Investigating the Investigators of the Upcoming Post-Infectious NIH Study

halcyon

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One question I would like answered - who is pushing for the use of functional movement disorder, a problematic diagnosis, as a comparison arm? Does anyone know?
It seems to be a topic of active interest at NINDS, with several of the study members publishing on it previously.
 

Valentijn

Senior Member
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15,786
Hallett was involved in a research study in the late 90's where they found post exercise similarities between CFS and depressed patients.
http://www.ncbi.nlm.nih.gov/pubmed/8960719
Full text is available at http://www.neurology.org/content/47/6/1410.full . The P-value differences between the CFS patients and depressed controls was 0.068 on one measurement and 0.059 on another. Meaning a larger sample or fewer comparisons could have resulted in statistical significance. No mention of that possibility in the paper though :rolleyes:

4 of the 18 controls were the investigators, who would have known to put a lot more effort into the exercise.
One question I would like answered - who is pushing for the use of functional movement disorder, a problematic diagnosis, as a comparison arm? Does anyone know?
Based on their research, it sounds like Hallett & Maurer would be the ones pushing for that.
If findings from the NIH study are inconclusive or null, then not a physical disease, then Dr Mary Lee shifts from good to bad.
No, a null result does not mean a researcher is bad. Sabotaging a study to ensure a null result means a researcher is bad. Results are often null because there is really no correlation between the disease being investigated, and the biological factor being investigated. Null results are a normal and healthy part of science.
 

Valentijn

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I'm relieved to see we're up to 10 investigators who look pretty good. I was a little worried at first with all the quacks appearing after a bit of digging :p I'm also not too bothered by the borderline "uncertain" ones. Those two don't seem like they really bring anything to the table, but they also don't seem like they'd be any sort of disruption either.

I'll look into Drinkard today. Which leaves 11 investigators to be investigated!
 

Valentijn

Senior Member
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Bart Drinkard looks like he's done a couple dozen studies involving the CPET in various disease. One involves ME/CFS (and RA and polymyositis).

Straus was a co-author, but deceased long before the paper was submitted. Basically they were looking to better describe and measure fatigue, by comparing questionnaire answers (fatigue and activity) with maximal CPET results. There's some talk of "Moods" in the POMS-fatigue subscale, but it's just asking "have you been weary/fatigued/sleepy/tired/etc the past week". So I think they're referring to "moods" as a potentially temporary/passing state, compared to chronic fatigue or chronically reduced activity.

In describing the three diseases, they are generally using the same sort of terminology. There's no apparent attempt to contrast CFS with the "real" diseases. CFS did get singled out a bit in reported activity not correlating nicely with CPET performance - CFS patients did a bit better than expected. But the authors didn't really emphasize this or make it sound like the CFS patients were exaggerating or catastrophizing.

There was some talk of deconditioning, but in pretty neutral terms, not as a value judgement or the cause of illness, and CFS was not singled out. I was impressed that they mentioned that low CPET values from bedrest in healthy volunteers plateau at around 70% of normal, whereas all three groups in the study were at 58.2% on average (CFS = 56.1%, polymyositis = 53.8%, and RA = 64.3%). They concluded that that indicates the diseases are impacting the results, separately from any deconditioning which may have also impacted the results.

They were also very upfront about the problems with the small sample sizes (29 patients total), clearly labeled it as a pilot study, and included a "trend" p-value of 0.15.

In short, I'm certain he's capable of running maximal CPET testing, could understand the importance of a 2-day CPET, and wouldn't attempt to spin any outcomes. He's conducting exercise trials in some of his other research, but does seem to approach the diseases as being distinct, without touting exercise as the grand panacea for everyone.

http://www.sciencedirect.com.sci-hub.cc/science/article/pii/S1934148209004365
 
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LiveAgain

Senior Member
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103
I think Joshua Milner can go on the 'looks good' list. He's been studying a newly defined disease having to do with mast cell, joint hypermobility, & dysautonomia (linked below) and based on some of his other papers, he seems to find biomarkers. See second link for selected publications.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4016972/

http://irp.nih.gov/pi/joshua-milner


Joshua David Milner, M.D., S.B.
0011492968.jpg

Senior Investigator
Genetics and Pathogenesis of Allergy Section
NIAID/DIR
Building 10, Room 5-3950
10 Center Drive
Bethesda, MD 20892
301-827-3662
jdmilner@niaid.nih.gov

