Post-Exertional Malaise: Neurobiological Changes / Video 6 of 7

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This video series is intended to review the clinical presentation, scientific underpinnings, and treatment approach for patients with post-exertional malaise (PEM)/post-exertional symptom exacerbation (PESE).

For an abbreviated version highlighting the clinical pearls, please watch videos 1, 2, and 7. Videos 3-6 offer a deeper dive into the scientific and evidence-based pathophysiology of PEM/PESE.
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Post-exertional malaise (PEM)/post-exertional symptom exacerbation (PESE) is an altered physiological state and pathognomonic finding unique to ME/CFS that is now being recognized in those with post-acute sequelae of COVID-19 (PASC), also known as Long COVID.

It is critical that healthcare professionals recognize PEM/PESE and support the patient in avoiding a push-crash-cycle which can exacerbate disease processes and contribute to worsened long-term functional prognoses.

In video six of this seven-part series Brayden Yellman, MD, and Lucinda Bateman, MD, examine the physiological happenings within the brains of those with ME/CFS.

Video details:
- Microglial cells & proinflammatory cytokines (IL-6, TNF-alpha, and interleukin-1-beta)
- Magnetic resonance spectroscopy & metabolic activity associated with neuroinflammation
- Brain lactate & Choline
- Brain thermometry
- Positron emission tomography (PET): measuring radio-labeled isotope ligand to the translocator protein (or TSPO)
- Default Mode Network (DMN) uncoupling in ME/CFS

This video was made possible by the OMF-funded Medical Education Resource Center (MERC) at BHC, our generous donors, and viewers like you.

Citations:

Nakatomi Y, Mizuno K, Ishii A, et al. Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An ¹¹C-(R)-PK11195 PET Study. J Nucl Med. 2014;55(6):945‐950. doi:10.2967/jnumed.113.131045

Rayhan RU, Baraniuk JN. Submaximal Exercise Provokes Increased Activation of the Anterior Default Mode Network During the Resting State as a Biomarker of Postexertional Malaise in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Front Neurosci. 2021;15:748426. Published 2021 Dec 15. doi:10.3389/fnins.2021.748426
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Thank you for your continuing research.

minecraftlifexD
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Such an amazing series!! So very much appreciated.

joeynarciso
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Very interesting. Wonderful research, thank you for what you are uncovering.

me-cfs-strategiesforhealing
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how are these changes viewed in our brains? i have all the symptoms and "normal" MRI.

storiesuntoldunfold
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It’s crazy because the frontal cortex is where I feel the swelling and burning

natashannmarieeklove
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These are great findings. How can this be treated?

cwebbwash
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