The weekly research round-up includes recent publications about ME/CFS and Long Covid. We highlight the studies that have particularly caught our interest and follow these with the full list of publications together with their abstracts (summaries).
The ME Association maintains a comprehensive index of published research on ME/CFS and Long Covid that is free to use and updated weekly.
MEA Comments from Katrina Pears
ME/CFS Research Published 8 – 14 February 2022
There have been five new ME/CFS studies and twelve studies on Long Covid this week.
Only two of the ME/CFS studies this week are published in peer-reviewed journals.
We have highlighted these studies below:
Paper one (1) is a review of evidence on cognitive impairment in ME/CFS and is published in a fairly well-respected journal. The study reviews 764 already published studies, the significant findings of the study showed that ME/CFS effects visuo-spatial immediate memory (ability to perceive, analyse, synthesise, manipulate and transform visual patterns and images), reading speed and graphics gesture (any tap, swipe, drag, pinch, or otherwise interaction).
It is surprising however, that the review found no difference in executive functions (working memory, flexible thinking, and self-control) between ME/CFS patients and healthy controls, especially seeing that brain fog is a major symptom of ME/CFS. I’m also surprised that no striking differences were reported for attention in ME/CFS.
The authors themselves comment how they were surprised with the differences in cognitive function found between patients and that findings were not consistent between studies. This study is limited by the interpretation of results between the studies reviewed. I am personally quite disappointed that this study does not give a more definitive clinical picture and shows the need of one sound methodology to be used to fully evaluate cognitive impairment.
Paper five (5) is on an unusual treatment option, which looks at the benefits of molecular hydrogen (H2). The study used 23 ME/CFS patients who were asked to drink up to five glasses of enriched hydrogen water daily for 28 days. It is thought that enriched hydrogen water provides increased anti-inflammatory and antioxidant properties.
Unfortunately, we cannot access the full research study as it is behind a paywall, however, I do not think that we would gain much by reading this as no significant results were found. Especially seeing as the small improvements in fatigue were reported with the placebo treatment!
I also find this a very unusual research study to come from Fred Friedberg who is a Professor in Applied Behavioural Medicine and is the President of the International Association for CFS/ME (IACFS) and we reported on a series of their conference reports in the Summer. The co-author is Dennis Choi who is a Professor in Neurology.
This week we have also seen a few Long Covid research studies on children and adolescents, which you may be interested in reading, papers two (2), four (4) and five (5) in the Long Covid reference section.
ME/CFS Research References and Abstracts
Kusama Y, Fukui S, Maruyama M, Kamimura K, Maihara T.
Pediatr Int. 2022 Jan;64(1):e14976.
No Abstract available- Full content available online
Aoun Sebaiti M, Hainselin M, Gounden Y, Sirbu CA, Sekulic S, Lorusso L, Nacul L, Authier FJ.
Sci Rep. 2022 Feb 9;12(1):2157.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is commonly associated with cognitive complaints.
To bring out the neuropsychological symptomatology inherent to ME/CFS, we conducted a systematic review according to PRISMA and MOOSE guidelines of the literature through the analysis of 764 studies published between 1988 and 2019 by using PubMed Central website and Clarivate analytics platform.
We performed a meta-analysis to delineate an idea of the neuropsychological profile inherent in ME/CFS. The clinical picture typically affects visuo-spatial immediate memory (g = – 0.55, p = 0.007), reading speed (g = – 0.82, p = 0.0001) and graphics gesture (g = – 0.59, p = 0.0001).
Analysis also revealed difficulties in several processes inherent in episodic verbal memory (storage, retrieval, recognition) and visual memory (recovery) and a low efficiency in attentional abilities.
Executive functions seemed to be little or not affected and instrumental functions appeared constantly preserved.
With regard to the complexity and heterogeneity of the cognitive phenotype, it turns out that determining a sound clinical picture of ME/CFS cognitive profile must go through a neuropsychological examination allowing a complete evaluation integrating the notion of agreement between the choice and the number of tests and the complexity intrinsic to the pathology.
Todd E. Davenport, Staci R. Stevens, Jared Stevens, Christopher R. Snell, J. Mark Van Ness
No Abstract available- Full content available online
Flottorp SA, Brurberg KG, Fink P, Knoop H, Wyller VBB.
Lancet. 2022 Feb 12;399(10325):611-613.
The National Institute for Health and Care Excellence (NICE) in the UK published a new chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) guideline in October, 2021.
The previous NICE 2007 guideline recommended cognitive behavioural therapy (CBT) and graded exercise therapy (GET) for people with mild or moderate CFS/ME based on evidence from randomised trials.
Since then, more randomised trials and systematic reviews have provided additional evidence supporting these recommendations.
No new or more effective interventions have been identified. Although we applaud guideline efforts, it is remarkable that recommendations in the 2021 NICE guideline differ substantially from the previous one, and do not include CBT and GET as means to treat CFS/ME. The new guideline presents strengthened evidence, but a major shift in interpretation. How could this happen?
Fred Friedberg & Dennis Choi
Fatigue: Biomedicine, Health & Behavior
Background: Given the absence of effective medical treatments for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), the testing of a new intervention that may ameliorate potentially pathologic levels of oxidative stress, sympathetic arousal, and inflammation may yield symptomatic improvements.
Objective: To explore in a pilot study, the possible beneficial effect of molecular hydrogen (H2) for the symptoms and functional limitations of ME/CFS.
Methods: Twenty-three subjects were randomized to H2 or active placebo which involved drinking up to five glasses daily of hydrogen-enriched water or placebo water for 28 days. Assessments included: (i) self-report fatigue, physical function, and stress; (ii) salivary C-Reactive Protein (inflammation), Uric Acid (antioxidant status), and Alpha-Amylase (sympathetic function); and (iii) heart rate variability (parasympathetic activity). Data were analysed with Wilcoxon rank-sum tests.
Results: Completion rate for the primary outcome measure of fatigue severity was 100% for the 11 hydrogen participants and 91.7% (n = 11) for placebo participants. No significant changes were found on self-report or biological variables in the active vs. placebo treatment conditions. A small, but significant reduction in fatigue was found in the placebo condition. Adverse effects led to treatment discontinuation in 27.2% of H2 subjects. All severe- and moderate-intensity effects were found in the active treatment condition. Adverse effects were not significantly associated with any demographic or symptom variable.
Conclusions: Therapeutic molecular hydrogen did not yield improvement on any biological or symptom measure in individuals with ME/CFS. Dosage reduction might benefit any future trial of hydrogen therapy in this illness.
Long-COVID Research References
- Long COVID symptoms in SARS-CoV-2-positive adolescents and matched controls (LongCOVIDKidsDK): a national, cross-sectional study
- Physical and mental health 3 months after SARS-CoV-2 infection (long COVID) among adolescents in England (CLoCk): a national matched cohort study
- Clinical patterns of somatic symptoms in patients suffering from post-acute long COVID: a systematic review
- Exploring the Trajectory Recovery Curve of the number of Post-COVID Symptoms: The LONG-COVID-EXP-CM Multicenter Study
- Determinants of Persistence of Symptoms and Impact on Physical and Mental Wellbeing in Long COVID: A Prospective Cohort Study
- Long COVID-19 symptoms: clinical characteristics and recovery rate among non-severe outpatients over a six-month follow-up
Dr Katrina Pears
The ME Association.