News From Jarred Younger / Neuroinflammation, Pain, and Fatigue Laboratory at UAB, From Aug 2020

Has there been any updates on Younger's leukocyte tracking scan or his PET and MRI scans in ME/CFS patients? He mentioned the PET scan should be done in 2024 but it seems like its been a while since he's given any new info.
 
Eddie said:
Has there been any updates on Younger's leukocyte tracking scan or his PET and MRI scans in ME/CFS patients? He mentioned the PET scan should be done in 2024 but it seems like its been a while since he's given any new info.
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Here are the two ME/CFS neuroimaging studies out of his university that I can see. I think the first is the one you're asking about. Both still say "recruiting".

Tracking Peripheral Immune Cell Infiltration of the Brain in Central Inflammatory Disorders Using [Zr-89]Oxinate-4-labeled Leukocytes.
Primary/Study Completion (Estimated)
2028-10

Assessment of Neuroinflammation in Central Inflammatory Disorders Using [F-18]DPA-714.
Primary/Study Completion (Estimated)
2026-04-10
 
"Sorry for being gone for so long! Here are some new analyses from my lab that show elevated lactate in the myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) brain. I believe these results show that ME/CFS involves brain inflammation.

You can find the article mentioned in the video here:
https://pubmed.ncbi.nlm.nih.gov/30617782/

The brain images presented use this tool: https://neurotorium.org/tool/brain-atlas/

Jarred Younger"

051 - What is this lactate in the ME/CFS brain?
 
The lactate theory seems to vaguely gibe with effort preference theory or functional disorder. I'm not saying that in pejorative sense; I think it's possible that some part of the brain gets hypersensitized to what normally causes fatigue as in "key targets of inflammation causing drastically reduced activity". But I'm rather dismissive of the subtype theory. It's difficult to imagine multiple different direct causes resulting in same set of key symptoms. If there are indeed three distinct subtypes, I'd think they are more likely downstream expressions of the cause rather than the causes themselves.
 
poetinsf said:
The lactate theory seems to vaguely gibe with effort preference theory or functional disorder. I'm not saying that in pejorative sense; I think it's possible that some part of the brain gets hypersensitized to what normally causes fatigue as in "key targets of inflammation causing drastically reduced activity". But I'm rather dismissive of the subtype theory. It's difficult to imagine multiple different direct causes resulting in same set of key symptoms. If there are indeed three distinct subtypes, I'd think they are more likely downstream expressions of the cause rather than the causes themselves.
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I don't have a strong opinion on subgroups but don't think we have good reasons for ruling them out.

The key symptoms of ME/CFS are still vague enough to result from different processes. As we have seen in other threads, PEM is not one unique thing and is described differently in different people. I think it is hard to know if people with other conditions like MS or cancer would experience a definition of PEM and be included in ME/CFS if they didn't have a different diagnosis. The intermural study showed that some people that fit the definition of ME/CFS don't have it.

The mechanism that causes symptoms in ME/CFS might be caused by different upstream processes. In this case ME/CFS would not be one thing, and it would probably require different treatments to fix the same problem. If ME/CFS symptoms were caused by low oxygen in the brain for example, this could be for multiple reasons. Each reason might cause symptoms in the same way but would need different treatments.

I don't think the existence of subgroups changes how we approach the issue though. If there are subgroups we need to investigate those cases and understand them so we can remove them from the pool of ME/CFS people.
 
"A scan that measures your brain fuel

A technique called 31P magnetic resonance spectroscopy allows us to measure how much critical adenosine triphosphate (ATP) you have in your brain. This scan may show us why people with ME/CFS have limited resources for sustained physical or mental activity. - Jarred Younger"

 


I'm a bit confused with this video, isn't he jumping the gun by saying in the future we'll be able to get treated by this technology? How does he know it works, if it's not been fully tested yet?
 
It’s high frequency focused ultrasound (HIFU) and is currently approved as a treatment for essential tremor and tremor dominant Parkinson’s. It works really well for those conditions but a friend who works in Parkinson’s told me that it hasn’t taken off because it is not profitable for hospitals or neurosurgeons bc of the way procedures like this are reimbursed in US. So that has delayed adoption. Not sure about the devices he’s talking about. The company I know of is called Insightec.

Don’t know how it could conceivably work for ME, or how you get approval for such a powerful device to be used in a study without a lot of evidence it could work..

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Braganca said:
I
Don’t know how it could conceivably work for ME
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Younger talks about morphing microglia from inflammatory state to anti-inflammatory one. But he doesn't say how HIFU does that. It seems to me drugs are a better way if the inflammation is wide-spread as he thinks. I don't know why he would be turning to a focused energy device when he already has two "promising" drugs he wants to trial.
 
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