iiinova — where your digital self keeps evolving

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Tom Kindlon @tomkindlon.bsky.social · 09/04/2026

Natalie Hilliard on Physiotherapy for ME chroniclivingtherapy.com/natalie-hill... Image is from the AMMES April 2026 newsletter #MEcfs #PwME @chronicliving123.bsky.social @physiosforme.bsky.social

Photo of Natalie Hilliard

Natalie Hilliard on Physiotherapy for ME
Natalie is a physiotherapist and one of the co-founders of the UK-based organisation Physios for ME. This small organisation has punched above it its weight since it was founded, leading education and research programmes as well as publishing a guidebook. She works in private practice, specialising in supporting people with M.E.
In her first article (part two will follow) she shares insights from physiotherapy that will be of particular use to therapists and counsellors. This includes an understanding of post-exertional malaise, the challenges of trying to pace properly, and the impact of emotional exertion on people with M.E.
Read more here>>

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Adam @abrokenbattery.bsky.social · 19/03/2026

BBC Feedback interview with Dr Charles Shepherd, Medical Advisor to the ME Association, discussing Radio 4’s recent Inside Health programme on the Decode ME study (8 mins 30). youtu.be/xgTxQmPjVUU?...

youtu.be

BBC Feedback | Interview with Dr. Charles Shepherd

YouTube video by Broken Battery

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Nicky Proctor @nickyproctor.bsky.social · 26/02/2026

@ashleydaltonmp.bsky.social Your words “these must become never events” PLEASE INTERVENE TO SAVE LIFE Savannah has not eaten for 9 weeks. There are no NHS services for severe ME - 7 months since publication of the Delivery Plan for ME/CFS www.meresearch.org.uk/claims-of-nh...

meresearch.org.uk

Claims of NHS inaction over specialist services for severe ME cases – Savannah Victora-May

* Caution - This article contains a report of the medical condition and treatment of a person with severe ME* My body cannot take even a shred more of this. I’m not physically able to continue, I am s...

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Alex @admiringbog.bsky.social · 25/02/2026

Getting diagnosed with endometriosis kind of felt like getting diagnosed with ME/CFS all over again. The years long diagnostic process, the lack of good treatment options, the lack of funding for research, and in the back of my mind, knowing the symptoms can get much much worse.

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Lucibee @lucibee.bsky.social · 24/02/2026

OK. Here's a suggestion, Dr CS. Why don't the charities set up their own in-patient unit for people with very severe ME and show the blinkin medical establishment how it's done? Because until you put your money and expertise where it actually matters, nothing will change. #MEDeliveryPlan

Dr Charles Shepherd, ME Association replies to a comment on Facebook:

You may not agree but there is a limit to what charities and other advocates, even with the help of the media, politicians etc, can do to change the minds of health professionals and a very powerful medical establishment about the cause and management of ME/CFS. But suggestions are always welcome!

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Michiel @murtoz.bsky.social · 24/02/2026

#pwME URGENT - looking for someone ME literate who can sit with Savannah in hospital in London from 4:30pm TODAY for a few hours. Travel will be reimbursed. Please share widely #SaveSavannah #SevereMErgency @tomkindlon.bsky.social @abrokenbattery.bsky.social @drelke.bsky.social

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Elke Hausmann @drelke.bsky.social · 24/02/2026

Worth catching up on if you missed this @daltmann.bsky.social how can you get involved in the Rosetta Stone Study as a patient, is it only for people who can travel to London, or are there remote options? #LongCovid #ME www.bbc.co.uk/programmes/m...

bbc.co.uk

BBC Radio 4 - Inside Health, Is the tide turning on ME research?

The new wave of ME research that could bring clarity to this perplexing condition.

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Didier @medidier.bsky.social · 24/02/2026

The f**** pictures, the title with CFS instead of ME, the somewhat justification of abuse and gaslighting, the 'recovery' narrative permanent bullshit, the total silence about daily life of severe... www.theguardian.com/society/2026...

theguardian.com

My maddening battle with chronic fatigue syndrome: ‘On my worst days, it feels almost demonic’

The long read: I suffered with my mystery illness for decades before gaining a diagnosis. Could retraining my brain be the answer?

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Brian Fog @uselesspriest.bsky.social · 24/02/2026

It wouldn't do to mention severe ME in articles like this. The conceit is that it's a Victorian-era "malaise" that puts a dampener on your life periodically. The reality for many is dark rooms, eye masks, feeding tubes and medically assisted death.

