I came here to post this exact same thing. I saw the big hype on reddit, (this mechanism resonates with me, as I feel hungover and feel like my body/brain just doesn't repair overnight, unrefreshing sleep was my first symptom) and came to check here to understand if this actually had some legs. Very grateful this forum and it's smart contributors exist.
Disrupted Glymphatic Function and Its Relationship with Sleep and Cognitive Impairment in ME/CFS Assessed via DTI-ALPS, 2026, Marshall-Gradisnik et al
- Thread starter John Mac
- Start date
Re-read the abstract, but replace "glymphatic function" with "restaurant spending". I'm pretty sure that a study would show that PWME spend less in restaurants than healthy controls (we feel too lousy to enjoy the experience, plus risk of PEM). It's easy enough to claim that less spending in restaurants "may lead to symptoms such as cognitive dysfunction and sleep disturbance experienced by ME/CFS." Spending probably correlates with severity, and probably also has a gender bias, supporting the theory. How difficult would it be to firmly disprove that theory?
It's far too easy, and without serious drawbacks, to publish studies or theories that promise an easy fix, which gets some people excited.
It's far too easy, and without serious drawbacks, to publish studies or theories that promise an easy fix, which gets some people excited.
MrMagoo
Senior Member (Voting Rights)
@Jonathan Edwards said elsewhere recently that in RA there were over 50 steps or processes that were affected. He would guess with ME there are many, many more otherwise we’d have worked it out sooner.
This was useful as a non-scientist because this sort of “glymphatic clearance” thing doesn’t sound like a lot of steps. It’s likely that when it’s worked out what “ME” is doing it will be really complex, but I’m sure at that point someone will be along to dumb it down into “basically like a corrupted file on a computer” or something.
This was useful as a non-scientist because this sort of “glymphatic clearance” thing doesn’t sound like a lot of steps. It’s likely that when it’s worked out what “ME” is doing it will be really complex, but I’m sure at that point someone will be along to dumb it down into “basically like a corrupted file on a computer” or something.
DMissa
Senior Member (Voting Rights)
same thing with "energy" and the supplement industry
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Still doing the rounds on various aggregator news sites. The findings are a bit all over the place, as Hip pointed out on Reddit: "Anyone have an idea why a new study found the right brain hemisphere glymphatic system faulty in ME/CFS, but an earlier study found the left hemisphere glymphatic system faulty in long COVID"
Our thread is Asymmetrical glymphatic dysfunction in patients with long Covid associated neurocognitive impairment- correlation with BBB disruption (2025)
Whereas this thread's study found —
There's also the earlier study in "recovered" patients Glymphatic system dysfunction in recovered patients with mild COVID-19: A DTI-ALPS study (2023)
Our thread is Asymmetrical glymphatic dysfunction in patients with long Covid associated neurocognitive impairment- correlation with BBB disruption (2025)
Whereas this thread's study found —
There's also the earlier study in "recovered" patients Glymphatic system dysfunction in recovered patients with mild COVID-19: A DTI-ALPS study (2023)
For me, this study is a prime example of how discussions about ME on social media often drift away from science and toward emotional argumentation like "theory/explanation XY is sooooo relatable to how I feel, so it MUST be true".
Another example is like you said the people firmly believing in inflammation as their root cause because their body/brain FEELS inflamed, or the peiple who firmly belief in Covid Viral persistence as a root cause because their symptoms FEEL like the virus gets reactivated.
MrMagoo
Senior Member (Voting Rights)
Well the problem is that people don’t understand the science and that the media (legacy and socials) push out clickbait headlines with simplistic representations of trials. It’s not much different to saying ‘I think there’s nits going round” and watching people start scratching.
The other week it was an issue with a calcium channel effect and people were all threatening to drink milk because it has calcium in, so obviously that would fix the issue.
People just want a simple explanation, and media does to so it can push out a story, and there just isn’t one.
Utsikt
Senior Member (Voting Rights)
There are quite a lot of self-appointed influencers and advocates (including the associations) that contribute to this mess as well.
LizWorthey
Established Member (Voting Rights)
My 2 cents.
The biggest issue is the control group, as others noted. Controls seem to have had no chronic illness or current medical conditions, while the ME/CFS group had substantial sleep disturbance, pain, inactivity, and disability. So the groups were not well matched and given this is a comparator study that would be important.
Something also looks off in Table 3. The standard deviations appear to be missing a decimal place; reported as 0.86 and 0.97 instead of 0.086 and 0.097, which are given elsewhere. The effect sizes also do not seem to be calculatable from the other numbers in the table, even allowing for that error.
The way the regions of interest were selected (manual selection, no mention of blinding) also seems like it could introduce bias? Not my area, but it seems like it could have been done better.
