Brain retraining

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Brain training is a proposed treatment approach advanced by a group of former patients and researchers who believe that ME/CFS--due to its complexity, the multiplicity of symptoms involved and systems affected, and the diverse ways that some people eventually recover while others do not--that the illness is a result of the dysfunction of the autonomic nervous system. The autonomic nervous system (ANS) is associated with the digestive, endocrine, circulatory and other systems that tend to be involved with ME/CFS.

This is not to imply that symptoms are imagined by patients, but that the nervous system is at the heart of the diverse manifestations of symptoms that show up physically. There are several voices in the brain training movement, such as Ashok Gupta[1] and Dan Neuffer,[2] that believe that the disease begins and perpetuates itself through a series of complex reactions involving the amygdala and other parts of the brain, where the brain and nervous system become sensitized to certain triggers resulting in a variety of symptoms, which themselves become triggers for symptoms, resulting in a self-reinforcing feedback loop.[3] Brain training proposes that the way beyond this ANS dysfunction involves rewiring the nervous system through simple interventions, like breathing exercises, that assist the patient in lowering their ANS arousal while also deliberately freeing up their attention to other sensations other than their symptoms.

To date there is very limited empirical research on brain training and ME/CFS. There is research on similar interventions for other conditions, such as PTSD,[4] and researchers have measured heart rate variability (HRV, one indicator of autonomic function) in ME/CFS,[5][6] but published research on the effects on ME/CFS symptoms of interventions like the ones brain training proposes is limited to a clinical audit Gupta conducted of the effect of his amygdala retraining techniques for 33 of his patients.[7] He found that over the course of a year, 93% of the 27 who completed the program reported their functioning improved, with 67% reporting significant improvement (regaining at least 80% of their pre-illness functioning). However this study included no randomization, control group, controlling for other treatments, or blinding to prevent researcher and sample bias.[7]

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  1. "The Gupta Program". www.guptaprogram.com. Retrieved April 6, 2019. Cite has empty unknown parameter: |dead-url= (help)
  2. "Author of CFS Unravelled that recovered from CFS". CFS Unravelled. Retrieved April 6, 2019.
  3. Gupta, Ashok (2002). "Unconscious amygdalar fear conditioning in a subset ofchronic fatigue syndrome patients" (PDF). Medical Hypotheses. 59 (6): 727–735.
  4. Ginsberg, Jay P.; Berry, Melanie E.; Powell, Donald A. (July 2010). "Cardiac coherence and posttraumatic stress disorder in combat veterans". Alternative Therapies in Health and Medicine. 16 (4): 52–60. ISSN 1078-6791. PMID 20653296.
  5. Meeus, Mira; Goubert, Dorien; De Backer, Fien; Struyf, Filip; Hermans, Linda; Coppieters, Iris; De Wandele, Inge; Da Silva, Hellen; Calders, Patrick (October 2013). "Heart rate variability in patients with fibromyalgia and patients with chronic fatigue syndrome: A systematic review". Seminars in Arthritis and Rheumatism. 43 (2): 279–287. doi:10.1016/j.semarthrit.2013.03.004. ISSN 0049-0172.
  6. Malfliet, Anneleen; Pas, Roselien; Brouns, Raf; De Win, Joris; Hatem, Samar M.; Meeus, Mira; Ickmans, Kelly; van Hooff, Robbert-Jan; Nijs, Jo (2018), "Cerebral Blood Flow and Heart Rate Variability in Chronic Fatigue Syndrome: A Randomized Cross-Over Study", Pain Physician, 21 (1): E13-E24 Cite has empty unknown parameter: |1= (help)
  7. 7.0 7.1 Gupta, Ashok (September 2010). "Can amygdala retraining techniques improve the wellbeing of patients with chronic fatigue syndrome" (PDF). Journal of holistic healthcare. 7 (2): 12–15.