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Elke Hausmann @drelke.bsky.social · 24/02/2026

For anyone who wants to follow up on Joe Dispenza mentioned in this article, this podcast is a good place to start: podcasts.apple.com/gb/podcast/c...

podcasts.apple.com

98: Placebo Joe Dispenza

Podcast Episode · Conspirituality · 8 April 2022 · 1h 41m

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Tom Kindlon @tomkindlon.bsky.social · 24/02/2026

(UK) “Six months since the publication of the Final Delivery Plan for ME” blog post by by #ThereForME @thereforme.bsky.social Links: www.thereforme.uk/p/campaign-u... www.gov.uk/government/p... Screenshot from latest Science for ME weekly update #MEcfs #CFS #PwME #MyalgicEncephalomyelitis

UK #ThereForME “Six months since the publication of the Final Delivery Plan for ME”
The UK government policy paper was published on 22 July 2025. In a blog post #ThereForME summarise developments since then:
“What progress has been made? Are there signs the plan is making a difference? Today we’re taking a whistlestop tour of the latest developments in three priority areas.”
Blog | Plan | Thread

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Adam @abrokenbattery.bsky.social · 19/02/2026

Update on Savannah: They are now urgently seeking any UK doctors or hospitals willing to provide TPN and restart cyclizine. If no safe option is found, they are even considering treatment abroad. If you have suggestions, please fill in the form tally.so/r/81KxGO

tally.so

Please share any trusted doctors for (very) severe pwME. UK or Western Europe. NHS or private.

Made with Tally, the simplest way to create forms.

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Michiel @murtoz.bsky.social · 19/02/2026

@everydoctor.org.uk are you aware of the below situation? A repeat of what happened to Maeve in 2021. Coroner's urgent findings in 2024 PFR completely ignored. While questions have been asked in parliament, nobody seems willing to overrule the hospital that is literally starving her to death. HELP!

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Lucibee @lucibee.bsky.social · 16/02/2026

I was particularly surprised by this "aim" from RCP that all of their ~40,000 members would undertake the modules by the end of 2025. Particularly as (afaik) they have made no attempt to tell members about the modules, and no CPD points are available for completing the modules. #MEDeliveryPlan

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Dr Jo Greer @drjogreer.bsky.social · 16/02/2026

Concerning that the trust have issued a misleading statement about Tessa's position. 'We welcome MP Munt’s call for more support for patients living with severe ME, including care facilities that are better suited to non-medical care and rehabilitation.' Non medical care and rehabilitation??

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Tessa Munt MP 🔶 @tessamunt.bsky.social · 16/02/2026

Thanks to The Times for highlighting Savannah’s story and the critical issue that there is no specialist NHS service for very severe ME. Grateful to Ashley Dalton for our recent brief call but still waiting for progress report re ME Plan commitment to explore such a service, including treatments.

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ME Association @meassociation.org.uk · 16/02/2026

The ME/CFS Alliance are marking their 20th Anniversary with a symposium, “Stronger Together”, at Winchester Cathedral. The event is set to include talks from numerous researchers, find out more: meassociation.org.uk/ctcf #pwME

IMAGE DESCRIPTION: Flier for the 'Stronger Together' Symposium.

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Lucibee @lucibee.bsky.social · 13/02/2026

The first of the papers mentioned in this article has one of the most astonishing figures I've ever seen wrt ME. www.mdpi.com/ijms/ijms-24...

Panel C shows the huge range of changes seen in the urine of controls post exercise vs baseline. Whereas panel D shows that pwME/CFS (with PEM) show no variation in those constituents at all.
Seems to indicate that normal post-exercise clearance mechanisms simply don't happen in people with ME.

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Elke Hausmann @drelke.bsky.social · 13/02/2026

How many people like this doctor are walking around thinking that ‚maybe this was what being in my mid-30s entailed: I had begun an early neurocognitive decline, and that was that‘. #LongCovid underdiagnosis

The word-finding difficulties were the most debilitating and bothersome to me. I often found myself frozen in time, unable to verbalize words that were familiar to me,
while delivering patient reports or presentations to my supervisors or in casual conversations. I had the words in my mind and could visualize them, but I simply could not verbalize them. I was unable to piece together what was happening to me. I thought that maybe this was what being in my mid-30s entailed: I had begun an early neurocognitive decline, and that was that.
However, I was determined to not let these symptoms beat me. I decided to do something about the situation.