Biography
Joshua Milner graduated with an S.B. in biology from the Massachusetts Institute of Technology (MIT) in 1995 and an M.D. with distinction in immunology from the Albert Einstein College of Medicine in 2000. He was the recipient of the Pediatric Scientist Development Program Fellowship and did his fellowship in allergy and immunology at NIAID. He completed a postdoctoral fellowship with Dr. William Paul, NIAID, examining issues of mouse T-cell receptor repertoires. He was in the NIAID Clinical Research Transition Program immediately prior to being named chief of AIU as a clinical tenure-track investigator in NIAID.

Research Topics
The Genetics and Pathogenesis of Allergy Section is a basic, translational, and clinical lab focused on understanding the immunology of atopic disease through patients with genetic diseases associated with atopic manifestations, patients with immune deficiency and atopy, and patients with severe atopic dermatitis. Through studies of patients and mouse models, we hope to gain better insights into the mechanisms of immunodysregulation that lead to atopic inflammatory disease. Josh Milner and an NIAID research team have found that wet wrap therapy combined with education on long-term skin care can dramatically improve the lives of children with severe eczema.

Investigation of Defects in T-Cell Receptor Signaling and Repertoires
Weak T-cell receptor (TCR)-mediated signaling of yet-undifferentiated naïve T cells can lead to inappropriate Th2 differentiation in mouse models. Insufficient TCR diversity can lead to impaired regulation of T cells by other T cells due to insufficient TCR specificity overlap of effector and regulatory populations or due to the absence of competition between T cells leading to the inappropriate emergence of weakly signaling TCRs specific for a given antigen. Our lab is developing and applying techniques to determine whether certain human disorders of atopy may be caused by defects in TCR diversity or signaling function.

Analysis of Patients With Known Genetic Diseases Associated With Atopy
Via the study of selected genetic diseases that have allergic symptoms as an associated manifestation, we hope to derive lessons in the pathophysiology of atopy from the known affected pathways. Examples of diseases studied include the autosomal dominant hyper-immunoglobulin (IgE) syndrome due to mutations in STAT3, Wiskott-Aldrich Syndrome, adenosine deaminase (ADA)-deficiency severe combined immunodeficiency disease (SCID) associated with high IgE and others.

Search for Novel Genetic Diseases Associated With Atopy

AIU is also centrally focused on defining and understanding new genetic diseases of atopy in order to find novel pathways in the pathogenesis of allergy from these unique diseases. One example is PLCG2-associated antibody deficiency and immune dysregulation (PLAID), which we recently described. Patients with PLAID have cold urticaria, atopy, immune deficiency, and autoimmunity. Research is ongoing into the pathophysiology of PLAID and into the role of the PLCG2 and its pathway in other related disorders.


 

LiveAgain

Senior Member
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103
Luigi Ferrucci, M.D., Ph.D.

Senior Investigator
Longitudinal Studies Section
NIA
Scientific Director

Biography
Dr. Luigi Ferrucci is a geriatrician and an epidemiologist who conducts research on the causal pathways leading to progressive physical and cognitive decline in older persons. In September 2002, he became the Chief of the Longitudinal Studies Section at NIA and the Director of the Baltimore Longitudinal Study on Aging.

http://irp.nih.gov/pi/luigi-ferrucci for research interests, full bio and selected publications.
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Researches the biologic process of aging and age related illness/ disability and also idiopathic fatigue. Found a few references to "chronic fatigue syndrome" in projects/ articles he's involved in - nothing alarming, he seems okay.

In this article he talks about biological mechanisms of fatigue. Thankfully they separate CFS out from regular fatigue or fatigue from causes like cancer. http://www.boston.com/news/health/articles/2008/10/13/way_too_tired/?page=full

In a research agenda for Idiopathic Fatigue and Aging, CFS is separated out as a disease: "DISEASE-BASED MODELS OF FATIGUE A number of diseases are known to cause fatigue and may serve as models for how underlying impaired physiological processes contribute to fatigue, particularly those in which energy utilization may be an important factor, but the link between these underlying mechanisms and self-reported or performance-based fatigue has not necessarily been clarified in each disease model below. A number of relevant disease models are also not represented here, notably neurodegenerative disease (e.g., multiple sclerosis) and rheumatological diseases (e.g., fibromyalgia and chronic fatigue syndrome)."

