I hope this is OK to post here! I know Mike personally and was confused about his research and funding situation so I asked him to clarify and thought I would share. Also, his experience as a young researcher was interesting to me as a patient, and thought maybe some other people would be curious.
Currently, Mike is spearheading two studies on ME.
1) The first is a dual PET/MRI brain scan. This study is already fully funded. He is looking for evidence of neuroinflammation, which presents in the form of active microglia. These tiny cells work as the "immune system" of the central nervous system, and if they are active it means inflammation is present. The MRI part of the scan shows the brain’s structure, which allows for a targeted analysis of the PET part of the scan. PET is a kind of scan that uses nuclear tracers to measure activity and it can pick up on inflammation. Doing these two scans together shows the neuroscientist exactly where any inflammatory activity is located. This is a replication of sorts of Nakatomi 2014 which showed evidence of neuroinflammation, but using updated methods. (Read Mike’s recent paper on research methods
here.) Mike has been able to secure a donation of weekend scan time from Massachusetts General Hospital (MGH), and a generous family has donated the rest of the money needed.
2) The second study involves PEM provocation. This study
still needs funds to complete. Patients are given an MRI/fMRI brain scan and then sent to fellow researcher David Systrom for an invasive CPET. After they are rife with PEM exhaustion, they are scanned again. (I am grateful to the patients who agree to this torture!)
The two studies may give more information when analyzed together. Mike is targeting the brainstem which is the brain’s seat of autonomic function. He feels it is a likely culprit of neuroinflammation, and that optimal techniques have not yet been used to study this area of the brain. While PET may be useful in identifying neuroinflammation in a research setting, the radioligands (radioactive dyes) Mike is using with PET aren’t available widely in community hospitals for clinical tests. MRIs, on the other hand, are widely available. While you can’t see neuroinflammation on an MRI, an analysis such as fMRI can infer inflammation. So by correlating these two studies, it may be possible to develop a widely available test that physicians could use to support an ME diagnosis.
Mike is working on funding for the MRI/fMRI study. When possible, he works with patients and their doctors to have the iCPET clinically ordered so their insurance will pay for it. This is helpful because the test costs roughly $16,000. But not every patient or control can have the cost covered this way. MGH is donating “developmental” scan time for this study as well, and his collaborator Ken Kwong is donating time. (Ken Kwong invented the fMRI!) He is hoping for more private donations, and to use pilot data to apply for grants.
He is part of the Harvard Research Collaborative run by the OMF. I think that is Pineapple funding? Money has not been disbursed yet and Mike isn't sure if he will receive any, but he's hoping some of the bloodwork in his fMRI/MRI/iCPET study will be funded.
Mike hasn’t been eligible so far for NIH funding because he was starting out from scratch and they don't give grants for pilot work. Since he has accrued some scans at this point, he can use that data to apply for a grant for his MRI/fMRI study. Mike says NIH grant applications are labor intensive. The NIH will fund
only 20% of applications received. So it can be inefficient to commit the necessary time and rigor to apply with little hope of receiving funding. Mike doesn't have a large staff with a grant writer or anything like that so he would be doing a lot of the work himself. As we know, the NIH has said that they are unwilling to increase funding for ME/CFS until they receive more grant applications. Mike feels it’s worth applying as an act of advocacy for the community, even if he has little chance of receiving funds.
I know in the past he’s been hesitant to ask patients for money because so many of us are not working, on disability, or trying to get on disability. He’s very aware of how strained the community is regarding donations. He has a donor page but doesn’t promote it much for this reason and prefers to find other ways to get funding. But I feel any little bit helps!
Hearing Mike’s side of things has been interesting for me as a patient, but in many ways disheartening. A career in ME is not a path you take as a researcher if you want a lot of accolades or a lucrative path. It’s not prestigious. Funding is a huge challenge. If your assigned peer reviewer is from the UK and thinks ME is psychological, it’s an obstacle to publishing. You have to be passionate about helping patients like us. Mike lives on a shoestring in Boston which is one of the most expensive cities in the US. He rents a room which is only marginally bigger than my bathroom, and works a second job teaching classes at Tufts year round to make the rent. Research is not just about the science work -- time must be spent reading journals to stay current, working on funding, networking to find quality collaborators, recruiting patients. Ushering data to publication involves many steps and takes years.
It’s frustrating to me that the NIH has a stance of sitting back and waiting for applications before they’ll commit to the funding this disease deserves. Koroshetz has said
it’s difficult for young researchers to get started because of uncertainty in the field, and yet the NIH is doing so little to support young people starting out, like Mike. A lot of our researchers are friends and family who happen to have medical or research training. While it’s wonderful that they have the compassion to help, we need a larger pool of people willing to work on ME in order to move the field forward. And that takes money.
A lot of us are burned out on advocacy but we need to keep at it!