Longitudinal MRI shows no cerebral abnormality in chronic fatigue syndrome

Abstract

MRI has previously provided conflicting results when used to search for brain abnormalities in sufferers of chronic fatigue syndrome (CFS). Eighteen CFS patients and nine healthy volunteers each underwent MRI on two occasions, one year apart. The resulting images were examined for abnormalities in brain atrophy, deep white matter hyperintensities (WMH) and cerebral blood and cerebrospinal fluid (CSF) flow. Mean proportionate CSF volume was not significantly different between subject groups. All participants showed a slight increase in CSF between scans, but no significant difference was found between those with CFS and those without. Between-group comparisons of ventricular volume revealed no significant differences at study commencement and no significant change over the year. No significant inter-group differences were found for any of the cerebral blood and CSF flow parameters. Low levels of WMH were found in all participants. Objective scoring of WMH using Scheltens' scale revealed no change in summary components (prosencephalic deep white matter hyperintensities, basal ganglia hyperintensities and infratentorial hyperintensities) or in individual component variables between the baseline and 1 year follow-up scans. No abnormal patterns in rate and extent of brain atrophy, ventricle volume, white matter lesions, cerebral blood flow or aqueductal CSF flow were detected in the CFS population. These results throw open the debate into whether MRI scanning can reveal diagnostic signs of CFS and clinically questions the diagnoses of CFS made on the basis of previous research conclusions.

Overlap between functional GI disorders and other functional syndromes: what are the underlying mechanisms?

“…104 Despite the limitations that depression patients were taking tricyclic antidepressants and that a high proportion of CFS patients had a prior history of depression and were on antidepressants, this study suggested a possible role of an overactive thalamus associated with hypervigilance and hyperattentiveness in CFS patients. 104 However, neuroimaging studies have reported contradictory results in CFS, 105,106 and therefore the role of structural or functional changes in the brain in the pathogenesis of CFS is not yet well understood.…”

Abnormal Resting-State Functional Connectivity in Patients with Chronic Fatigue Syndrome: Results of Seed and Data-Driven Analyses

“…Previous investigations of brain abnormalities in ME/CFS were mostly inconclusive (Lange et al, 1998). There is conflicting evidence for altered brain structure in this illness, with some studies reporting either globally decreased gray matter or local abnormalities in several brain regions (Puri et al, 2012 andOkada et al, 2004), while others report no such findings (Perrin et al, 2010).…”

“…Global or regional reductions in cerebral blood flow (CBF) at rest have been reported in ME/CFS (Biswal et al, 2011;Cope and David, 1996;Tirelli et al, 1998;Yoshiuchi et al, 2006), but some investigators found no group differences in CBF compared to normal controls (Perrin et al, 2010). However, functional MRI (fMRI) has shown altered cortical activation during cognitive challenges in ME/CFS (De Lange et al, 2004;Tanaka et al, 2006).…”

Functional Neural Network Connectivity in Myalgic Encephalomyelitis

“…In a recent literature review, Fischer and colleagues (Fischer et al, 2014) found neuroanatomical differences (using magnetic resonance imaging; MRI) between some patients with ME and healthy controls, but there is still no unifying explanation for the diversity of, or at times absence of, structural findings. Results in some studies have suggested involvement of white matter (Lange et al, 1999;Natelson, Cohen, Brassloff, & Lee, 1993), but other studies found only grey matter abnormalities (de Lange et al, 2005;de Lange et al, 2004;de Lange et al, 2008;Okada, Tanaka, Kuratsune, Watanabe, & Sadato, 2004;Puri et al, 2012) and two studies reported no significant abnormalities in ME (Cope & David, 1996;Perrin, Embleton, Pentreath, & Jackson, 2010). Regarding functional characteristics in ME, cerebral hypoperfusion was found using single-photon emission computed tomography (SPECT) in some (Biswal, Kunwar, & Natelson, 2011;Costa, Tannock, & Brostoff, 1995;Ichise et al, 1992;Schwartz, Komaroff, et al, 1994) but not all studies (Lewis et al, 2001;MacHale et al, 2000;Schmaling, Lewis, Fiedelak, Mahurin, & Buchwald, 2003).…”