Research Digest 29/11/19

Welcome to the 36th Emerge Australia Research Digest, where you will find summaries of some of the latest research and information about ME/CFS, with links to the complete articles.

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Evidence of altered cardiac autonomic regulation in myalgic encephalomyelitis/chronic fatigue syndrome

Authors: Nelson MJ, Bahl JS, Buckley JD, Thomson RL, & Davison K.
Link: https://journals.lww.com/md-journal/Fulltext/2019/10250/Evidence_of_altered_cardiac_autonomic_regulation.36.aspx

Davison et al conducted a meta-analysis of studies relating to heart rate (HR) parameters with ME/CFS patients and found “significant differences between patients and controls in a number of parameters” namely higher resting HR, lower peak HR, higher orthostatic response HR, lower HR at submaximal exercise threshold, and numerous others.

The results indicate altered regulation of HR in ME/CFS patients due to “reduced vagal modulation and increased sympathetic modulation of HR in patients with ME/CFS.”

The authors note that, while some studies found significant differences between ME/CFS patients and controls on measures of fitness (such as VO2max), those which included a measure to determine if participants had given maximal effort did not find such a difference. The authors concluded that, while some ME/CFS patients may be deconditioned due to lack of activity, deconditioning does not explain all of the differences in HR measures between ME/CFS patients and healthy controls. They emphasise that deconditioning is not a cause, but a consequence of living with ME/CFS.

Although to date HR parameters alone are not enough to be used as diagnostic tools, further research should be conducted to determine its viability and useability in any future diagnostic tests.

A logistic regression analysis of risk factors in ME/CFS pathogenesis

Authors: Lacerda, E.M., Geraghty, K., Kingdon, C.C., Palla, L., & Nacul, L.
Link: https://link.springer.com/article/10.1186%2Fs12883-019-1468-2

This paper explores the risk factors involved in developing ME/CFS, by examining the characteristics of ME/CFS, multiple sclerosis and healthy control samples from the UK ME/CFS Biobank. The study found that a history of frequent colds or flu before onset was the strongest risk factor for later developing ME/CFS. Additionally, being single, having a lower income and a family history (but not personal history) of anxiety were also associated with having ME/CFS.

It is important to note that the study is not implying that being single or on a low income makes someone more likely to develop ME/CFS. Association studies do not allow for the interpretation of cause, however the researchers note that these factors may in fact be reverse causal, that people with ME/CFS may be more likely to be on a low income or single due to the impact of the condition on employment and relationships. Finally, severe ME/CFS was associated with lower age of ME/CFS onset and a family history of neurological illnesses.

A systematic review of natural killer cells profile and cytotoxic function in myalgic encephalomyelitis/chronic fatigue syndrome

Authors: Eaton-Fitch, N., du Preez, S., Cabanas, H., Staines, D., & Marshall-Gradisnik, S.
Link: https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-019-1202-6

This literature review from the team at Griffith University examines research relating to natural killer (NK) cell functionality in ME/CFS patients. Across the seventeen eligible publications in this review, impaired NK cell cytotoxicity (ability to kill abnormal cells) was the most consistently identified abnormality. Changes in NK cell lytic protein levels were also reported. Other results were inconsistent across studies.

The authors note that small sample sizes coupled with differences in methodologies, NK cell subsets studied and diagnostic criteria used between studies are likely to have contributed to the inconsistent results, making comparisons between studies difficult. They recommend that consistent methodology be adopted.

The authors conclude that current research provides a good foundation for further study and suggest that NK cell abnormalities could be a potential biomarker for identifying a subset of ME/CFS patients.

Do your thing, Ricky - with captions

Author: Women with Disabilities Victoria (WDV) Channel
Link: https://www.youtube.com/watch?v=9itwI6_m8k4&feature=youtu.be

This short (7-minute) video, featuring ME/CFS patient advocate Ricky Buchanan, was published by Women with Disabilities Victoria as part of the 'Do Your Thing' series. This video series celebrates a diverse group of women with a disability living in Victoria. The videos focus on each woman's work, passions and connection with their community.

Ricky discusses her journey with ME/CFS over the years, her use of assistive technology to help her manage daily life being bedridden and projects she likes to work on.

One such project is Ricky’s 'Just Invisible' report, which addresses medical access issues for home and bedbound patients. You can read Ricky’s report on her website: https://notdoneliving.net/justinvisible/.

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