Patients often describe the relapsing of their disease symptoms following physical or mental activity as a “crash” or “hitting the wall”. The biomedical field describes this characteristic and hallmark feature of ME/CFS as post-exertional malaise (PEM) – a term that grossly understates the debility that comes with this disease-defining symptom.
Deciphering PEM is a critically important area of research for ME/CFS; you can’t begin to fix a problem like post-exertional malaise until you can understand its underlying cause. If research can help our understanding of PEM we will move closer to mitigating its effects.
Despite the lack of gravity and specificity a term like “post exertional malaise” signifies, research into what PEM is and how to measure it has been some of the most important research conducted on ME/CFS. It has also been among the most popular. The Journal of Translational Medicine ranks its most highly accessed articles in three categories: “Top Cited Articles of 2014”, “Top Downloaded Articles of 2014” and the “Top Social Articles of 2014”. In this month’s Research Digest we take a look at some of the most highly accessed and shared studies, both of which dealt with PEM.
First in downloads and 3rd in social shares was research conducted by Betsy Keller at Ithaca College titled, “Inability of myalgic encephalomyelitis/chronic fatigue syndrome patients to reproduce VO2peak indicates functional impairment.” Keller used a 2-day cardiopulmonary exercise test (CPET) to show that physiological values in ME/CFS patients worsened on the second CPET, a phenomena unique to ME/CFS patients.
We featured Keller’s work in our May 2014 Research Digest
You can also access it directly via the Journal of Translational Medicine here:
The Dutch Vermeulen team’s article titled, “Decreased oxygen extraction during cardiopulmonary exercise test in patients with chronic fatigue syndrome” ranked second in the Journal of Translation Medicine among “Top Social Articles.” They used CPET to show that oxygen extraction – or the ability of oxygen to be removed from the blood and used by tissues to support metabolism – was significantly lower in ME/CFS patients and could be a causal explanation for exercise intolerance in ME/CFS patients.
You can access the full text of this paper via The Journal of Translational Medicine here:
It is interesting – and exciting – that papers on ME/CFS ranked so high in their review of 2014 downloads and social shares. The Solve ME/CFS Initiative funded some of the first PEM and CPET studies and continues to fund top research to understand and objectively measure PEM (https://solvecfs.org/deciphering-post-exertional-malaise/). We are certain that by doing so, we will be able to solve ME/CFS.
The Solve ME/CFS Initiative is taking strategic steps to speed up progress. Despite our modest budget, SMCI was the first organization to fund research into epidemiology, viral causes, immunology, neuroimaging, exercise physiology and the autonomic nervous system. This is made possible through the support of our donors. The investments made by those suffering with ME/CFS and their loved ones have fueled the Solve ME/CFS Initiative’s work. With your support, we are paving the road to objective diagnosis, treatment and a cure.