Wishing everyone a great 2015

Emergency CBT 4 professor Simon Wessely as the NIH wants to retire the Oxford criteria

198 patients immunized with sera from recovering polio patients developed ME, 1st known as atypical polio, rather than polio !!

http://www.masscfids.org/resource-library/15-conference-reports/444-dr-byron-hyde-2012-fall-lecture-summary#LAEpidemic 1934 Los Angeles ME epidemic: Dr. Hyde had the opportunity to examine two physicians who had become ill during the 1934 polio epidemic outbreak at the Los Angeles (LA) County Hospital. According to Dr. Hyde’s slide, 198 healthcare workers, who were immunized with sera from recovering patients, fell ill with ME, but not polio. He believes in this case that the combination of an immunization and viral infection triggered their ME. The two doctors sued the hospital and the city of LA and received about 2 million dollars each. Dr. Hyde’s hypothesis is that this was a wake-up call for insurance companies to dismiss the illness and from then onward, anything resembling ME was mocked. There were times then, and even now, where ME patients were put into psychiatric hospitals and labeled as crazy (plus they were given drugs that made them sick). So, when CFS came along, it seemed to follow the same pattern. Same illness, different name, same outcome.

Jeremy Laurance trying 2 work out Simon Wessely's contribution ...

Jeremy Laurance trying 2 work out Simon Wessely's contribution in getting ME patients proper treatment

The DIFFERENCE between a debilitating disease and wesselian shite ...

Postexertional neuroimmune exhaustion (PENE pen’-e): Compulsory
This cardinal feature is a pathological inability to produce sufficient energy on demand with prominent symptoms primarily in the neuroimmune regions. Characteristics are as follows:
1. Marked, rapid physical and/or cognitive fatigability in response to exertion, which may be minimal such as activities of daily living or simple mental tasks, can be debilitating and cause a relapse.
2. Postexertional symptom exacerbation:e.g.acute flu-like symptoms, pain and worsening of other symptoms.
3. Postexertional exhaustion may occur immediately after activity or be delayed by hours or days.
4. Recovery period is prolonged, usually taking 24 h or longer. A relapse can last days, weeks or longer.
5. Low threshold of physical and mental fatigability (lack of stamina) results in a substantial reduction in pre-illness activity level.

PENE is also objectively verifiable and measurable using the 2-day cardiopulmonary exercise test (CPET):

"A test-retest cardiopulmonary exercise study revealed a drop of 22% in peak VO2 and 27% in VO2 at AT [anaerobic threshold] on the second day evaluation. [39] Both submaximal and self-paced exercise resulted in PENE. [40] These impairments and the loss of invigorating effects distinguish ME from depression." [IC Primer, page 2]

The cardinal feature of CFS, on the other hand, is subjective, self-reported, unexplained fatigue that can only be assessed using variable responses to questionnaires.

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2796.2011.02428.x/full

CHRISTMAS party in CBT land ...

Psychiatrist charged with 52 counts of fraud

A psychiatrist has been charged with 52 counts of health care billing fraud mainly involving nursing home residents or patients who died. Dr. Robert Hadley Gross of San Angelo faced a court appearance Thursday in Abilene. Federal prosecutors in Lubbock say Gross was arrested Wednesday at his office on charges that he defrauded Medicare and Medicaid of more than $1.7 million. http://m.washingtonexaminer.com/texas-psychiatrist-charged-with-52-counts-of-fraud/article/feed/2173684

Professor, What The Hell Is POTS?

BEDBOUND woman named a Point of Light by Prime Minister David Cameron

A BEDBOUND woman from Bookham whose illness inspired her to start a charity bringing joy to hundreds of sick children has received an award from the Prime Minister on her 30th birthday. Vikki George was named a Point of Light by David Cameron on Sunday in recognition of her charity Post Pals, which endeavours to cheer up seriously ill children with cards, letters and gifts. The 30-year-old's achievements are all the more poignant given her diagnosis with severe myalgic encephalomyelitis, commonly known as ME, at the age of 17. The condition has, over the past five years, affected her ability to walk, talk or even lift her head. Read more: http://www.dorkingandleatherheadadvertiser.co.uk/Bedbound-woman-Bookham-honoured-Prime-Minister/story-25762525-detail/story.html#ixzz3N0usbYVW   Follow us: @dorkingnews on Twitter  | dorkingleatherheadad on Facebook

Merry Christmas and a Happy New Year 2 u ALL !!

BREAKING NEWS: revealed the text of the death threat against Simon Wessely, and it was issued by ...

"@VKatDH @CosmopolitanUK I can now retire and die happy....my work is done.... 3:11pm - 18 Dec 14"

the text of the "death threat" against Simon Wessely, and it was issued by the man himself !!

