Is PEM Triggering Neurological?


Active Member
I had a new thought about PEM, and how exertion triggers it. My PEM triggers on both physical exertion and cerebral exertion (such as driving and socializing). Most theories seem to focus on muscle tissue, which doesn't apply to cerebrally-triggered PEM. I wondered if the cerebral effort of physical exertion could be a trigger. A quick check shows that yes, physical exertion does require significant cerebral exertion, and that cerebral effort increases with the level of physical effort required. Thus, if for some reason, your muscles aren't performing efficiently, it would take more cerebral activity to force them to move, and something in that cerebral activity might trigger the state we know as PEM.

I like this theory, since all my ME symptoms and responses to treatments seem to be neurological and not physical. Counterevidence is that my responses are different: physically-induced PEM has a consistent 24 hr delay (which seems consistent with IFN-g response to muscle exertion) while my cerebrally-induced PEM has a shorter and variable delay (might be less than an hour). Also, cumin (Cuminum cyminum) is very effective at blocking (or treating it if I forgot to take it before) my physically-induced PEM, but it doesn't work on my cerebrally-induced PEM.

I'm having a particularly sluggish brain today, so I'm not up to doing in-depth online research, but I thought I'd post this hypothesis here for clearer-minded individuals to think about. If you think of any strong counterarguments, or strong supporting evidence, please post.

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