Van der Meer says he thinks CFS is due to undetected inflammation in the brain

A recent Dutch article writes about long-term symptoms following COVID-19 and makes the connection to CFS.

Jos van der Meer, one of the Dutch researchers who helped develop the CBT-model for CFS in collaboration with Bleijenberg, is interviewed. The interesting thing is that this article writes that Van Der Meer suspects CFS is due to undetected inflammation in the brain. It writes (translated with DeepL):

The article is titled: "Ook maanden na corona nog extreem moe: ‘Dit is een nieuwe ziekte. En een buitensporige'" en published in de Volkskrant.
https://www.volkskrant.nl/wetenscha...JbeVZm3dlTDzzh-EBj-Zq-bi8PoM1cdboqFfVR9zvNflo

 

While that's interesting to hear, I suspect he would fit into the "bio"-psycho-social side. And, perhaps argue CBT helps undue this ongoing inflammation by calming the brain, reducing negative thoughts and resetting normal patterns.

I had heard the NIH or OMF or perhaps both we're collecting brains for autopsy - but I haven't heard anything since. I wish it was just inflammation, but I'm afraid that's something every patient has tried and failed to some degree. Steriods and the like. Seems like just a simple non-info "inflammation you can never detect". I can't believe that's true today.

 

I don't entertain the idea that he has changed his opinions since:
https://www.researchgate.net/public...ort_in_Patients_With_Chronic_Fatigue_Syndrome

The whole discussion section simply assumes (as a bias) that there is no peripheral issues, particularly with regard to afferent input and places the blame solely on dysfunctional effort beliefs and symptom focusing, as influenced by this paper:
https://pubmed.ncbi.nlm.nih.gov/22641838/

Also, they made this claim in their conclusion:

Their trial was first registered in December 2013, protocol published in 2015 they've had two years to test the hypothesis, and well, nada...

 

Danish BPS proponents also argue something is wrong in the brain and use it to justify the biology part of the bio-psycho-social model of functional illnesses (they have no evidence obviously, and are as vague about it as possible to avoid being proven wrong).

 

one of the premises of 'psychoneuroimmunology' is geared towards 'inflammation of the brain' for numerous mental health issues. This is just an extension of that.
The other 'favourite' is cortisol which bPS proponents claim to be able to alter with CBT.

Psychoneuroimmunology: Psychology's Gateway to the Biomedical Future
https://journals.sagepub.com/doi/10.1111/j.1745-6924.2009.01139.x
https://sci-hub.tw/10.1111/j.1745-6924.2009.01139.x#

while there may be something in it on a purely biological level (eg VanElzakkers work), the danger comes when psychologists use it to justify psychotherapies with no directly related biomedical evidence.

 

However it is approached, the two things should not be conflated by anyone:

• Physiological inflammation in the brain, versus
• Hotchpotch notions of how CBT might supposedly fix such things.

Wonder they've not suggested CBT as a fix for meningitis (or maybe they have?).

 

A great response by a psychologist on a study by van der Meer about CBT changing grey matter.

https://academic.oup.com/brain/article/132/6/e110/322958#

 

Mike Van Elzakker has talked about facilitating access for ME/CFS patients brains at the Harvard brain bank (one of the worlds biggest brain banks). I can't see anything formally written but there are several tweets by him discussing setting the process up.
https://twitter.com/user/status/1208020680522051584

https://twitter.com/user/status/1208077560648585216

 

That article sounds worrying overall. Van der Meer is not a good person to have involved.

 

Many Swedish BPS proponents too, for example the Jonsjö/Olsson team with their ME = "sickness behaviour" hypothesis.

Inflammation seems to be a major part of behavioural studies nowadays, for example in so called "psychoneuroimmunology", "psychoneuroendocrinology" etc. Especially in the context of stress, fatigue, burnout, depression etc. But the focus seems to be on how inflammation (or the "sickness behaviour" that lingers after an inflammation) changes the patient's behaviour/feelings/thoughts, not the inflammation itself.

Proposed treatments are, unsurprisingly, ACT, CBT, graded activity/graded exposure etc.

 

That's really interesting. I'd heard the meme that they'd shown CBT led to changes in the brain--I think Wessely made that point somewhere. But I had no idea that they did the same thing essentially that Wessely and Chalder did in their most recent study--they measured changes before and after CBT and attributed the changes to the CBT. The comparison in the brain study was a group of healthy controls, measured at the same two time points but with no CBT. It makes no sense. You need a control group of patients who don't get CBT to say anything about whether CBT did anything.

In reading the abstract, I see where the fallacy might come in. The rightness of CBT is a given--they're not testing CBT. It's already been proven to work. They're testing whether the known benefits from CBT are also reflected in brain changes. If you know the CBT already works, then any brain changes that you can claim are linked to the specific cognitive problems facing patients were obviously also induced by the CBT.

 

Apparently that paper was one of the most cited CFS papers of the last decade. There was a thread on it here: https://www.s4me.info/threads/incre...ith-cfs-2008-de-lange-et-al.7465/#post-133014

 

Wow, so they really improved from the CBT increasing cortisol study (https://www.kcl.ac.uk/ioppn/depts/pm/research/cfs/publications/assets/2009/Robertssalivary.pdf), where they opted for no control group at all. And that reasoning is exactly given in the the cortisol paper. You can't have controls because you can't depirve them of an effective treatment.

 

i.e. Them saying it would be unethical and/or impractical to do it scientifically, therefore they consider it legitimate and 'scientific' to do it unscientifically. A common theme for many BPS'ites, and an argument that seems to convince many.

 

Nerve issues do not equal psychological issues.

I learned the following method from @rvallee:

Repeat several times: Nerve issues do not equal psychological issues. Nerve issues do not equal psychological issues. Nerve issues. Do not equal. Psychological issues.