Hard to see any relevance, I have almost never heard of those things being any lower in pwME. In fact they might even be above normal. It's not the traditional definition of effort, but when simply existing requires massive effort on a second-by-second basis, that's still a high degree of sustained effort."This is called the anterior mid-cingulate cortex, or the aMCC. Now this region drives motivation, will power and perseverance and sustained effort. And it does this by monitoring available energy in the brain and assessing whether there's sufficient energy to do the thing that you're thinking of doing."
Plus all those "drive motivation, will power and perseverance and sustained effort" as far and as best as current neuroscience defines them, which is obviously crude and superficial.