NIH P2P: PACE Trial using the Oxford criteria is seriously flawed

"38 The Oxford criteria (published in the Journal of the Royal 39 Society of Medicine in February 1991) are flawed and include people with other conditions, 40 confounding the ability to interpret the science." "378 Specifically, continuing to use the Oxford definition may impair progress and cause 379 harm. Thus, for needed progress to occur we recommend (1) that the Oxford definition be 380 retired" SOURCE: https://prevention.nih.gov/docs/programs/mecfs/ODP-MECFS-DraftReport.pdf

CBT: Christmas Beard Time

Howard University: Ampligen strongly inhibites the Ebola minigenome

Hemispherx Announces:

December 09, 2014 09:51 ET | Source: Hemispherx Biopharma, Inc.

PHILADELPHIA, Dec. 9, 2014 (GLOBE NEWSWIRE) -- Hemispherx Biopharma, Inc. (NYSE MKT:HEB) (the "Company" or "Hemispherx"), announced today that it has received a new research report (dated December 5, 2014) from researchers at Howard University, Washington DC. The report describes a study in which Ampligen® (Poly I : Poly C₁₂U) strongly inhibited the Ebola minigenome in the human embryonic kidney cell system. The Ebola minigenome replication system was recently described by the researchers in the Journal of Biological Chemistry (2014) (Role of Protein Phosphatase 1 in Dephosphorylation of Ebola Virus VP30 Protein and Its Targeting for the Inhibition of Viral Transcription; Ilinykh et al. 289(33):22723-22738). In the minigenome replication system, certain genetic information for viral proteins has been deleted from the genomic array to permit safer and more efficient laboratory manipulations.

Most importantly, the current Howard University results taken in conjunction with previous data on anti-Ebola actions of Ampligen® reported by other US and European collaborators, indicate that the antiviral molecular actions of Ampligen® may be triggered at levels reached by the common human treatment regimens of Ampligen which have historically been used in clinical studies in a variety of other human diseases. These regimens of Ampligen®, an experimental therapeutic, have been deployed to date over 100,000 times in over 1,000 patients. Today's report also extends the histologic range of human cell types in which Ampligen® has demonstrated strong bioactivity against Ebola at low drug concentrations. Ebola is known to multiply in many different parts of the body destroying multiple types of cells, leading to high morbidity and mortality rates.

Recent articles in New England Journal of Medicine (November 27, 2014) emphasize that in subsets of severely ill EVD patients, parenteral therapy, rather than oral based treatments, will be necessary. Ampligen®, an experimental therapeutic, may be able to meet this requirement.

Previously, the Department of Life and Environmental Sciences, University of Cagliari, Italy reported that Ampligen® can successfully bind to the lethal EVD viral protein designated VP35. VP35 protein normally inactivates a patient's immune/antiviral system by binding to viral dsRNA thereby sequestering a critical antiviral/immune activator of the body which leads to high morbidity and death rates. The experimental outcome achieved by the Cagliari University is consistent with recent predictions published in the Nature group Emerging Microbes and Infections (3, e77; doi:10.1038/emi.2014.77; published online 29 October 2014) by affiliates of Hemispherx.

Another recent US government research report observed that the inhibiting concentration (EC50) of Ampligen® for Ebola was very low relative to the Ampligen® serum levels achievable in humans (See November 3, 2014 press release entitled Hemispherx Biopharma and United States Army Medical Research Institute of Infectious Diseases (USAMRIID) Collaborate on Alferon® and Ampligen® Against the Ebola Virus… Initial Ebola Studies of Alferon® and Ampligen® at USAMRIID Show Protective Activity of Both Compounds at Low Concentrationshttp://www.hemispherx.net/content/investor/default.asp?goto=805 ). Together, the three recent reports by Howard University, University of Cagliari, and USAMRIID scientists set the stage for accelerated clinical development of Ampligen® for prevention and treatment of EVD.

Our overall objectives include plans to continue seeking approval for commercialization of Ampligen® in the United States and abroad as well as to widen existing commercial therapeutic indications of Alferon® N Injection® presently approved in the United States and Argentina. In addition, we have formed collaborations with multiple research laboratories around the world to examine Ampligen®, an experimental therapeutic, and Alferon® N, an FDA-approved commercial product as potential preventatives for, and treatments of, Ebola Virus Disease. 

About Alferon® N

Alferon® N is the only natural source, multi-species alpha interferon currently approved for sale in the U.S. Alferon® N is approved in the U.S. only for the treatment of refractory or recurring external genital warts caused by human papilloma virus in patients 18 years of age, or older. Positive results against Ebola in vitro have been reported to the Company by the United States Army Medical Research Institute of Infectious Diseases (USAMRIID). Clinical trial data will be necessary to establish human efficacy of Alferon® N for Ebola virus.

