Brian Walitt

Brian Walitt, M.D., M.P.H. is a researcher in the Division of Intramural Research within the National Center for Complimentary and Integrative Health at the National Institutes of Health (NIH) in the United States and oversees intramural clinical protocols. He is the lead clinical investigator of the NIH Post-Infectious ME/CFS Study.

Research
Dr. Walitt's research interests include "pain and related interoceptive disorders (i.e. fibromyalgia, chronic fatigue)" and "social construction of illness and disease."

He is interested in studying "perceptual illness" which he defines as follows:

"'In these disorders, a person experiences a range of different bodily sensations, such as pain and fatigue, without any clear external cause. In some, these sensations can be bothersome while in others they can be disabling. The perceptual illnesses that interest me change their names with every generation, with current disorders being called fibromyalgia, chronic fatigue syndrome, and post-Lyme syndrome.'"

Controversy
Walitt has stated his belief that fibromyalgia is a "psychosomatic experience," a variant of normal, and not an abnormal disease state that should be medicalized. He has stated that fibromyalgia is not a disease but rather a way of "dealing with the difficulties of just being a human.”

In a 2015 paper on chemotherapy related cognitive dysfunction co-authored by Walitt, fibromyalgia and chronic fatigue syndrome are referred to as somatoform illnesses, with their hallmark being a "...discordance between the severity of subjective experience and that of objective impairment...".

Walitt has also stated that "Fibromyalgia is closely allied with and often indistinguishable from neurasthenia" and goes on to claim that "Time brings clarity to confusing illnesses of the past, and we now recognize that hysteria, neurasthenia, and railway spine were almost always psychogenic disorders."

In a very small uncontrolled study (n = 9) exploring the relationship between genetic expression and pain catastrophizing in Fibromyalgia, Walitt and his co-authors used a score of 16 on the Pain Catastrophizing Scale as the threshold for determination of "high catastrophizing". That is in stark contrast with the threshold of 30 recommended by the scale's creators to indicate a "clinically relevant level of catastrophizing," and a mean score for 851 injured workers was 20.90. Even the high catastrophizing subgroup (n = 5) in the study averaged a pain catastrophizing score of only 23.6, well below the recommended threshold. The authors concluded that "specific physiological pathways may possibly delineate pain and catastrophizing mechanisms."

Notable studies

 * 2007, The effects of multidisciplinary therapy on positron emission tomography of the brain in fibromyalgia: a pilot study
 * 2012, The Changing Nature of Fibromyalgia
 * 2013, Increased Brain White Matter Axial Diffusivity Associated with Fatigue, Pain and Hyperalgesia in Gulf War Illness (Full Text)
 * 2015, Chemobrain: A critical review and causal hypothesis of link between cytokines and epigenetic reprogramming associated with chemotherapy
 * 2015, Neuroimaging of Central Sensitivity Syndromes: Key Insights from the Scientific Literature

Talks and interviews

 * 2015, VIDEO: Fibromyalgia doesn’t fit the disease model (there is a transcript )

Online presence

 * PubMed - Brian Walitt
 * NIH - Dr Brian Walitt
 * Arthritis Research - Brian Walitt

Learn more

 * 2009, Fibromyalgia 201
 * 2012, The Changing Nature of Fibromyalgia Frederick Wolfe and Brian Walitt
 * 2013, Demystifying Medicine 2013 - Pain: How It Happens and What Can Be Done?
 * 2015, Prevalence of Fibromyalgia in Elderly Women
 * 2016, The Psychosomatic Researcher in the NIH's Big Chronic Fatigue Syndrome (ME/CFS) Study
 * 2016, NIH's initial response to comments and article on Walitt
 * 2016, Brian Walitt’s Radical Bias: Disorders of Subjective Perception, ME/CFS as Normal Life Experience?