Under recommendations for future fatigue research it says: "Conduct fatigue recovery studies in different populations, including younger adults, older adults, patients with chronic fatigue syndrome, and patients with various diseases and conditions." Seems like a good sign the report acknowledges "CFS" as a disease, no question. Cant link but it's: Bedside-to-Bench Conference: Research Agenda for Idiopathic Fatigue and Aging, ALEXANDER ET AL. MAY 2010–VOL. 58, NO. 5

From one edited by Ferrucci: "Although lack of energy in nonelderly adults has received considerable attention, and severe forms that are persistent and unexplained (e.g., chronic fatigue syndrome) have invoked considerable clinical and research interest (35,36), relatively little research has focused on lack of energy in older individuals." Again "CFS" taken seriously, but not sure they realize it's about much more than fatigue.
http://biomedgerontology.oxfordjournals.org/content/63/7/707.full
 

Valentijn

Senior Member
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15,786
I'll try to look up Dr. Bryan Smith next.
It looks like he's involved in looking at the neurological impact of diseases associated with infections, such as Ebola, MS, HTLV-1, etc. He works directly on Avi Nath's team as a "Staff Clinician", and has published with him.
http://www.neurology.org/content/84/14_Supplement/P5.235

There's many other Bryan Smiths who are doctors and researchers. I'm pretty sure this one isn't the one who does molecular imaging (turns up in NIH searches due to a fellowship) and he's probably not the one at John Hopkins (does HIV + stroke stuff, but very very recently with no mention of dual affiliations).
 

Valentijn

Senior Member
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15,786
Dr. Stephen Sinclair is a Clinical Psychologist at the NIMH. His specialty is "Affective Cognitive Neuroscience", which generally seems to involve the neurological mechanisms of emotions and thought.

His research deals with behavioral disorders in youths, attempting to find cognitive or brain abnormalities which correlate with them. The team he works with does seem genuinely interested in finding abnormalities, and presents null results prominently instead of hiding them. The research also seems completely focused on the discovery of abnormalities, with little or no interest in promoting particular treatments.

However, I don't know if their imaging results support their conclusions, since it's not an area I know anything about. I'm also not particularly enthusiastic about investigators specializing in behavioral disorders analyzing ME/CFS brain scans in general, but if it's going to happen, this is probably a good person to be doing it.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941702/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4491633/
http://ajp.psychiatryonline.org.sci-hub.cc/doi/full/10.1176/appi.ajp.2015.15020250
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4632075/
 
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This may be of interest in general: http://clinicalcenter.nih.gov/about/news/newsletter/2008/nov08/newsletter.html
The article is half way down the page.

ICSU%20Group.jpg


Note that all three in this picture are on the study. From left to right: Dr. Fred Gill, Stacey Solin (middle), and Dr. Penelope Friedman

Internal Medicine Consult Service lets investigators focus on the protocols

Clinical Center patients present with a wide variety of health issues that may or may not be related to the illness being studied. Patients with these types of issues require evaluation and care to allow them to participate safely in protocols.

That’s where the CC’s Internal Medicine Consult Service (IMCS) comes in—Chief Dr. Fred Gill, Dr. Penelope Friedman, and nurse practitioner Stacey Solin. Their services include diagnosis and care for general medical problems and coordination of care for complex patient cases involving multiple specialists.

[...]

As far as I can tell from the article, the Internal Medicine Consult Service is supposed to be involved in all studies, and is for patients who require treatment/care for any health problems they may have during the trial. Unless this is a coincidence and all three are part of this study in a different capacity, they are probably included by default.
 
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It looks like Fred Gill, Stacey Solin and Penelope Friedman have been working together at the Internal Medicine Consult Service since at least 2008. There is info about a clinical elective program for students at the IMCS on the NIH website, which lists all three under staff and is dated 2015.

Perhaps unsurprisingly, I have found nothing else about Stacey Solin, no documented research participation, no speeches/talks/educational material by her, whether related to ME/CFS or not.