About Ampligen®

Ampligen®, an experimental therapeutic, is a new class of specifically-configured ribonucleic acid (RNA) compounds targeted as potential treatment of diseases with immunologic defects and/or viral causation. Ebola virus specifically inhibits the dsRNA within cells via a sequestration process. Such RNA would otherwise cause a robust antiviral response to be mounted: Ampligen may be able to overcome this deficiency in host response. Positive results against Ebola in vitro have been reported to the Company by the United States Army Medical Research Institute of Infectious Diseases (USAMRIID) and other research/academic institutions. Clinical trial data will be necessary to establish human efficacy of Ampligen® for Ebola viruses.

About Hemispherx Biopharma

Hemispherx Biopharma, Inc. is an advanced specialty pharmaceutical company engaged in the manufacture and clinical development of new drug entities for treatment of seriously debilitating disorders especially life-threatening viruses. Hemispherx's flagship products include Alferon® N Injection® and the experimental therapeutics Ampligen® and Alferon® LDO. Ampligen® is an experimental RNA nucleic acid being developed for globally important debilitating diseases and disorders of the immune system, including Chronic Fatigue Syndrome. Hemispherx's platform technology includes components for potential treatment of various severely debilitating and life threatening diseases including cancers. Because both Ampligen® and Alferon® LDO are experimental in nature, they are not designated safe and effective by a regulatory authority for general use and are legally available only through clinical trials. Hemispherx has patents comprising its core intellectual property estate and a fully commercialized product (Alferon® N Injection®), approved for sale in the U.S. and Argentina. The FDA approval of Alferon® N Injection® is limited to the treatment of refractory or recurrent external genital warts in patients 18 years of age or older. The Company's Alferon N Injection® approval in Argentina includes the use of Alferon N Injection® (under the brand name "Naturaferon") for use in any patients who fail, or become intolerant to recombinant interferon, including patients with chronic active hepatitis C infection. Most newer regimens for creating apparent "cures" in chronic active hepatitis C disease require interferon as a vital component of a successful treatment regimen. The Company wholly owns and exclusively operates a GMP certified manufacturing facility in the United States for commercial products. For more information please visit www.hemispherx.net.

Disclosure Notice

The information in this press release includes certain "forward-looking" statements including without limitation statements about additional steps which the FDA may require and Hemispherx may take in continuing to seek commercial approval of the Ampligen^® NDA for the treatment of Chronic Fatigue Syndrome in the United States. The production of new Alferon® API inventory will not commence until validation phases are complete. While the facility is approved by FDA under the Biological License Application ("BLA") for Alferon®, this status will need to be reaffirmed upon the completion of the facility's enhancements prior to commercial sale of newly produced inventory product. If and when we obtain a reaffirmation of FDA BLA status and have begun production of new Alferon® API, we will need FDA approval as to the quality and stability of the final product to allow commercial sales to resume. The final results of these and other ongoing activities could vary materially from Hemispherx's expectations and could adversely affect the chances for approval of the Ampligen® NDA in the United States and other countries. Any failure to satisfy the FDA regulatory requirements or the requirements of other countries could significantly delay, or preclude outright, approval of the Ampligen^® NDA in the United States and other countries. 

Information contained in this news release, other than historical information, should be considered forward-looking and is subject to various risk factors and uncertainties. For instance, the strategies and operations of Hemispherx involve risk of competition, changing market conditions, changes in laws and regulations affecting these industries and numerous other factors discussed in this release and in the Company's filings with the Securities and Exchange Commission. The final results of these efforts could vary materially from Hemispherx's expectations.

Forward-Looking Statements

To the extent that statements in this press release are not strictly historical, all such statements are forward-looking, and are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Words such as "intends," "plans," and similar expressions are intended to identify forward-looking statements. The inclusion of forward-looking statements should not be regarded as a representation by Hemispherx that any of its plans will be achieved. These forward-looking statements are neither promises nor guarantees of future performance, and are subject to a variety of risks and uncertainties, many of which are beyond Hemispherx's control, which could cause actual results to differ materially from those contemplated in these forward-looking statements. Examples of such risks and uncertainties include those set forth in the Disclosure Notice, above, as well as the risks described in Hemispherx's filings with the Securities and Exchange Commission, including the most recent reports on Forms 10-K, 10-Q and 8-K. You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date hereof, and Hemispherx undertakes no obligation to update or revise the information contained in this press release, whether as a result of new information, future events or circumstances or otherwise revise or update this release to reflect events or circumstances after the date hereof. No evidence is suggested that Alferon® N, Alferon® LDO and/or Ampligen will ever be commercially approved for the new potential treatment indications mentioned in this release.