Since coming to terms with long COVID, I have had many conversations with family members and friends who have reported similar symptoms that followed their acute COVID-19 illness, persisting for months and even years. They too have realized that they have been casualties of COVID-19 and have been suffering with long COVID well after their acute infection.

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Prof Ros Gleadow FAA 💙💚 @rgleadow.bsky.social · 11/02/2026

David Tuller is always worth reading on #MEcfs

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Lucibee @lucibee.bsky.social · 11/02/2026

wrt this action statement in the #MEDeliveryPlan, are there any UK GPs on here who can confirm whether the RCGP has indeed been sharing and promoting the NHSE e-learning modules on ME/CFS? Thanks!

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valebodi.bsky.social @valebodi.bsky.social · 10/02/2026

The German Accident Insurance (Deutsche Unfallversicherung) forces people with #MECFS to undergo diagnostic tests as part of the evidence gathering process for expert opinions, tests that can be extremely harmful to the patients – my exclusive investigation @riffreporter.bsky.social is available ⬇️

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Adam @abrokenbattery.bsky.social · 09/02/2026

FOI response shows uptake of ME/CFS e-learning from the government delivery plan: • Intro: 371 • Community care: 101 • Severe ME: <50 From a workforce of ~188k doctors & ~423k nurses This is the problem when training is “promoted” and not mandatory.

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Cass Macdonald @cm7505.bsky.social · 09/02/2026

Thanks for everything you’re doing. I recently had an exchange over training; there is NO formal MSc in post viral conditions like MECFS and if we want properly qualified, specialist healthcare professionals for this, Long Covid, PoTS, MCAS etc, that’s what’s needed. I despair

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Michiel @murtoz.bsky.social · 09/02/2026

it's beyond pitiful. less than 0.0055% of NHS doctors & nurses with basic awareness of severe ME. This is what happens when the govt doesn't put their money where their mouth is. Just more hot air and neglect They can't be this incompetent? This has to be intentional. Protecting Sir Simon?

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Lucibee @lucibee.bsky.social · 09/02/2026

This is *pitiful*. 😞 @ashleydaltonmp.bsky.social Your department needs to try an *awful* lot harder.

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Lucibee @lucibee.bsky.social · 09/02/2026

5/n Today, I received their answer. This is the data table they sent me, of the number of people who have completed each of the 3 modules up to 20 January 2026:

Table shows the numbers completing each module, split by type of email account. An asterisk indicates there were 5 or fewer.

Module 1: An introduction to ME/CFS = 8 (.gov.uk), 51 (.ac.uk), 227 (.nhs), 85 (other).
Module 2: ME/CFS: guidance for community-based healthcare practitioners = 8 (.ac.uk), 74 (.nhs), 19 (other).
Module 3: Managing severe ME/CFS = * (.gov.uk), 7 (.ac.uk), 33 (.nhs), * (other).

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Lucibee @lucibee.bsky.social · 09/02/2026

4/n According to the Nuffield Trust, about 1.7 million people work in the NHS. This includes 188,000 doctors and around 423,000 nurses and midwives. The Royal College of Physicians has over 40,000 members. www.nuffieldtrust.org.uk/resource/the...

nuffieldtrust.org.uk

The NHS workforce in numbers

Facts on staffing and staff shortages in England.

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Lucibee @lucibee.bsky.social · 09/02/2026

3/n The UK Government stated that "The Royal College of General Practitioners, the Chartered Society of Physiotherapy and the Royal College of Occupational Therapists agreed to share and promote NHS England’s e-learning modules," and that they were working with the Royal College of Nursing.

Extract from the UK Government's ME/CFS Delivery Plan.

Attitudes and education.

Action: DHSC will ask relevant stakeholders to:
a) consider developing a shared learning resource on ME/CFS, which could be held in an education hub,
b) request that the Medical Schools Council (MSC) encourages shared learning and the NHS England e-learning package on ME/CFS to all UK medical schools and encourages medical schools to provide undergraduates with direct patient experience,
c) use its networks to raise awareness of NHS England’s e-learning module on ME/CFS.
Progress: Discussed potential education hub with the Task and Finish Group - to be explored further.
DHSC discussed raising awareness of NHS England’s e-learning with relevant professional bodies.
The Royal College of General Practitioners, the Chartered Society of Physiotherapy and the Royal College of Occupational Therapists agreed to share and promote NHS England’s e-learning modules. DHSC will continue to reach out to networks including the Royal College of Nursing to promote NHS England’s e-learning modules.
NICE has added e-learning to its tools and resources page, with further modules to be added as they become available.
DHSC to develop and run a public awareness initiative on ME/CFS, and signpost to e-learning and NICE guidelines as part of the initiative.
Timeline and measure of success: Sharing of resources with a wider stakeholder group and a public awareness initiative (by May 2026) are expected to improve both the public and professionals’ understanding of ME/CFS.
E-learning to be shared with stakeholders in July 2025.
NHS England’s user statistics and feedback on DHSC-led awareness initiative to be monitored and reviewed.

