Brain inflammation

A great response by a psychologist on a study by van der Meer about CBT changing grey matter.

https://academic.oup.com/brain/article/132/6/e110/322958#

 

Mike Van Elzakker has talked about facilitating access for ME/CFS patients brains at the Harvard brain bank (one of the worlds biggest brain banks). I can't see anything formally written but there are several tweets by him discussing setting the process up.
https://twitter.com/user/status/1208020680522051584

https://twitter.com/user/status/1208077560648585216

 

That article sounds worrying overall. Van der Meer is not a good person to have involved.

 

Many Swedish BPS proponents too, for example the Jonsjö/Olsson team with their ME = "sickness behaviour" hypothesis.

Inflammation seems to be a major part of behavioural studies nowadays, for example in so called "psychoneuroimmunology", "psychoneuroendocrinology" etc. Especially in the context of stress, fatigue, burnout, depression etc. But the focus seems to be on how inflammation (or the "sickness behaviour" that lingers after an inflammation) changes the patient's behaviour/feelings/thoughts, not the inflammation itself.

Proposed treatments are, unsurprisingly, ACT, CBT, graded activity/graded exposure etc.

 

That's really interesting. I'd heard the meme that they'd shown CBT led to changes in the brain--I think Wessely made that point somewhere. But I had no idea that they did the same thing essentially that Wessely and Chalder did in their most recent study--they measured changes before and after CBT and attributed the changes to the CBT. The comparison in the brain study was a group of healthy controls, measured at the same two time points but with no CBT. It makes no sense. You need a control group of patients who don't get CBT to say anything about whether CBT did anything.

In reading the abstract, I see where the fallacy might come in. The rightness of CBT is a given--they're not testing CBT. It's already been proven to work. They're testing whether the known benefits from CBT are also reflected in brain changes. If you know the CBT already works, then any brain changes that you can claim are linked to the specific cognitive problems facing patients were obviously also induced by the CBT.

 

Apparently that paper was one of the most cited CFS papers of the last decade. There was a thread on it here: https://www.s4me.info/threads/incre...ith-cfs-2008-de-lange-et-al.7465/#post-133014

 

Wow, so they really improved from the CBT increasing cortisol study (https://www.kcl.ac.uk/ioppn/depts/pm/research/cfs/publications/assets/2009/Robertssalivary.pdf), where they opted for no control group at all. And that reasoning is exactly given in the the cortisol paper. You can't have controls because you can't depirve them of an effective treatment.

 

i.e. Them saying it would be unethical and/or impractical to do it scientifically, therefore they consider it legitimate and 'scientific' to do it unscientifically. A common theme for many BPS'ites, and an argument that seems to convince many.

 

Nerve issues do not equal psychological issues.

I learned the following method from @rvallee:

Repeat several times: Nerve issues do not equal psychological issues. Nerve issues do not equal psychological issues. Nerve issues. Do not equal. Psychological issues.

 

Merged
"Evidence supports presence of encephalitis"
1995, Charles Shepherd
*****************

https://www.bmj.com/content/310/6990/1330.2

 

I think Charles may have changed his mind about that. He was later in favour of changing the name from myalgic encephalomyelitis to myalgic encephalopathy on the grounds that inflammation was not established.

And although Charles has been a great advocate he may not be the best authority on neuropathology.