Company/Investor Contact
Charles Jones
CJones & Associates Public Relations
Office: 888-557-6480
Cell: 305-987-7418
Email:

- See more at: http://globenewswire.com/news-release/2014/12/09/689822/10111624/en/Hemispherx-Announces-Data-Showing-Inhibition-of-Ebola-by-Ampligen-R-Enlarged-by-Howard-University-Research.html#sthash.cbim3z1y.dpuf

CBT Psychiatry 4 ME defined by MLK Jr

 

"Injustice anywhere is a threat to justice everywhere." - MLK, Jr.

BREAKING NEWS: top secret picture of todays NIHp2p meeting

Prof, "CBT is a scam and a waste of money", says leading psychologist

By Jenny Hope, Medical Correspondent for the Daily Mail:

PUBLISHED: 18:23 GMT, 10 November 2014 | UPDATED: 18:25 GMT, 10 November 2014

People with mental health problems are victims of  a ‘scam’ therapy that is wasting vast sums of money, a leading psychologist has warned.

They are being misled because the short-term fix offered by Cognitive Behavioural Therapy (CBT) does not have a lasting benefit, says Oliver James.

The most popular of the ‘talking therapies’ CBT aims to help people manage their problems by changing the way they think and behave to become more positive.

It is frequently recommended for people with problems ranging from anxiety and depression to eating disorders.

In the short-term, 40 per cent of those who complete a course of CBT, typically five to 20 sessions of up to an hour, are said to have recovered.

But ‘extensive evidence’ shows that two years on, depressed or anxious people who had CBT were no more likely to have recovered than those who had no treatment, said Mr James.

He said: ‘As a treatment, rafts of studies have shown it to be ineffective in delivering long-term therapeutic benefits to patients with anxiety and depression.

‘While studies show that in the short-term - six to 12 months - patients who have received CBT are more likely to report themselves as ‘recovered’ compared to those who have received no treatment, these results are not sustained in the long-term.

‘CBT is largely ineffective for the majority of patients. It is in essence a form of mental hygiene.

‘However filthy the kitchen floor of your mind, CBT soon covers it with a thin veneer of ‘positive polish’.

Unfortunately, shiny services tend not to last. CBT fails to address the root cause of many people’s problems, which often stem from traumatic experiences during their childhood.

The UK Government has pledged up to £400 million on treatment programmes which mostly use CBT and it is recommended as frontline NHS treatment for many mental health issues. 

Mr James, a chartered psychologist, author and broadcaster, delivered his argument to the CBT industry at the Limbus Critical Psychotherapy Conference in Devon this weekend.

WHAT IS CBT? 

CBT, or Cognitive Behaviour Therapy, is a talking therapy. 

It has been proved to help treat a wide range of emotional and physical health conditions in adults, young people and children. 

CBT looks at how a person thinks about a situation and how this affects the way they act. 

In turn actions can affect how a person thinks and feels.

The therapist and client work together in changing the client’s behaviours, or their thinking patterns, or both of these.

He and other psychotherapists are calling on the Government and policymakers to refocus funding into alternative talking treatments, such as psychodynamic therapy, which focus on addressing the root cause of people’s cognitive problems.

The NHS has been advised that CBT may be offered to patients with a range of conditions by the National Institute for Health and Clinical Excellence (NICE), the guideline body.

It is free on the NHS after referral by a GP but not available in all areas and there can be long waiting lists.

The cost of private therapy sessions varies, but it is usually £40 - £100 a session.

Many mental health groups welcome the shift in emphasis in recent years away from medication towards personalised therapy.

But Mr James says research shows CBT is no more effective than placebo in treating anxiety or depression

He says proponents have ‘mis-sold’ the treatment to policymakers and the public, who are wasting their time.

P2P ME/CFS Workshop Infographic updated version

psychiatrists with Functional Disorders !!

money power ignoring evidence 2 further their own careers aka psychiatrists with Functional Disorders !!

Names of members of Staff with Functional Disorders in Denmark !!

Names of members of Staff with Functional Disorders in Denmark u can find HERE : http://funktionellelidelser.dk/en/about-the-clinic/staff/

Medieval psychiatry at Hammel Neurocenter DENMARK

"Also, please note that we have no further information to share on Karina's current condition, as no one from the family has seen her for over a year." Justice for Karina Hansen, October 8 at 5:55pm 2014. @ https://www.facebook.com/story.php?story_fbid=885102518176124&id=100000291531400&comment_id=887044924648550&offset=0&total_comments=24&notif_t=share_comment&ref=m_notif&refid=48#!/story.php?story_fbid=774252402636219&id=521548841239911 no one from the family has been ALLOWED to see Karina for over a year in a western european country, ABSOLUTELY DISGRACEGUL !!!

how can Karina Hansen have a somatoform disorder causing Brain damage ?

sounds like more psycho crap. Those drs need to be tried at the Hague for crimes against humanity. doing jail time with the lifers!!! where is amnesty ???