TBH (and likely some won't agree) - I'm always a bit cautious of papers in Frontiers journals. The review quality in these can be pretty variable. Sometimes that means the science isn't as rigorously reviewed as it should be. For example; the errors in reported SDs are items that a reviewer would normally catch. That's not to say that some robust papers aren't in frontiers journals. But I'm always cautious. Same with MDPI.
The biggest issue is the control group, as others noted. Controls seem to have had no chronic illness or current medical conditions, while the ME/CFS group had substantial sleep disturbance, pain, inactivity, and disability. So the groups were not well matched and given this is a comparator study that would be important.
Something also looks off in Table 3. The standard deviations appear to be missing a decimal place; reported as 0.86 and 0.97 instead of 0.086 and 0.097, which are given elsewhere. The effect sizes also do not seem to be calculatable from the other numbers in the table, even allowing for that error.
The way the regions of interest were selected (manual selection, no mention of blinding) also seems like it could introduce bias? Not my area, but it seems like it could have been done better.
TBH (and likely some won't agree) - I'm always a bit cautious of papers in Frontiers journals. The review quality in these can be pretty variable. Sometimes that means the science isn't as rigorously reviewed as it should be. For example; the errors in reported SDs are items that a reviewer would normally catch. That's not to say that some robust papers aren't in frontiers journals. But I'm always cautious. Same with MDPI.
Utsikt
Senior Member (Voting Rights)
Well spotted with the numbers.
Are there really any journals we can have any degree of trust in? I know some are probably worse than others, but I’d be very surprised if any are reliable enough. And that’s before considering that most authors tend to sneak in their interpretations in one way or another even when just presenting the results.
Jonathan Edwards
Senior Member (Voting Rights)
SOme would agree. I would not put a data paper in Frontiers anyway. It has a place for spculate reviews but the review quality is poor.
DMissa
Senior Member (Voting Rights)
I don't put any blind faith into any journal. It is better to put on blinders to the journal and focus on content without preconceptions. I personally know of horror story mistakes in Nature papers. LLMs have made everything worse as well. People paste papers into the chat window and use that as their review. It's farcical.
I will repeat the mantra: focus on the content. No good will come of having positive preconceptions from something being published in a "reputable" journal and missing something that should have been scrutinised more closely. If the opposite is true and a paper in a less reputable journal is scrutinised more closely, so be it, but consciously avoid letting it condition you into lowering your guard in those cases where the "bad journal" cognitive heuristics aren't setting off alarms. We should always be vigilant.
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A senior materials scientist once told me that when he reads a paper, after reading the abstract to find out what the paper purports to be about, he goes straight to the methodology section for a quality check. Said it saved him a lot of time, and it was disappointing how many papers failed at that early stage.
LizWorthey
Established Member (Voting Rights)
I agree - always need to be wary. But some seem worse than others. And Frontiers falls in to the be wary category for me. MDPI for sure also. But they are all in it for the money - publishing science is such a strange system
.
Yann04
Senior Member (Voting Rights)
I agree with the broader point that this paper shouldn’t really be taken seriously since it has loads of problems.
I think metabolic waste can be quite a “quick” thing, not typically something that changes only over weeks but more over hours. I agree the paper claiming causation on this is far fetched but I don’t this the “me changes quickly” discounts it.
Personally I have.
Since the discussion is about the brain's waste removal system that works during deep sleep, it wouldn't cause a dramatic switching of state during daytime. Now I'm wondering whether I might have had some temporary remissions when I was asleep, gone before waking.
DMissa
Senior Member (Voting Rights)
So this is very true but the problem here is you need to be expert in the methodology for this to work. This is why is it essential that a place like this exists where people with different expertise can chime in when it's needed.
Separate tangent:
On the effects of sleep quality: it is very hard to tease apart imo, because even completely healthy people may feel unwell after a night or two of poor sleep. Hard to know whether sleep loss tied to feeling worse in a person with ME/CFS could be a reflection of specific mechanism or just a reflection of how generally impactful sleep is.
As another example, I've been battling a chronic neuro-otological condition this year and sleep quality is the biggest correlate with my symptom severity by far but my condition does not affect my sleep quality and has no specific mechanistic link to sleep that I am aware of or could posit. There was a clear event that immediately caused the sudden onset of my illness and this had no association with sleep, either.
Loss of sleep quality as a reported consequence of illness is probably a cleaner thing to try to dissect in the first instance. That could give us clues about mechanism (what might go wrong that stops someone sleeping well?).
Do people feel that their inability to sleep restoratively (or at all) is inexplicable, or is it borne of discomfort etc that obviously interferes with good sleeping? That would be the first question I would ask. Has this been studied rigorously?
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Which is what a working scientist is supposed to be. Or at least competent enough in the basics to not get it too wrong, too often.