Citations 2
Long COVID Syndrome and Associated New Daily Persistent Headache ( NDPH ) Presenting With Crossed Clonus Response
Wetmore, Emma , Wetmore, Emma , Grach, Stephanie, Grach, Stephanie L. , Boes, Christopher J. , Lanzino, Giuseppe , Kissoon, Narayan
Clinical Case Reports | March 20, 2026 | Volume: 14 | Issue: 3 | Pages: No page available
ABSTRACT Evaluating patients following a COVID‐19 infection with multiple chronic, progressive symptoms can be challenging, but easy to navigate by using the temporal profile obtained from the clinical history, findings from the neurological exam, and screening for red flag symptoms.
Low Dose Rapamycin Alleviates Clinical Symptoms of Fatigue and PEM in ME/CFS Patients via Improvement of Autophagy
Ruan, Brian T., Bulbule, Sarojini , Reyes, Amy, Chheda, Bela, Bateman, Lucinda , Bell, Jennifer , Yellman, Braydon, Berner, Jon , Peterson, Daniel L., Kaufman, David L. , Gottschalk, C. Gunnar , Grach, Stephanie, Roy, Avik , Ruan, Brian T. , Gile, Brooke, Reyes, Amy, Bell, Jennifer, Yellman, Brayden P., Grach, Stephanie L.
No container title available | June 3, 2025 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Background: mTOR activation is associated with chronic inflammation in ME/CFS. Previous studies have shown that sustained mTOR activation can cause chronic muscle fatigue by inhibiting ATG13-mediated autophagy. This highlights the pivotal role of mTOR in the pathogenesis of ME/CFS. Methods: We conducted a decentralized, uncontrolled trial of rapamycin in 86 patients with ME/CFS to evaluate its safety and efficacy. Low-dose rapamycin (6 mg/week) was administered, and core ME/CFS symptoms were assessed on days 30 (T1), 60 (T2), and 90 (T3). Plasma levels of autophagy metabolites, such as pSer258-ATG13 and BECLIN-1, were measured and correlated with clinical outcomes, specifically MFI. Results: Rapamycin (6 mg/week) was tolerated without any SAEs. Of the 40 patients, 29 (72.5%) showed strong recovery in PEM, fatigue, and OI, along with improvements in MFI fatigue domains and SF-36 aspects. High levels of BECLIN-1 were detected in T3. Plasma pSer258-ATG13 levels were strongly downregulated at T1. Spearman’s correlation analysis indicated an association between autophagy impairment and reduced activity. Conclusions: Low-dose rapamycin effectively reduced PEM and other key symptoms in patients with ME/CFS, as measured by BAS, SSS, MFI, and SF-36. Future studies should encompass dose optimization and develop a diagnostic tool to identify responders with mTOR-mediated autophagy disruption.