The Solve ME/CFS Initiative is proud to support the research of Dr. Dane Cook, Co-Director of the Exercise Psychology Laboratory and Director of the Marsh Center for Research in Exercise and Movement at the University of Wisconsin-Madison, as he continues his work on post-exertional malaise (PEM) that was launched with the help of a Solve ME/CFS Initiative award. PEM has been described as a debilitating exacerbation of the entire constellation of ME/ CFS symptoms following even mild physical or mental exertion. PEM is the “hallmark” symptom of ME/CFS. Clinical descriptions and results from research strongly suggest that PEM affects multiple physiological systems, consistent with the evidence that ME/CFS is a chronic multi-system disease.
In a recent SMCI-funded study from Dr. Cook, brain imaging was incorporated to examine the neural consequences of PEM. Participants were asked to perform 30 minutes of exercise on a bicycle at 70% of their estimated peak heart rate. Prior to and 24 hours post-exercise, detailed symptom data were gathered, blood samples collected and participants performed both non-fatiguing and fatiguing cognitive tasks while collecting functional brain data. Preliminary results from the ongoing studies suggest that, consistent with previous studies, submaximal exercise results in large increases in a host of symptoms, such as fatigue, pain and difficulty with attention. Moreover, this data suggest that cognitive performance worsens 24 hours post-exercise and the worsening is accompanied by increased brain activity compared with controls.
Work is concentrated now on determining whether changes in brain function are related to peripheral markers of PEM, that is, upregulated gene expression. This work is evolving into a promising collaboration among Dr. Cook at the University of Wisconsin-Madison, Dr. Alan Light at the University of Utah and Dr. Gordon Broderick at Nova Southeastern University—all previous recipients of Solve ME/CFS Initiative research funds. This new, multi-center collaboration incorporates gene expression data, neuroimaging data, as well as additional physiological systems to determine the interactions among them in the pathophysiology of PEM. SMCI is so pleased to see the early results of our research investment in this publication.