I've looked into Penelope/Penny Friedman as well and haven't found anything remarkable either.

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If the IMCS is a standard part of NIH clinical research and that's the reason why Gill, Solin and Friedman show up as investigators, then they aren't really involved in the study per se and there is little reason to worry about their influence I think.

On the other hand, trial participants who need medical help would understandably be concerned about not being taken seriously if they are seen by IMCS staff, given Fred Gill's position.
 
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0010050939.jpg


Neal Young, M.D.
Senior Investigator, Cell Biology Section, Chief of the NHLBI's Intramural Research Hematology Branch


His research focus is on bone marrow failure diseases and he conducted research on immuno-suppressive drugs for aplastic anemia which resulted in the first effective treatment for the disease. He also studies parvovirus B19 (anemia) and diseases related to the telomere (lung fibrosis, liver cirrhosis). In his review article on parvovirus B19 (2004) he wrote the following, citing a paper/case report of 3 fibromyalgia patients:
Case reports suggest that parvovirus infection may mimic, precipitate, or exacerbate juvenile rheumatoid arthritis, systemic lupus erythematosus, and fibromyalgia.


Avindra Nath said he involved Neal Young because of his expertise in immunology. From the MEAction's transcript of his talk on 15 Feb:
So, I put together a panel of really outstanding immunologists to guide me, although I do consider myself a neuro-immunologist, there are people… every immunologist is not the same. People who specialize in B cells and T cells and NK cells, and so on and so forth. So what I did is call on Dr Neil (sic) Young who is an expert immunologist at NIH and Ronald Germain who is a National Academy of Science member so we sat and discussed various kinds of things.


He's also authored a paper together with Ioannidis, who has written the famous paper "Why Most Published Research Findings Are False", on publication bias/distortion of research results and science.


And for what it's worth, this Washington Post article describes him as someone who likes to solve a mystery:
“It [aplastic anemia] was a horrific and intriguing disease: untreatable, often afflicting the young, but so mysterious that there was a possibility of getting patients better immediately,” he said — if only the mystery could be solved.


Couldn't find any red flags, so he seems all right.
 
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Jay%20Chung_thumb.jpg


Jay H. Chung, Ph.D., M.D.
Senior Investigator
Laboratory of Obesity and Aging Research

From the NIH website:
Background
Jay Chung earned a B.S. in electrical engineering and a B.S. in biology from the Massachusetts Institute of Technology before receiving a M.D. and Ph.D. in genetics from Harvard Medical School, during which he received the James Tolbert Shipley Prize for Research in 1998. After an internship and residency in internal medicine at Brigham and Women’s Hospital, he became an endocrine fellow at the National Institute of Diabetes and Digestive and Kidney Diseases at the NIH where he worked with Gary Felsenfeld. He moved to the NHLBI in 1994 as an Investigator in the Laboratory of Biochemical Genetics.

Research Interests
Dr. Chung's primary research interest is in understanding how aging decreases our ability to burn calories and generate energy. This aging-related metabolic decline plays an important role in the development of obesity and obesity-related diseases such as type 2 diabetes and cardiovascular disease. Dr. Chung is working to understand the key molecular mechanisms that underlie the beneficial effects of caloric restriction in order to develop therapeutic strategies that mimic these effects and protect against metabolic diseases.

The NIH site lists his publications as well. It's all purely biomedical and highly technical. He wants to understand the biological mechanisms of metabolism in humans, how it changes with age and its relationship with diseases. For instance:
He described obesity as partly a “disease of aging.” As people grow older, the body’s ability to metabolize energy declines. This contributes to weight gain, particularly around the midsection. People with this type of fat, known as visceral fat, are at increased risk for type 2 diabetes, Alzheimer’s disease and heart disease, among others.

I still went ahead and tried to find a connection to anything BPS-related, but unsurprisingly nothing came up. Jay Chung passes PR's quality assurance test.
 
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I'll do Dr. Eugene Major next.

As for Elizabeth Unger, do we need to look into her? If I remember correctly, her position has been discussed quite extensively elsewhere, and it's a bit of a mixed bag, but not to the extent that it can be considered detrimental to the study. I might be wrong, so corrections are welcome.
 
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