Trial Report People with Long Covid and ME/CFS Exhibit Similarly Impaired Dexterity and Bimanual Coordination: A Case-Case-Control Study, 2024, Sanal-Hayes

[Dolphin]

https://www.amjmed.com/article/S0002-9343(24)00091-3/fulltext
People with Long Covid and ME/CFS Exhibit Similarly Impaired Dexterity and Bimanual Coordination: A Case-Case-Control Study

• Nilihan E.M. Sanal-Hayes, PhD
• Lawrence D. Hayes, PhD
• Marie Mclaughlin, PhD
• Ethan C.J. Berry, BSc (Hons)
• Nicholas F. Sculthorpe, PhD

Open Access
Published: February 23, 2024
DOI:https://doi.org/10.1016/j.amjmed.2024.02.003

Abstract

Purpose
Dexterity and bimanual coordination had not previously been compared between people with long COVID and people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Therefore, this study determined dexterity and bimanual coordination in people with long COVID (∼16 month illness duration; n=21) and ME/CFS (∼16 year illness duration; n=20), versus age-matched healthy controls (n=20).

Methods
Dexterity, and bimanual coordination was determined using the Purdue pegboard test.

Results
The main findings of the present investigation were that people with ME/CFS and people with long COVID were generally comparable for Purdue pegboard tests (p>0.556 and d<0.36 for pairwise comparisons). It is worth noting however, that both these patient groups performed poorer in the Perdue pegboard test than healthy controls (p<0.169 and d>0.40 for pairwise comparisons).

Conclusions
These data suggest that both people with long COVID and people with ME/CFS have similarly impaired dexterity, and bimanual coordination. Therefore, there is an urgent need for interventions to target dexterity and bimanual coordination in people with ME/CFS, and given the current pandemic, people with long COVID.

Key words

• Dexterity
• Bimanual Coordination
• Myalgic Encephalomyelitis
• Chronic Fatigue Syndrome
• Post-Exertional Malaise
• Purdue Pegboard Test
• Neural

https://twitter.com/user/status/1761903725046636553

 

[Sean]

This is the kind of study there needs to be a lot more of. Basic motor functions, including gait, balance, coordination, etc. Properly controlled for PEM, of course.

 

[Hutan]

Notes the multiple overlaps of LC with ME/CFS
Notes that ME/CFS is a debilitating condition
Notes that there is no known cure or definitive treatment

Mechanistically, it would seem logical that people with ME/CFS (and to an extent long COVID, given the overlap in symptomology) would exhibit lower dexterity as a result of central fatigue demonstrated by several twitch interpolation studies which identified unaltered peripheral fatiguability 44,45. Indeed, Sacco et al. 46 reported reduced amplitude of motor potentials evoked by transcranial magnetic stimulation (TMS) of the motor cortex in the biceps brachii muscle, concluding diminution in central motor drive in people with ME/CFS. Similarly, brain areas associated with bimanual coordination include primary sensorimotor areas 47,48, supplementary motor area 49,50, premotor cortex 49,50, prefrontal cortex 48, motor cingulate 48, basal ganglia 48,51, and the cerebellum50,52.

This 'ruling out peripheral fatiguability thing' - I'm getting the sense from some references I've read lately that it's not as straightforward as that. That the tests that are supposed to separate out peripheral fatigue from central fatigue aren't as clear cut, the signals aren't as pure, as has been supposed. I think we (I) need to understand more about motor evoked potentials and nerve conduction... There are some references given here that might be worth following up on.

Schrijvers et al. 54 revealed that individuals with chronic fatigue syndrome (CFS) performed slower than controls in a line-copying task that required motor effort and demonstrated an overall fine motor slowing.

'Fine motor slowing' wouldn't be great if you were doing, oh, I don't know, maybe a button tapping task with your non-dominant little finger... (reference to the NIH study)

 

[Hutan]

Differences in mean BMI - LC=34; ME/CFS=31; control =24
Could that affect dexterity?

The study itself doesn't have any electrophysiology stuff, it's just purely measures of success with fine motor tasks.

There is a lot of overlap in the results of the LC and ME/CFS groups with the control group e.g. a typical chart - controls are green


On rehabilitation:

Therefore, data presented herein suggests fine motor disability may be a symptom of the underlying pathology of ME/CFS and long COVID. This is pertinent because upper extremity function, particularly in the fingertips, is imperative for daily activities and quality of life 55,56. Consequently, rehabilitation programs directed at enhancing fine motor skills could be of interest to these patient groups, with the aim of enhancing quality of life. However, individuals with ME/CFS and long COVID experience severe fatigue, so rehabilitation should be approached cautiously and probably confined to a subset of individuals.

On psychosomaticism:

Patient groups frequently express a conflict between their emphasis on physical symptoms and clinical services that may perceive the illness as psychosomatic, potentially harming the care and well-being of patients and leading to misdiagnosis, mistreatment, and stigmatisation
64
. The findings of this study align with the growing body of evidence affirming that both ME/CFS and long COVID involve authentic physiological symptoms impacting health and well-being, necessitating direct attention. Looking forward, future research should focus on uncovering the mechanisms underlying long COVID and ME/CFS, as well as developing interventions to improve outcomes.

 

[Sean]

Consequently, rehabilitation programs directed at enhancing fine motor skills could be of interest to these patient groups,

*sigh*

 

[Midnattsol]

Differences in mean BMI - LC=34; ME/CFS=31; control =24
Could that affect dexterity?

Yes, but at the same time how fat tissue is deposited on the body can vary a lot, so the size of an effect would be uncertain.