Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is an illness characterized by a diverse range of debilitating symptoms including autonomic, immunologic, and cognitive dysfunction. Although neurological and cognitive aberrations have been consistently reported, relatively little is known regarding the regional cerebral blood flow (rCBF) in ME/CFS. In this study, we studied a cohort of 31 ME/CSF patients (average age: 42.8 ± 13.5 years) and 48 healthy controls (average age: 42.9 ± 12.0 years) using the pseudo-continuous arterial spin labeling (PCASL) technique on a whole-body clinical 3T MRI scanner. Besides routine clinical MRI, the protocol included a session of over 8 min-long rCBF measurement. The differences in the rCBF between the ME/CSF patients and healthy controls were statistically assessed with voxel-wise and AAL ROI-based two-sample t-tests. Linear regression analysis was also performed on the rCBF data by using the symptom severity score as the main regressor. In comparison with the healthy controls, the patient group showed significant hypoperfusion (uncorrected voxel wise p ≤ 0.001, FWE p ≤ 0.01) in several brain regions of the limbic system, including the anterior cingulate cortex, putamen, pallidum, and anterior ventral insular area. For the ME/CFS patients, the overall symptom severity score at rest was significantly associated with a reduced rCBF in the anterior cingulate cortex. The results of this study show that brain blood flow abnormalities in the limbic system may contribute to ME/CFS pathogenesis.
Highlights
Histogram analysis of the inter-subject averaged regional cerebral blood flow (rCBF) data for the healthy controls (HC) group indicated the histogram can be fitted reasonably well with two overlapping Gaussian functions, with two peak values at 17 ± 12 and 54 ± 25 mL/100g/min corresponding to the average rCBF for gray and white matter, respectively
The results from the current study based on a cohort of Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients and adult HC subjects demonstrate that there was a statistically significant difference in the cerebral rCBF between the ME/CFS and HC subjects
The involved hypoperfusion brain regions were mainly localized in the limbic system, including the anterior cingulate cortex (ACC), prefrontal cortex, left anterior ventral insular area, pallidum, and caudate nucleus
Summary
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is an illness characterized by a diverse range of debilitating symptoms including autonomic, immunologic, and cognitive dysfunction. In comparison with the healthy controls, the patient group showed significant hypoperfusion (uncorrected voxel wise p ≤ 0.001, FWE p ≤ 0.01) in several brain regions of the limbic system, including the anterior cingulate cortex, putamen, pallidum, and anterior ventral insular area. For the ME/CFS patients, the overall symptom severity score at rest was significantly associated with a reduced rCBF in the anterior cingulate cortex. 1. Introduction with regard to jurisdictional claims in Fatigue is a subjective feeling commonly reported in many neuropsychiatric illnesses, including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) [1], depression, traumatic brain injury (TBI) [2,3,4], and Parkinson disease (PD).
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