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I recognised the name right away. She is one of the ME4ICC hardliners who were much more prominent about a decade ago. Will probably tell you Byron Hyde figured out ME decades ago. That sort of thing.

The first author is a long-time collaborator and colleague of Michael Maes. I hope they are happy with their editorial, which was likely written by AI.

It's also open for comments and intended to be a living document. I don't know if S4ME or anyone here has had any input yet.

Very good. This final line here is a very important point. Something I'd wanted to flag for a while. PEM can be unpredictable. You can't automatically assume PEM will be induced by, e.g., an exercise test, even if it's over someone's usual capacity.

https://forward-me.co.uk/fme-briefing-paper-on-clinical-assessment-of-people-with-very-severe-me-cfs/

If you mean in-cell hijacking of energy production / metabolism by viruses, then yes, I supose that wouldn't involve central processes.

But wouldn't such mitochondrial or energy issues be downstream of some sort of 'signalling' ultimately coming from the brain?

I think a central mechanism is much more likely given cognitive effort causes very similar or identical issues to physical exertion/effort.

The Wust study is an outlier in that they specificially recruited LC patients meeting CCC. That is unusual. The usual approach is just to study long covid patients. Some studies go on to identify different subsets and phenotypes. So yes, there is a lot of research on all forms of long covid...

Thanks @Hutan

I wrote about this here (https://bjsm.bmj.com/content/60/8/600.responses#post-exertional-malaise-cannot-be-reduced-to-exercise-intolerance-and-often-does-not-respond-well-to-traditional-rehabilitation-approaches) in response to a paper by Charlton + Wust plus Putrino and Systrom, which itself...

Exercise intolerance involves any abnormal symptoms during exertion, most notably fatigue, chest pain, rapid heart rate, and shortness of breath. The focus is almost always on physical exertion and it is often attributed to deficits/dysfunction of the cardiopulmonary and respiratory systems —...

Rob Wust replied, stating that they only enrolled LC patients with PEM, which is not quite what I asked but I don't think I'm going to probe much further.

Fibromyalgia seems like a rather less well-defined syndrome and I worry about misdiagnosis. It really seems to capture anyone with unexplained chronic (widespread) pain, and the crossover with anxiety and depression is perhaps more pronounced. There used to be a focus on tenderness and fascia...

I find this bizzare. I have asked Rob on Twitter whether they actively selected for LC meeting CCC, but it would not surprise me if they didn't, given their insistence that basically everyone with LC has PEM. The fact that this LC group could be considered an LC-ME/CFS group would have...

Now in press at Nature Communications: https://www.nature.com/articles/s41467-026-75725-y

I am sceptical about relating HRV to PEM. That's not what I've observed, at least based on nighttime readings (which apparently are the most accurate). I am sceptical of the view that HR can be used as a proxy for some sort of cardiovascular threshold over which PEM is induced. I very much...

Copied post The Lincolnshire NHS Specialist ME/CFS service has created a series of videos. They are unlisted on YouTube. I came across the video series via the Lancashire ME/CFS service's webpage. See the drop down boxes at the bottom of the page...

This is silly. There's no involvement of Wessely in this project. Wessely is simply one of hundreds of clinicians and academics who have had an NIHR Senior Investigator award at some point. Not sure which trust this is referring to. Probably the Cornwall Partnership NHS Foundation Trust, which...

Yes, this is one of those public health topics that remains under-the-radar despite growing evidence that it is somewhat harmful to everyone, not just those with asthma.