodilators which increase blood flow to a specific area of the brain:

That's particularly interesting re brain fog, if ATP is already in short supply due to innate immunity being triggered in the brain (triggering the itaconate low-atp pathway), neurons will be unable to release it and so there would't be any left to signal vasodilation...? ..would be a "double whammy"

 

[Wishful]

This is interesting, as one ME/CFS patient (Keshav) rapidly improved in a matter of days from ATP tablets and ATP injections.

Serum ATP seems to have a lot of effects, including making inflammation more severe. ATP isn't just "cell fuel"; it's an important signalling molecule. I'm surprised that as a supplement it doesn't cause all sorts of problems, as various cells think the body in under attack or something.

Would much of oral or injected ATP reach the brain's blood vessels, or would it get absorbed or reacted with very quickly?

 

[Hip]

Would much of oral or injected ATP reach the brain's blood vessels, or would it get absorbed or reacted with very quickly?

I don't know. I've tried Swanson's Peak ATP supplement in the past, which contains 400 mg of the sodium salt of ATP in each capsule. I don't notice much from that, except maybe a very slight mood elevation.

@Keshav took the Douglas Labs ATP-20 oral supplement, which contains 20 mg of ATP per tablet, rather than the ATP sodium salt I took. I don't know if that makes a difference. He then switched to ATP injections, using Heel ATP ampoules, which contain 275 mg of ATP. Both seems to work for him:

I ordered sublingual ATP-20 tablets from Douglas Laboratories. Taking it three times a day, I found to my disbelief that I was much improved in less than three days. Not great, but better and feeling encouraged. In the interim,

I found I could get Heel brand injectable ATP offered by several places in Europe It came quickly via DHL from Germany. I injected half an ml in my hip with a bit of Magnesium Sulfate which is supposed to make it more effective. Next morning, I woke up after a bad night sleep, expecting to feel like crap all day, but after being away 15 minutes I noticed my mind was much sharper, my mood was really good and my energy was very good. It's not a "speedy" energy, but rather a nice calm energy.

This Heel brand ATP injection seems to be widely available, and costs about $20 for 10 ampoules. Goldpharma.com also stock it.

 

[wabi-sabi]

Well, you know there's no treatment more powerful than good old fashioned willpower. I'm surprised any doctor bothers to prescribe medications at all. If CBT can't fix it, it's just not worth fixing.