Ms Chowdhury, did she overdose on CBT and NLP ??‏

What gets me down about having severe M.E. ...

What gets me down about having severe M.E... Its not the poverty or the loneliness or the total sleep disruption -all or nothing- 0r even the loss of my previous life as a qualified dental nurse that gets me down, nor the fact I was a talented painter attnding uni for my "B.A. Hons.fine art history and practice" with a view to teaching, (but now due to loss of spatial judgement I can't even draw, and can't read books now due to cognitive dysfunction). And its not that I miss my weekly horse riding hacks or the regular long walks I loved (beach, forest, mountain) or being unable to communicate verbally,  nor my severely restricted diet (without which I am faecally incontinent,)  it is not being house and bedbound for many years now, Nor that I can't use my wheelchair any more to "walk" my own dog,  Nor the constant muscle and joint pain,  Its not even the severe cognitive dysfunction and endless headaches, it isn't the total isolation of being confined to one darkened room. IT IS the total loss of my credibility and complete lack of support directly resulting from the ubiquitous disbelief that has been deliberately generated by political machinations of rich healthy Psychiatrists blithely working outside their field for financial gain (i.e. M.E. is Neurological thus totally not their Dept) . Excuse my spelling, I have M.E. x by Sally Katch1na.

pushed into severe disability by graded exercise

Many of us were pushed into severe disability by graded exercise. The last thing we need is yet more psychobabble.

See also: GET (graded exercise therapy) is torture for ME patients and directly contravenes the do NO Harm principle of the GMC

Summary of AfME's severe ME symposium ...

Message 4 Hammel NC ....

I vote for squirrels. They eat nuts instead of behaving like them ...

RSNA Press Release: MRI Identifies Brain Abnormalities in Chronic Fatigue Syndrome Patients

@ RSNA (Radiological Society of North America):

RSNA Press Release

MRI Identifies Brain Abnormalities in Chronic Fatigue Syndrome Patients

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Released: October 29, 2014

At A Glance

• MRI showed that patients with chronic fatigue syndrome (CFS) had lower white matter volume and other abnormalities in their brains.
• CFS is a debilitating disease, characterized by profound fatigue and brain fog that do not improve with bed rest, lasting for at least six months.
• Currently, there is no standalone test for diagnosing CFS.

RSNA Media Relations
1-630-590-7762
media@rsna.org

Linda Brooks
1-630-590-7738
lbrooks@rsna.org

Emma Day
1-630-590-7791
eday@rsna.org

OAK BROOK, Ill. — Researchers using a combination of different imaging techniques have found structural abnormalities in the brains of people with chronic fatigue syndrome (CFS), according to a new study published online in the journal Radiology. The results suggest a potential role for imaging in diagnosing and treating the condition.

CFS is characterized by profound fatigue and "brain fog" that do not improve with bed rest, lasting for at least six months. The condition affects more than 1 million adults and children in the United States, according to the Centers for Disease Control and Prevention. Diagnosis is complicated and usually involves ruling out many other conditions. There is no standalone test to diagnose CFS.

download full-size photo

Michael M. Zeineh, M.D., Ph.D.

"This is a very common and debilitating disease," said the study lead author Michael M. Zeineh, M.D., Ph.D., assistant professor of radiology at Stanford University School of Medicine in Stanford, Calif. "It's very frustrating for patients, because they feel tired and are experiencing difficulty thinking, and the science has yet to determine what has gone wrong."

For the new study, Dr. Zeineh worked with a Stanford CFS and infectious disease expert, Jose G. Montoya, M.D., to perform magnetic resonance imaging (MRI) on 15 CFS patients and 14 age- and gender-matched controls. They applied three different MRI techniques: volumetric analysis to measure the size of different compartments of the brain, diffusion tensor imaging (DTI) to assess the integrity of the signal-carrying white matter tracts of the brain, and arterial spin labeling (ASL) to measure blood flow.

When they compared results between the CFS patients and the controls, they found that the CFS group had slightly lower white matter volume, meaning there was less overall white matter in the brain. The CFS group also had abnormally high fractional anisotropy (FA) values—a DTI measure of the diffusion of water— in a specific white matter tract called the right arcuate fasciculus, suggesting something was going on in the white matter in the right hemisphere.

