Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and fibromyalgia are indistinguishable by their cerebrospinal fluid prote… (Schutzer et al, 2022)

[Consul]

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and fibromyalgia are indistinguishable by their cerebrospinal fluid proteomes

Abstract

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and fibromyalgia have overlapping neurologic symptoms particularly disabling fatigue. This has given rise to the question whether they are distinct central nervous system (CNS) entities or is one an extension of the other. To investigate this, we used unbiased quantitative mass spectrometry-based proteomics to examine the most proximal fluid to the brain, cerebrospinal fluid (CSF). This was to ascertain if the proteome profile of one was the same or different from the other. We examined two separate groups of ME/CFS, one with (n=15) and one without (n=15) fibromyalgia. We quantified a total of 2,083 proteins using immunoaffinity depletion, tandem mass tag isobaric labeling and offline two-dimensional liquid chromatography coupled to tandem mass spectrometry, including 1,789 that were quantified in all the CSF samples. ANOVA analysis did not yield any proteins with an adjusted p-value < 0.05. This supports the notion that ME/CFS and fibromyalgia as currently defined are not distinct entities.

The study (preprint)
https://www.biorxiv.org/content/10.1101/2022.09.14.506792v1

 

[ljimbo423]

I have both ME/CFS and fibromyalgia, and have for many years. I've never looked at them as separate illnesses. I think they are the same illness, just expressing itself with different primary symptoms.

 

[Pyrrhus]

Related papers, also from Benjamin Natelson:

Is chronic fatigue syndrome the same illness as fibromyalgia: evaluating the ‘single syndrome’ hypothesis (Abbi and Natelson, 2012)
https://forums.phoenixrising.me/thr...rome-hypothesis-abbi-and-natelson-2012.88629/

Elevations of Ventricular Lactate Levels Occur in Both Chronic Fatigue Syndrome and Fibromyalgia (Natelson et al. 2017)
https://forums.phoenixrising.me/thr...onic-fatigue-syndrome-and-fibromyalgia.57035/

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Fibromyalgia: Definitions, Similarities, and Differences (Natelson, 2019)
https://forums.phoenixrising.me/thr...finitions-similarities-and-differences.75364/

 

[Pyrrhus]

From a recent Phoenix Rising interview with Dr. Dane Cook:
https://phoenixrising.me/myalgic-en...ome/pain-pem-dane-cook-fibromyalgia-exercise/

Phoenix Rising:

The current diagnostic criteria for fibromyalgia do not explicitly mention PEM, although they do list “physical or mental fatigue” as a core diagnostic symptom of fibromyalgia, cognitive dysfunction (brain fog) as a “major feature” of fibromyalgia, and hypersensitivities to light, sound, odors, etc. as “common complaints.”​

​

Furthermore, they note that “physical fatigue may manifest as a complaint of physical exhaustion after physical activity, including an inability to function within normal limits for activities that constitute normal daily activities, and the requirement for rest periods after activity.” ​

​

Does your systematic review or previous work support the idea that fibromyalgia comes with PEM?​

Dr. Dane Cook:

I think the literature and our meta-analysis clearly show that fibromyalgia is associated with PEM. Although our data focused on increased pain post-exercise, other studies have shown multiple symptoms are worsened with physical effort. If we define PEM based on self-reported symptoms, then yes, the data support PEM as an element of fibromyalgia.​

 

[Wishful]

The abstracts just shows that they studied two groups with ME. The lack of difference could just mean that fibromyalgia has no effect on the CSF, rather than both providing exactly the same changes. If you did the same test with the second group having toe fungus infection rather than fibro, you'd probably get the same result, but wouldn't claim that they're the same disease.

Aside from that, CFS testing won't show all possible differences between PWME and people without ME. It's possible that the differences are limited to small portions of the brain, with the critical chemicals short-lived.

 

[Rufous McKinney]

The abstracts just shows that they studied two groups with ME. The lack of difference could just mean that fibromyalgia has no effect on the CSF, rather than both providing exactly the same changes. I

I am not critiquing science today, post doctor visit.

But your comments, if true, suggest none of these researchers should get a paycheck, If they can't come up with decent null hypotheses to test, and decent controls and proper levels of power and strength: why is anyone bothering?

 

[Wishful]

My complaint isn't about the science; it's about the interpretation of the results. "The results did not show any distinct differences." is correct, and worthwhile to report. "The lack of difference implies that the diseases are the same." is not correct. If they'd included appropriate controls, to identify the differences both diseases had with those, it might indicate possible similarities.

 

[Hufsamor]

I have both ME/CFS and fibromyalgia, and have for many years. I've never looked at them as separate illnesses. I think they are the same illness, just expressing itself with different primary symptoms.

I have a friend with fibromyalgia.
As long as she’s vigorously exercising several time each week, she’s symptom free.
Her sister has fibromyalgia as well, but she can’t exercise, it makes her symptoms flare. (I suspect she has a mild me/cfs on top of her fibromyalgia)

It seems to me that fibromyalgia and me/cfs have something in common, and I believe a lot of people with fibromyalgia have me/ cfs as well.
But I’m quite sure they are two distinct different illnesses.

 

[Rufous McKinney]

I tend to view ME from my own biased perspective, as being heavily lymphatic. Fibro seems more neurological.

I am the MOST sick on the right side of my body. Many symptoms are concentrated there, including my unraveling neck....