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Lucibee @lucibee.bsky.social · 09/02/2026

2/n The reason I asked was because the ME/CFS Delivery Plan makes some quite distinct promises (alright, "aims") about their e-learning package, including this item in their table of Agreed Actions. www.gov.uk/government/p...

Extract from the ME/CFS Final Delivery Plan (UK Government, 22 July 2025).

Action: The Royal College of Physicians (RCP) will ensure that its training on ME/CFS keeps pace with research and guidance in the core postgraduate training for primary and secondary care physicians.

Progress: RCP will, for now, rely on NHS England’s e-learning modules, which are considered suitable by RCP.

Timeline and measure of success: Aim for all RCP members to undertake the e-learning by the end of 2025.

My comment: This should be easily measurable. Has it been achieved?

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Lucibee @lucibee.bsky.social · 09/02/2026

About a month ago, I made a FOIA request to the NHS England Learning Hub about their new learning modules on ME/CFS... 🧵 1/n

Email sent to NHS elearning enquiries on 12 January 2026.

Subject - Request for information.

Dear NHSE elearning hub,

I am making a freedom of information request (FOIA 2000) for the following data.

In 2024/5, the NHS England elfh e-learning hub introduced 3 new modules on ME/CFS:

1. An introduction to ME/CFS (May 2024).
2. ME/CFS: guidance for community-based healthcare practitioners (January 2025).
3. Managing Severe ME/CFS (September 2025).

Please can you tell me how many people have completed each module to date (from date of introduction), and what the breakdown is for logins by NHS staff (nhs.uk), and those in government (gov.uk), academic (ac.uk), and social care sectors (if available).

I am happy for your response to be sent to this email address.

Many thanks for your help,

Lucy B

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Tom Kindlon @tomkindlon.bsky.social · 08/02/2026

🧵 Interview with @bi-ta.bsky.social - medical sociologist & author of "Contested & neglected: Social and medical marginalization in severe Chronic Fatigue Syndrome" chroniclivingtherapy.com/nezamdoust-m... Screenshot from @chronicliving123.bsky.social newsletter #MEcfs #SevereME #CFS #PwME 1/

Bita Nezamdoust - medical sociologist

We start 2026 with this interview in which Bita Nezamdoust reflects on her recent publication, looking at how isolated patients use social media. She reflects on how this may help therapists to understand the experiences of people with severe and very severe ME.

This patient group is often neglected due to the 'non-standard' approaches needed to search them out and listen to them. Using short communications on social media is an ingenious way to amplify some of the voices and needs of these patients.

Bita gave generously of her time in answering my many questions and the article gives an empathetic insight into the lives of people with severe, and very severe, ME.

Read Bita Nezamdoust's article

Photo of Bita Nezamdoust

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valebodi.bsky.social @valebodi.bsky.social · 04/02/2026

#ME/CFS and Long Covid. They can then apply this knowledge to any treatment plan. For example, we know there is an energy production dysfunction in this patient group: any treatment needs to take this into account.” Natalie Hilliard @chronicliving123.bsky.social @physiosforme.bsky.social

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Tom Kindlon @tomkindlon.bsky.social · 04/02/2026

From @danielmissailidis.bsky.social on X We're starting another round of home blood collections today for two ME/CFS and Long COVID studies! If you live in Victoria, Aus and are interested in participating, please fill out the following: redcap.latrobe.edu.au/redcap/surve... #MEcfs #LongCovid

redcap.latrobe.edu.au

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Dan Wyke @danwyke.bsky.social · 01/02/2026

A well written piece on living with severe #MyalgicEncephalomyelitis. Really ought to be read by health professionals, particularly those amateur psychologists who work in the counselling profession. #MECFS virology.ws/2026/01/27/t...

virology.ws

Trial By Error: An Essay on Living with Severe ME | Virology Blog

By David Tuller, DrPH I’ve been totally out of commission for three weeks while recovering from bruised ribs sustained in a fall. I have devoted most of my ...