"Within CFS patients, right anterior arcuate FA increased with disease severity," Dr. Zeineh said. "The differences correlated with their fatigue—the more abnormal the tract, the worse the fatigue."

The results suggest that FA at the right arcuate fasciculus may serve as a biomarker for CFS that can help track the disease.

The imaging study also found abnormalities among CFS patients at the two points in the brain that connect the right arcuate fasciculus. Each connection point, known as a cortex, was thicker in CFS patients.

"This is the first study to look at white matter tracts in CFS and correlate them with cortical findings," Dr. Zeineh said. "It's not something you could see with conventional imaging."

Although the study involved only 15 CFS patients, the technique already shows tremendous promise as a diagnostic tool for identifying people with CFS, according to Dr. Zeineh.

"We used automated techniques to look at these tracts and were able to achieve 80 percent accuracy for CFS detection," he said.

Dr. Zeineh added that the findings need to be replicated and expanded upon in future studies to refine understanding of the relationship between brain structure and CFS.

"Right Arcuate Fasciculus Abnormality in Chronic Fatigue Syndrome." Collaborating with Drs. Zeineh and Montoya were James Kang, M.D., Scott W. Atlas, M.D., Mira M. Raman, M.S., Allan L. Reiss, M.D., Jane L Norris, P.A., and Ian Valencia, B.S.

Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc. (http://radiology.rsna.org/)

RSNA is an association of more than 53,000 radiologists, radiation oncologists, medical physicists and related scientists, promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)

For patient-friendly information on MRI of the brain, visit RadiologyInfo.org.

Stanford University: Right Arcuate Fasciculus Abnormality in Chronic Fatigue Syndrome

@ pubmed:

Radiology. 2014 Oct 29:141079. [Epub ahead of print]

Right Arcuate Fasciculus Abnormality in Chronic Fatigue Syndrome.

Zeineh MM1, Kang J, Atlas SW, Raman MM, Reiss AL, Norris JL, Valencia I, Montoya JG.

Author information

• 1From the Department of Radiology, Lucas Center for Imaging, Stanford University School of Medicine, 1201 Welch Rd, Room P271, Stanford, CA 94305-5488.

Abstract

Purpose To identify whether patients with chronic fatigue syndrome ( CFS chronic fatigue syndrome ) have differences in gross brain structure, microscopic structure, or brain perfusion that may explain their symptoms. Materials and Methods Fifteen patients with CFS chronic fatigue syndrome were identified by means of retrospective review with an institutional review board-approved waiver of consent and waiver of authorization. Fourteen age- and sex-matched control subjects provided informed consent in accordance with the institutional review board and HIPAA. All subjects underwent 3.0-T volumetric T1-weighted magnetic resonance (MR) imaging, with two diffusion-tensor imaging ( DTI diffusion-tensor imaging ) acquisitions and arterial spin labeling ( ASL arterial spin labeling ). Open source software was used to segment supratentorial gray and white matter and cerebrospinal fluid to compare gray and white matter volumes and cortical thickness. DTI diffusion-tensor imaging data were processed with automated fiber quantification, which was used to compare piecewise fractional anisotropy ( FA fractional anisotropy ) along 20 tracks. For the volumetric analysis, a regression was performed to account for differences in age, handedness, and total intracranial volume, and for the DTI diffusion-tensor imaging , FA fractional anisotropy was compared piecewise along tracks by using an unpaired t test. The open source software segmentation was used to compare cerebral blood flow as measured with ASL arterial spin labeling . Results In the CFS chronic fatigue syndrome population, FA fractional anisotropy was increased in the right arcuate fasciculus (P = .0015), and in right-handers, FA fractional anisotropy was also increased in the right inferior longitudinal fasciculus ( ILF inferior longitudinal fasciculus ) (P = .0008). In patients with CFS chronic fatigue syndrome , right anterior arcuate FA fractional anisotropy increased with disease severity (r = 0.649, P = .026). Bilateral white matter volumes were reduced in CFS chronic fatigue syndrome (mean ± standard deviation, 467 581 mm3 ± 47 610 for patients vs 504 864 mm3 ± 68 126 for control subjects, P = .0026), and cortical thickness increased in both right arcuate end points, the middle temporal (T = 4.25) and precentral (T = 6.47) gyri, and one right ILF inferior longitudinal fasciculus end point, the occipital lobe (T = 5.36). ASL arterial spin labeling showed no significant differences. Conclusion Bilateral white matter atrophy is present in CFS chronic fatigue syndrome . No differences in perfusion were noted. Right hemispheric increased FA fractional anisotropy may reflect degeneration of crossing fibers or strengthening of short-range fibers. Right anterior arcuate FA fractional anisotropy may serve as a biomarker for CFS chronic fatigue syndrome . © RSNA, 2014 Online supplemental material is available for this article.

