Parallels between post-polio fatigue and CFS: A Common Pathophysiology?, 1998, Bruno

[Hutan]

Mentioned in this thread Differentiating post-polio syndrome from myalgic encephalomyelitis and chronic fatigue syndrome, 2019, Jason et al

Richard L. Bruno, HD, PhD, et al. American Journal of Medicine,1998, 105 (3A): 66-73.
https://www.papolionetwork.org/uplo...en_post-polio_fatigue_and_chronic_fatigue.pdf

Abstract

Fatigue is the most commonly reported and most debilitating Post-Polio Sequelae (PPS) affecting the more than 10 million worldwide polio survivors. Post-polio fatigue is characterized by subjective reports of difficulty with attention, cognition and maintaining wakefulness, symptoms reminiscent of nearly two dozen outbreaks during this century of post-viral fatigue syndromes (PVFS) that are related clinically, historically, anatomically or physiologically to poliovirus infections.

Recent studies that relate the symptoms of post-polio fatigue and Chronic Fatigue Syndrome (CFS) to clinically significant deficits on neuropsychological tests of attention, histopathologic and neuroradiologic evidence of brain lesions, impaired activation of the hypothalamic-pituitary-adrenal axis, increased prolactin secretion and EEG slow wave activity are reviewed. Described will be a possible common pathophysiology for post-polio fatigue and CFS, based on the Brain Fatigue Generator Model of PVFS, and a possibility pharmacotherapy for PVFS based on the replacement of brain dopamine.

 

[Mithriel]

I will take their word for it that fatigue is the commonest problem with post polio syndrome but I think this is similar to the way the commonest symptom of ME. Very common, but not the most important.

My friend has PPS from the polio she had as a child but can still exercise at a gym, go on holiday and go out easily though she has brain fog and tires more than she would like. She has been told that the muscle attachments (something like that) are weakened by polio and as they are used over the years they break so many survivors end up needing wheelchairs and stairlifts.

She has splints and uses a stick at times. It bears little resemblance to ME.

 

[ladycatlover]

I remember reading about Post Polio Syndrome back when this paper came out. Back then it seemed to me to be very similar to ME. I still think that's the case. Post Polio is another viral post viral syndrome, it may be a bit different to ME, but in my view it's certainly in the same family.

 

[Snow Leopard]

The Bruno 1998 paper has been discussed quite a bit over the years, here and on related forums such as Phoenix Rising.

His book is somewhat controversial, but he brings up some interesting points.

Here is a woman with lived experience of post-polio reflecting on the book and her experience:
https://www.afterfiftyliving.com/a-message-to-the-boomer-post-polio-generation/

My friend has PPS from the polio she had as a child but can still exercise at a gym, go on holiday and go out easily though she has brain fog and tires more than she would like. She has been told that the muscle attachments (something like that) are weakened by polio and as they are used over the years they break so many survivors end up needing wheelchairs and stairlifts.

There seem to be two potential facets, permanent axonal damage (permanent weakness) and ME type symptoms. Some post-polio patients may primarily have the former, or only mild ME-like symptoms. Others may have more severe ME-like symptoms, limiting those activities you decribed.

I also note parallels between post-polio, ME and post-Guillain Barre Syndrome, where around a third of GBS have long term ME-like symptoms and yes, they do suffer from the same PEM-like patterns.

I propose a speculative hypothesis that it might not be the initial axonal damage per se that is contributing to the additional symptoms, but dysfunction of the axonal regeneration process and effects on endothelial function.