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Eleanor Fielding @meownersclub.bsky.social · 01/02/2026

A great but unbearably sad essay. I appreciate the recognition but I’m also terribly concerned for the post-Xmas crash+the loss+grief The perpetrators of the #BPS model didn’t just betray #pwME; in preventing research they set the stage for this post-pandemic #LC crisis #ShameOnThem #Wessely #ME

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Elke Hausmann @drelke.bsky.social · 01/02/2026

What an excellent Substack bringing together lots information to show how Covid is being erased when talking about children‘s problems in the media, lending weight to the ,narrative compression‘ and ‚narratives of closure‘ re Covid argued here: www.tandfonline.com/doi/full/10.... #LongCovid

tandfonline.com

A call for a critical medical anthropology of the COVID-19 pandemic

This paper is a call for a renewed critical medical anthropology (CMA) of the COVID-19 pandemic, one that attends not only to the pandemic’s acute phase but also to its enduring afterlife. We argue...

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lyssinum.bsky.social @lyssinum.bsky.social · 31/01/2026

"...Ich erlebte genau das, wovor der Artikel warnte (während ich las). Im Artikel wurden zwei Personen interviewt, die von ME genesen waren, aber keine, die es nicht waren, obwohl die Genesungsrate bei 5–10 % liegt.“ Die Realität, die nicht gesehen wird. Wieder und wieder. Helft uns endlich! #MEcfs

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Tom Kindlon @tomkindlon.bsky.social · 31/01/2026

Brigitte, a mainstream German women's magazine, has published a special edition about #MECFS drvjdg.clicks.mlsend.com/ty/cl/eyJ2Ij... Google translation www-brigitte-de.translate.goog/gesund/mecfs... Screenshot from @chronicliving123.bsky.social newsletter #CFS #PwME @lammasleaves.bsky.social

'Brigitte' Magazine (German)
German women's magazine, Brigitte, a mainstream publication with a large circulation, has published a special edition about ME/CFS.

I've not read it all yet, but by all accounts it's well-informed about the history of, and biomedical research into, the condition. Interviews and feature articles with patients, carers, doctors and researchers explain the condition and the impact it can have.

Most interesting to therapists is an in-depth interview with renowned ME advocate and psychotherapist, Dr Bettina Grande, who explains how therapy can (and how it can't) help people with ME/CFS.

*** You have to allow adverts to read the magazine for free. You may be able to have your browser translate the text. Alternatively, you could copy and paste it into 'google translate' or similar, to read it in your own language.

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Tom Kindlon @tomkindlon.bsky.social · 31/01/2026

British Association for Counselling and Psychotherapy 'Letter to the Ed' chroniclivingtherapy.com/wp-content/u... Screenshot from Chronic Living Therapy @chronicliving123.bsky.social newsletter #MEcfs #CFS #PwME #MyalgicEncephalomyelitis #ChronicFatigueSyndrome @lammasleaves.bsky.social

BACP 'Letter to the Ed'
A former therapist, Emma Hampson, has had a letter published in the BACP members' magazine, Therapy Today.

Emma's letter was sent in response to the article on therapy and chronic ill health we have written about before. Here's a flavour of her letter:

"It confused me to see what had begun as an article showing concern about the psychologisation of chronic illness to then switch to an interest in the psychologisation of ME.

My confusion compounded when the piece warns therapists that 'unconscious ableist beliefs often due to a lack of education, can harm clients even when subtly expressed'.

I was experiencing the very thing the article was warning against happening to me (as I read). The article interviewed two people who recovered from ME but none who hadn't, even though the recovery rate is 5%-10%."

Read complete letter from Emma Hampson (pdf)

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Adam @abrokenbattery.bsky.social · 30/01/2026

New article on Savannah’s case. Queen Elizabeth Hospital has declined to take up Sonya Chowdhury’s offer to advocate. Savannah remains without nutrition. Fluids restored after pressure, pain meds reduced, and she is still at serious risk. www.thecanary.co/uk/analysis/...

thecanary.co

London hospital STILL starving severe ME patient, Savannah — bias medical approach to blame

A South London hospital is still putting severe ME patient Savannah's life at risk and a clinician who psychologises ME might be why.