PMID:

 

25353054

Patients with CFS found to have reduced white matter and other brain abnormalities

By LIZZIE PARRY, 30 October 2014, @ dailymail.co.uk

• Study at Stanford University examined MRI scans of CFS patients comparing them to those of healthy volunteers
• Found three distinct differences in different parts of the brain 
• CFS patients found to have lower levels of white matter - which carries information and signals between different parts of the brain 
• A tract connecting the frontal and temporal lobes was found to be abnormal
• And grey matter - which processes information - in those two areas of the brain was thicker in CFS patients 
• Hopes the discovery will lead to better diagnosis and treatment of condition
• Adds weight to debate over legitimacy of the condition, which is constantly questioned and mistaken as being hypochondria  

By LIZZIE PARRY FOR MAILONLINE

PUBLISHED: 10:28 GMT, 30 October 2014 | UPDATED: 12:50 GMT, 30 October 2014

The brains of those diagnosed with chronic fatigue syndrome are distinctly different to those of healthy people, scientists have discovered.

The study promises to add weight to the debate over the legitimacy of the condition, which is repeatedly called into question.

A team of researchers at Stanford University School of Medicine believe their findings could lead to more definitive diagnoses of the syndrome and better treatments.

And it is thought the study could help point to an underlying mechanism governing the disease.

It is not uncommon for CFS patients to face misunderstanding of their condition, plagued by suspicions of hypochondria.

But the abnormalities identified in this study, published in the journal Radiology, will, it is hoped, go some way to helping resolve those ambiguities.

Lead author Michael Zeineh, assistant professor of radiology, said: 'This is a very common and debilitating disease.

'It's very frustrating for patients, because they feel tired and are experiencing difficulty thinking, and the science has yet to determine what has gone wrong.

'Using a trio of sophisticated imaging methodologies, we found that CFS patients' brains diverge from those of healthy subjects in at least three distinct ways.'

The condition affects between one and four million in the US and millions more worldwide.

Putting a definitive figure on the number of sufferers is difficult, because CFS can be difficult to diagnose.

While all patients share a common symptom - crushing, unremitting fatigue that persists for six months or longer - additional symptoms can vary from one patient to the next, often overlapping with other conditions. 

Professor Jose Montoya, the study's senior author, said: 'CFS is one of the greatest scientific and medical challenges of our time.

'Its symptoms often include not only overwhelming fatigue but also joint and muscle pain, incapacitating headaches, food intolerance, sore throat, enlargement of the lymph nodes, gastrointestinal problems, abnormal blood-pressure and heart-rate events, and hypersensitivity to light, noise or other sensations.' 

We asked ourselves whether brain imaging could turn up something concrete that differs between CFS patients' and healthy people's brains. And, interestingly, it did

The combination of symptoms can devastate a patient's life for decades.

In an effort to identify the syndrome's underlying mechanisms, Professor Montoya has been following 200 CFS patients for several years.

'In addition to potentially providing the CFS-specific diagnostic biomarker we've been desperately seeking for decades, these findings hold the promise of identifying the area or areas of the brain where the disease has hijacked the central nervous system,' he said.

Dr Zeineh added: 'If you don't understand the disease, you're throwing darts blindfolded.

'We asked ourselves whether brain imaging could turn up something concrete that differs between CFS patients' and healthy people's brains.

'And, interestingly, it did.' 

The researchers compared brain images of 15 CFS patients chosen from the group Professor Montoya has been following, to those of 14 age and sex-matched healthy volunteers.

The volunteers had no history of fatigue or other conditions causing symptoms similar to those of CFS. 

Their analysis yielded three noteworthy results.

First, an MRI scan showed that overall white matter content of CFS patients' brains was reduced compared to that of healthy participants' brains.

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Researchers at Stanford University found three differences after performing MRIs on a group of CFS patients and a control group of healthy volunteers with no history of CFS. File picture

The term 'white matter' denotes the long, cable-like nerve tracts carrying signals and information through dispersed concentrations of 'grey matter' - which specialise in processing information.

While Dr Zeineh said the first finding wasn't entirely unexpected, the second was.

Using advanced imaging techniques, he and his colleagues identified a consistent abnormality in a particular part of a nerve tract in the right hemisphere of CFS patients' brains.

The tract, which connects the frontal lobe with the temporal lobe, assumed an abnormal appearance in CFS patients. 

Furthermore, Dr Zeineh said the study identified a strong link between the degree of abnormality in the patient's tract and the severity of their CFS.

The third finding highlighted a thickening of the grey matter in the frontal lobe and temporal lobe in CFS patients, compared with the control group.

