Study finds clues to PEM in ME/CFS

Cort

Founder of Health Rising and Phoenix Rising
Staff member
Staud is a well-known Fibromyalgia researcher who's been focused on problems in the periphery (body) rather than the brain. Now he's looking at chronic fatigue syndrome

http://medicalxpress.com/news/2015-03-magnifies-exhaustion-chronic-fatigue-syndrome.html

The mechanism that causes high-performance athletes to "feel the burn" turns out to be the culprit in what makes people with chronic fatigue syndrome feel exhausted by the most common daily activities, new University of Florida Health research shows.
The study found that the same metabolites the Lights are focusing on in their ME/CFS work - activate the neural pathways in the brain. That find could suggest it all starts in the muscles in ME/CFS

Researchers focused on the role of muscle metabolites, including lactic acid and adenosine triphosphate, or ATP, in the disease. The study has demonstrated for the first time that these substances, released when a person exercises his or her muscles, seem to activate these neural pathways. Also, UF Health researchers have shown that these pathways seem to be much more sensitive in patients with chronic fatigue syndrome than in patients without the disease, something that hasn't been studied before.
During exercise, muscles produce metabolites, which are sensed by metaboreceptors that transmit information via fatigue pathways to the brain, according to the researchers. But in patients with SEID, these fatigue pathways have become highly sensitive to metabolites and can trigger excessive feelings of fatigue.

"For most of us, at the end of strenuous exertion we feel exhausted and need to stop—but we will recover rapidly," Staud said. "However, these individuals tire much more rapidly and sometimes just after moving across a room, they are fully exhausted. This takes a toll on their lives."
They did a hand-grip exercise - and inflated a blood pressure cuff to trap the muscle metabolites being produced in the muscles....

At the end of the hand-grip exercise, the blood pressure cuff on the participant's arm was inflated, almost instantly trapping the metabolites generated by the exercise within the forearm muscles. This allowed the metabolites to collect in the forearm tissue without being cleared by the circulatory system. There, the metabolites continued to activate fatigue pathways, sending messages of fatigue to the brain and allowing researchers to measure how much fatigue and pain may occur because of the trapped metabolites.

With the blood pressure cuff still inflated, the participants rated fatigue and then pain in their forearms every 30 seconds. Both patients with SEID and patients without the disease reported increasing fatigue, but patients with the disease recorded much higher levels of fatigue and pain.
"We found that the fatigued individuals reported more fatigue than the non-fatigued individuals during the exercise, and also found that they had more pain compared to the non-fatigued individuals," Staud said.
The study wasn't quite as succcessful as the authors made out. Yes, the ME/CFS patients reported more fatigue and pain but they started out with more fatigue and pain. Their fatigue and pain levels did not rise more than the fatigued patients once the blood pressure cuff was inflated. If their system was more sensitive they should have skyrocketed relative to the healthy controls but they didn't. Both groups had the same relative symptomatic response.
 

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