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Yep, he absolutely could be the kind of know-it-all-but-have-no-clue we all need to avoid, but since the same genuinely has been reported for both conditions he mentions, I wouldn't indict him just on these comments. I suspect that if he expanded on his comments, it would become abundantly...

@Dolphin I think the "nothing we didn't know" comment could be interpreted in ways other than having swallowed Walitt's spin. As a standalone comment in this piece, Walitt's quoted comment is ambiguous - it could mean people can do more than they think or less than they think. If the...

Regarding CPET, they do say That's relevant, right? And in a blow to women, they found what they interpret as more evidence of deconditioning in females, if I've understood correctly: I edited to add something and took it out again because it was a brain fog metabolite.

Thank you so much for that deep-dive into the catechols, Hutan! I have printed it out so that I can read and reread it. You mentioned Parkinson's and multiple system atrophy as two conditions with low levels of one of the catechols we may have low levels of. Certainly people with Parkinson's...

@B_V A huge thank you for taking part in the study, and for sharing insider scoops along the way. It sounds gruelling, and I’m sure it, the massive wait and community expectations have taken/take their toll. I’m so grateful to you and the other participants. Take care of yourselves.

Lots of findings have been critiqued or dismissed on this thread, but I'm interested to know which findings are, well, interesting. The results below are beyond my powers, but I would really appreciate others' views on them:

If long COVID is like ME/CFS, you will learn nothing until you get to placebo controlled trials, because there's a lot of spontaneous fluctuation up and down. Given that people have had long COVID for max 4 years, there will, again if it's like ME/CFS, be plenty of spontaneous recovery and...

Can someone explain this bit to me? They're saying that patients were pacing for easy tasks but not for hard tasks. Huh?

Yeah, the direct arrow between reduced activity and ME/CFS is a nice touch, isn't it? I find researchers always fail to account for why we're sick right at the beginning/when the infection has gone/in month 1/month 2. The "Outcome" column should come between the 2nd and third columns. By all...

Yes, I think you're right. Nicely explained too! And that would cause fatigue by causing deconditioning? Oof.

I don't follow. They're not saying that the fact that patients achieved an RER of 1:1 with hounding is proof of exertion avoidance in patients. They're saying it's further proof that patients don't have central or peripheral fatigue. I think.

I think they're saying "Unsupervised, pwME avoid exertion. With supervision, we can hound them into exerting normally." If I've misunderstood your point, just ignore this! And if I've misunderstood their point, well, brain fog.

I think we have to be realistic in terms of the starting point for Walitt. People can, of course, change their minds about an illness. But to me, the effort preference business in this paper, and a few other parts, are consistent with what he thought 10 years ago (quotes below). Since he was...

While figure 10 is only a hypothesis about the pathophysiology of ME/CFS based on their findings, I think it makes it visually very clear that intervening at the level of reduced activity would be foolish.

I think the reason I’m struggling to understand the effort preference thing is that it is not explained clearly in the paper. I feel like words are missing or wrong. In this interview, Walitt talks about the effort preference thing: This is ambiguous, does Walitt think patients think they...

I don’t think this section heading is accurate: It seems to contradict the corresponding figure title The patients had a rapid decline in force on repetitive grip testing. Have I misunderstood something?

I hear you. They defined central fatigue as post-exercise depression, which they identified when “Motor Evoked Potential amplitudes using transcranial magnetic stimulation… decreased over the course of the task”. They found this in the healthy volunteers but not in patients. This seems...

I think the bolded word is important.

Helpful. I'm gonna effort-prefer my way to monotherapy of the former type, should any effective one ever be identified.

In this study at a UK centre, 13% (24/179) of ME/CFS patients tested positive for POTS (I'm specifically saying tested positive meaning that they had a positive tilt test). https://onlinelibrary.wiley.com/doi/10.1111/joim.12022 This is still considered a significant proportion. It means that...