Dr Zeineh said while their results are 'quite robust', more research is needed. 

'This study was a start. It shows us where to look,' he said, adding the team are planning a substantially larger study.

   

October 29, 2014 | by Lisa Winter @ iflscience.com

Brain Abnormalities Discovered in Patients With Chronic Fatigue Syndrome

photo credit: Radiological Society of North America

Up to 4 million Americans experience Chronic Fatigue Syndrome (CFS), which are periods of extreme fatigue lasting at least 6 months. A recent study published in Radiology by lead author Michael Zeineh of the Stanford University School of Medicine found that patients with CFS have a reduced amount of white matter in their brains, as well as abnormalities in both the white and gray matter of the right hemisphere. 

CFS has been notoriously difficult to diagnose, as the symptoms are obscure and could apply to many other disorders. Though the symptoms can be intense and severely reduce quality of life, it is hard to definitively name CFS as the culprit.

“CFS is one of the greatest scientific and medical challenges of our time,” senior author Jose Montoya said in a press release. “Its symptoms often include not only overwhelming fatigue but also joint and muscle pain, incapacitating headaches, food intolerance, sore throat, enlargement of the lymph nodes, gastrointestinal problems, abnormal blood-pressure and heart-rate events, and hypersensitivity to light, noise or other sensations.”

The researchers have been involved in long-term study of 200 CFS patients in hopes of developing new effective treatments. This quest has been difficult, as the disease had not previously turned up physical markers that medication would be able to target. 

“If you don’t understand the disease, you’re throwing darts blindfolded,” Zeineh added. “We asked ourselves whether brain imaging could turn up something concrete that differs between CFS patients and healthy people’s brains. And, interestingly, it did.”

In fact, the team found three critical commonalities between the brains of CFS patients that set them apart from those without the disorder. Interestingly, the intensity of the brain abnormalities correlated with the intensity of their condition.

Compared to healthy individuals, people with CFS have a diminished amount of white matter in the brain. White matter is composed of nerve fibers, which help connect the neurons in the gray matter that actually process information. CFS is believed to be associated with inflammation, which would cause this effect.

The team also found that white matter in the right hemisphere of the brain appears abnormal in the region of the brain that connects the frontal lobe and temporal lobe, called the right arcuate fasciculus. The frontal lobe has a wide range of functions including using dopamine to regulate attention, motivation, and reward. The temporal lobe is responsible for processing sensory information, storing memories, and controlling emotions. 

In addition to the abnormal white matter, the right arcuate fasciculus was also shown to have additional gray matter among CFS patients compared to healthy individuals. 

“In addition to potentially providing the CFS-specific diagnostic biomarker we’ve been desperately seeking for decades, these findings hold the promise of identifying the area or areas of the brain where the disease has hijacked the central nervous system,” Montoyaexplained.

While the team got a lot of great data from this study, further analysis is needed in order to confirm the findings. The researchers will need to fully understand the mechanism behind these abnormalities before potential treatments can be explored

 “This study was a start,” Zeineh concluded. “It shows us where to look.”

Professor Michael Zeineh, radiologist, Stanford University: Brain scans show brain Changes in ME/CFS

By Michelle Fay Cortez @ bloomberg.com:

Brain Changes Point to Root of Chronic Fatigue in Study

By Michelle Fay Cortez  Oct 29, 2014 5:00 AM GMT+0100 

Brain scans may identify people with chronic fatigue syndrome, 
a finding that might point toward potential treatment targets for 
the mysterious ailment marked by unrelenting exhaustion, 
researchers said.

A small study using advanced imaging techniques showed chronic fatigue patients had less white matter than a healthy comparison group, as well as structural variations in the right hemisphere of the brain. The finding released today in the journal Radiology is one of the first that shows a concrete difference in people with the condition, which is currently diagnosed only by ruling out other ailments.

More work is needed to understand why the changes occur and determine whether they can be used to help fashion treatments for the ailment that affects as many as 4 million Americans, the researchers said. The findings may offer relief to patients who can struggle for years to get a diagnosis and are often told the cause is psychological, said lead researcher Michael Zeineh.

“We wanted to see what’s going on with chronic fatigue syndrome in the brain,” Zeineh, an assistant professor of radiology at Stanford University School of Medicine, said in a telephone interview. “We know these patients are suffering and traditional methods don’t show anything.”

The researchers examined brain scans of 15 patients and compared the results with 14 healthy people the same age and gender without the condition. The decrease in white matter makes sense because some scientists believe the disease stems from chronic inflammation. Inflammation can harm white matter, the brain tissue composed of nerve fibers that carry signals and connect the brain’s different regions.

Brain Connector

They also got abnormal readings when they looked at the right arcuate fasciculus, which