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To be fair, it is designed to fatigue healthy people (that is the effort, the cost), but it is explicitly designed not to exhaust... ...precisely. That's easy - the term was coined for the new paper while silently repurposing a reward motivation test as an undefined 'effort preference' test.

A couple of points I left off my 'final' post: @bobbler quoted Treadway saying that men were more likely than women to choose hard tasks. The HVs had a slightly higher male ratio - I wonder if the study allowed for that? The marginal 0.04 p value for hard choice ratio being lower for ME folk...

I think there might be 2 things going on here. 1. Effort preference, which means nothing and is a null test for the study population. 2. The separate rather odd fadings about lack of central fatigue (as shown by transcranial magnetic stimulation), which might mean something. I haven't read this...

My head is spinning and I'm going to bow out of the EFFrt discussion. Here's what I think I've learnt from others' helpful posts (and quotes from the underlying papers): 1. EEfRT was developed to probe anhedonia (an inability or relative inability to experience pleasure, presumably the rough...

Does the EEfRT test mean anything when used on PwME vs healthy volunteers? Thanks to @bobbler for digging out so much useful information. I'm afraid I bailed out after reading ten pages of printed posts, and haven't reached the end of this ever-growing thread. My thoughts so far: Comparing...

edited for clarity I think that at an online conference a couple of years ago, Workwell said they had data on about 400 subjects. I don’t understand why they haven’t published an analysis of al their data, which would go a long way to clarify the significance of these studies. At that...

+ 1 (thanks and printing for later)

But deconditioning is primarily about fitness and is measured by aerobic capacity, specifically by CPET - and the study demonstrated deconditioning. It would be odd if a group of people with ME were not. Grip strength and muscle mass are measures more of strength than fitness. The problem for...

I'm not sure if there is a logical flaw. I believe they are saying is that effort preference is a brain-related issue, not a muscle-deconditioning one. Whether or not effort preference is a meaningful concept is another matter. But I'm still trying to wrap my mind around the whole effort...

Astonishing. Again: why does this not happen in every other limiting illness? And ME-like syndrome would be the norm if this were true. More pertinently, they collected no evidence that allowed them to plausibly speculate along these lines. What they could easily have done is asked their...

Frustratingly, supplementary data table S7 gives group scores for PROMS, though only the aggregate Physical and Mental components from the SF36.: HV (n=21) HV (n=21) PI-ME/CFS (n=17) PI-ME/CFS (n=17) Mean , SD p-value (Mann-Whitney U) SF-36 Physical Component Score HV: 56.7, 3.1 | ME/CFS...

Surely the arrows are better placed like this. (Yellow arrows added) Or maybe their final image should be at the start as leading to everything else and the Reduced Activity is the final Outcome Yes, it's the assumed causality that troubles me, and the implicit failure to listen to patients...

First, the stats suggest many of the findings are iffy (though of course there is the problem of teeny sample size meaning true effects will be missed). But if we accept them as real signals, are they specific to ME or a generic chronic illness signal, particularly a chronic exhausting/PEM...

I hadn’t notice that: this is classic “ME is the result of deconditioning“. it shows the authors haven’t grasped the importance of post-exertional malaise. ADDED Or put another way, why doesn't every other limiting condition cause a syndrome similar to ME, complete with PEM. Why doesn't MS have...

Thanks. I guess regardless of its purpose, the battery of testing is also likely to be more challenging for PwME than for healthy volunteers, which might well add to the stress. So the autonomic functioning element looks a miss and physical conditioning probably applies to most chronic illnesses...

Autonomic dysfunction in ME/CFS Tilt table testing found no POTS or OI differences with controls. However, they also found reduced baroslope, which I think means that regulation of blood pressure when it changes is slower than optimal. A wearable 24-hour ECG showed reduced heart rate...

"exposure of brain endothelial cells to serum from patients with long COVID induced expression of inflammatory marker" Interesting, though I couldn't see the relevant figure (happy to look if someone points me to it).

Going back to the idea of effort preference, are the reported differences trustworthy? I've not read the paper yet (it's ***ing huge), but these criticisms look significant: @chillier was commenting on the fMRI data of participants doing repeated hand-grip tests, and pointing out that the...

Credible mechanism for how 'effort preference' issues could explain PEM & relapses? I queried how simply pushing overriding 'effort preference' could explain both PEM and relapses, where it seems (particularly for relapses) our body behaves as it is broken (e.g. legs giving way), as opposed to...

For this to be credible, we need an explanation for PEM and relapses. If our body was fine and the problem is with effort preference (or even central perception), why if we choose to do stuff regardless: 1. We get PEM - is that then purely a brain phenomenon (this is possible)? 2. We get...