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Bita Nezamdoust @bi-ta.bsky.social · 28/01/2026

That's right! And hopefully with more stats paper to come on mecfs/longcovid soon! However, qualitative papers do offer a phenomenal tool to explore and echo the patients' voice, as I tried to accomplish in this SSM paper.

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Adam @abrokenbattery.bsky.social · 19/01/2026

And here are the links: ▶️ Original Explainer Video (27 mins) youtu.be/RiwX9Y0NbiQ?... 🗒️ Explainer Video Transcript medium.com/@abrokenbatt... ✏️ New Follow up article medium.com/@abrokenbatt...

youtu.be

ME/CFS Scandal Explainer (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome)

YouTube video by Broken Battery

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Adam @abrokenbattery.bsky.social · 19/01/2026

Here’s a short trailer for the original #MECFS scandal explainer video. youtube.com/shorts/E8sym...

youtube.com

Trailer for the ME/CFS Scandal Explainer Video

YouTube video by Broken Battery

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Adam @abrokenbattery.bsky.social · 19/01/2026

My #MECFS scandal explainer video has just passed 200,000 views. Given the level of interest, I’ve written a follow-up article covering key examples I didn’t include, as well as some developments since. medium.com/@abrokenbatt...

medium.com

ME/CFS Scandal Follow up

The ME/CFS scandal goes much deeper than my 27-minute explainer video. That was just an introduction — how for decades patients were told…

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Tom Kindlon @tomkindlon.bsky.social · 25/01/2026

Description from @scienceforme.bsky.social update: Article with additional info to the YouTube video "ME/CFS Scandal Explainer". Both the video & the article provide overview & important details of the psychologisation of ME in the UK & the consequences for the patient group. #MEcfs #PwME #CFS

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Elke Hausmann @drelke.bsky.social · 26/01/2026

It’s a valid position to say that you respect everybody’s story equally - but it’s not the same as saying that everybody’s story’s relationship to the ‘truth’ is equal (which requires you to accept that there is something beyond stories). #LongCovid #ME emilymendenhall.substack.com/p/danger-in-...

The people I spoke to were deeply engaged in understanding their own illness and healing and many people were reading broadly and deeply about their own illness experiences. The stories I collected in the book (for many health conditions) drove the framing of the book, and this is one reason I was so surprised by the critique that the book psychologized
conditions like ME and Long Covid. I believe it is important to recognize that there are many people living with chronic health conditions— even Long Covid—who have found a great deal of healing by looking at it differently.

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Prof. dr. Vivienne Matthies-Boon @vmatthiesboon.bsky.social · 25/01/2026

@buechnerronja.bsky.social and I published 2 videos in German on the harms of #Psychologisation in #LongCovid, #MECFS, #MCAS, #PAIS. For those who do not understand German, you can press subtitles and automatic translation. www.viviennematthiesboon.com/biopsychosoc...

viviennematthiesboon.com

Psychologisierung – mit Ronja Büchner | Vivienne Matthies-Boon

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Tom Kindlon @tomkindlon.bsky.social · 24/01/2026

The Relation Between Cardiac Output and Cerebral Blood Flow in ME/CFS Patients with a POTS Response During a Tilt Test www.mdpi.com/2077-0383/14... Screenshot from the January 2026 AMMES newsletter #MEcfs #CFS #PwME #MyalgicEncephalomyelitis #ChronicFatigueSyndrome #POTS #OrthostaticIntolerance

Photo of somebody having a tilt table test

The Relation Between Cardiac Output and Cerebral Blood Flow in ME/CFS Patients with a POTS Response During a Tilt Test
In ME/CFS patients with POTS during tilt testing with measurements of both the CO [cardiac output] and the CBF [cerebral blood flow], two different patterns were observed: 1) appr. two-thirds of patients had an almost 1:1 relation between the %CBF reduction and the %CO reduction. This CBF reduction is abnormal, as in healthy controls the CBF reduction for a given CO reduction varies between 1:3 and 2:3, and may indicate endothelial dysfunction with an inability of cerebral vessels to adequately dilate in the presence of a CO reduction. Appr. one-third of patients showed a limited reduction in CO together with a substantial increase in HR. In these patients, there was no relation between the CO and CBF reduction. These data suggest the presence of a hyperadrenergic response. If this mechanism is proven by norepinephrine levels, the CO is a robust measure to distinguish between hyperadrenergic and non-hyperadrenergic responses.
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