Tai Chi increases functional connectivity and decreases chronic fatigue syndrome: A pilot intervention study with machine learning and fMRI analysis

Abstract
Background
The latest guidance on chronic fatigue syndrome (CFS) recommends exercise therapy. Tai Chi, an exercise method in traditional Chinese medicine, is reportedly helpful for CFS. However, the mechanism remains unclear. The present longitudinal study aimed to detect the influence of Tai Chi on functional brain connectivity in CFS.

Methods
The study recruited 20 CFS patients and 20 healthy controls to receive eight sessions of Tai Chi exercise over a period of one month. Before the Tai Chi exercise, an abnormal functional brain connectivity for recognizing CFS was generated by a linear support vector model. The prediction ability of the structure was validated with a random forest classification under a permutation test. Then, the functional connections (FCs) of the structure were analyzed in the large-scale brain network after Tai Chi exercise while taking the changes in the Fatigue Scale-14, Pittsburgh Sleep Quality Index (PSQI), and the 36-item short-form health survey (SF-36) as clinical effectiveness evaluation. The registration number is ChiCTR2000032577 in the Chinese Clinical Trial Registry.

Results
1) The score of the Fatigue Scale-14 decreased significantly in the CFS patients, and the scores of the PSQI and SF-36 changed significantly both in CFS patients and healthy controls. 2) Sixty FCs were considered significant to discriminate CFS (P = 0.000, best accuracy 90%), with 80.5% ± 9% average accuracy. 3) The FCs that were majorly related to the left frontoparietal network (FPN) and default mode network (DMN) significantly increased (P = 0.0032 and P = 0.001) in CFS patients after Tai Chi exercise. 4) The change of FCs in the left FPN and DMN were positively correlated (r = 0.40, P = 0.012).

Conclusion
These results demonstrated that the 60 FCs we found using machine learning could be neural biomarkers to discriminate between CFS patients and healthy controls. Tai Chi exercise may improve CFS patients’ fatigue syndrome, sleep quality, and body health statement by strengthening the functional connectivity of the left FPN and DMN under these FCs. The findings promote our understanding of Tai Chi exercise’s value in treating CFS.

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0278415

 

huh?

someone should get the journal to check their sources!

 

Tai Chi was one of the things I tried a long time ago, maybe in the 90s, maybe the 80s. It made me worse. I suspect some mild patients might find it helpful, but I doubt any patient who is severe or worse will benefit. I think many will get worse.

 

"Since the body is fatigued, whether CFS patients should avoid exercise was a controversial topic in the past [10]. However, with several milepost-type randomized trials demonstrating the usefulness of exercise [11–13] and growing evidence in support of it [14, 15], the view that exercise therapy is a potential effective treatment for CFS has been accepted and recognized [14, 16]. In addition, the National Institute for Health and Care Excellence updated its guidelines to recommend exercise therapy for CFS [17]. Hence, as the value of exercise therapy in treating CFS reaches a consensus, the focus of the discussion on CFS should also include why and where exercise therapy works."


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11. Sharpe M, Goldsmith KA, Johnson AL, Chalder T, Walker J, White PD. Rehabilitative treatments for chronic fatigue syndrome: long-term follow-up from the PACE trial. Lancet Psychiatry. 2015;2: 1067–1074. pmid:26521770

12. White PD, Goldsmith KA, Johnson AL, Potts L, Walwyn R, DeCesare JC, et al. Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial. Lancet. 2011;377: 823–836. pmid:21334061

13. Clark LV, Pesola F, Thomas JM, Vergara-Williamson M, Beynon M, White PD. Guided graded exercise self-help plus specialist medical care versus specialist medical care alone for chronic fatigue syndrome (GETSET): a pragmatic randomised controlled trial. Lancet. 2017;390: 363–373. pmid:28648402

14. Cheshire A, Ridge D, Clark L, White P. Guided graded Exercise Self-help for chronic fatigue syndrome: patient experiences and perceptions. Disabil Rehabil. 2020;42: 368–377. pmid:30325677

15. Clark LV, McCrone P, Pesola F, Vergara-Williamson M, White PD. Guided graded exercise self-help for chronic fatigue syndrome: Long term follow up and cost-effectiveness following the GETSET trial. J Psychosom Res. 2021;146: 110484. pmid:33895431

16. Dannaway J, New CC, New CH, Maher CG. Exercise therapy is a beneficial intervention for chronic fatigue syndrome (PEDro synthesis). Br J Sports Med. 2018;52: 542–543. pmid:28982730

17. Turner-Stokes L, Wade DT. Updated NICE guidance on chronic fatigue syndrome. BMJ. 2020; m4774. pmid:33328173

An 'interesting' selection of references there - no IOM 2015, nor despite the Turner-Stokes, Wade whinge of 2020 being in there, any ref to NICE 2021.

In reality treatment with Tai Chi was never going to produce a negative result under the current regime in China - at least not one that would be published, the same goes for TCM - Traditional Chinese Medicine (prop. Chairman Mao)

It's also relevant that few, if any, Chinese studies state compliance with the Declaration of Helsinki, this is specially important where outcomes are dependent on subjective responses from participants - heavy pressure to show how excellent both ancient custom and modern Chinese science are, precludes participants giving a negative view of their experience.