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They found clear evidence for this variant causing Bell's palsy from a meta-analysis of 4 GWAS's, all showing the same effect direction. But it's in an intergenic region, and they weren't able to associate it with any specific gene, so it's not clear what it does.

A meta-analysis uncovers the first sequence variant conferring risk of Bell’s palsy Published: 18 February 2021 [Line breaks added] Abstract Bell’s palsy is the most common cause of unilateral facial paralysis and is defined as an idiopathic and acute inability to control movements of the...

That sounds like what Grigor said. He said the idea is that the brain is misinterpreting the signals, not "people".

Oh, the paper says:

Yeah, looks like to me like AI was used for this paper. Similar to the recent US public health review: - https://www.politifact.com/article/2025/may/30/MAHA-report-AI-fake-citations/

There appear to be a lot of issues with the references. As in many don't seem to exist. I looked at the first 10, and couldn't find the following papers. I emailed Stephanie L. Grach, who has authored ME/CFS-related papers, about ref. 4, and she said she was not involved in that paper. More...

Here is their reasoning, but probably look at my next post first. References

ME Research UK – June e-newsletter [Links to S4ME threads added in brackets] Promising Findings from Our Researchers Articles London Marathon Place Big Give Christmas Challenge – Pledge Today Walk for ME – Thank you Alison! Link

Now available: Link | PDF

Doesn't this apply to basically all potential drug treatments as well? Separately, I'm pretty certain the second response from them is mostly written by an AI. The gratuitous bolding for emphasis, the section headers for each point, the summary at the end, the use of em dashes, and some of the...

Well, I'm exhausted, and I'm not totally sure we're even discussing the same thing, so I'm going to call it for now.

Similar for me. Sometimes delayed, sometimes seems pretty immediate.

Well, it wouldn't really fit the name of "malaise", so if only for that reason, it wouldn't seem to fit. But for the reasons I said, I think that is kind of arbitrary. Just saying that if fatigue+brain fog+vomiting is considered PEM, then vomiting is considered connected to the PEM process...

Hmm, yeah I suppose. I think my mental model of PEM is a delay plus it lasting strangely long (greater than 2 or 3 days) plus it being quite out of proportion to the exertion.

Is that the case? With muscle soreness, there's the DOMS diagnosis, right? But, people often suddenly get a lot more fatigued a day later? Maybe I'm working with an incorrect assumption that that is pretty rare.

I just think its arbitrary to use 3 symptoms instead of 1. I think we should err on the side of being potentially over-inclusive, not over-exclusive, for the sake of patients who, without the established ME/CFS communities [edit: like this forum] and support systems, [edit: and without any other...

No, I understood. I'm saying if we accept that vomiting is part of the pathophysiological PEM process if it occurs alongside fatigue, it seems logical to assume it could be related on its own as well. I'm mainly considering a delay of a single symptom if it's already associated with PEM if...

Maybe. So in that case, delayed fatigue, brain fog, and unrefreshing sleep are the three things required for it to be PEM? If someone had worsening fatigue, brainfog, and vomiting after 24 hours consistently, and the vomiting was considered related to PEM and not some total coincidence, then I...

I added the "not explained by anything else", but otherwise that basically seems like the NICE definition. They don't specify any specific symptoms in this definition. Why not? I think the most potentially useful way to separate PEM from pretty much anything else is that following a delay after...

If someone exercises and consistently 24 hours later they suddenly get a lot more fatigued, what is it if not PEM? Is there an established condition that this fits with? If not, what's the purpose of excluding those people and leaving them with no diagnosis? PEM is just describing a pattern that...