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Abnormal resting state functional connectivity in patients with chronic fatigue syndrome: An arteria

Kyla

ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ
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http://www.mrijournal.com/article/S0730-725X(15)00303-3/abstract


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Abnormal resting state functional connectivity in patients with chronic fatigue syndrome: An arterial spin-labeling fMRI study


Jeff Boissoneault, Janelle Letzen, Song Lai, Andrew O'Shea, Jason Craggs, Mike Robinson, Roland Staud

Published Online: December 17, 2015

DOI: http://dx.doi.org/10.1016/j.mri.2015.12.008

Publication stage: In Press Accepted Manuscript
Article Infoclick to expand contents
Background
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating disorder characterized by severe fatigue and neurocognitive dysfunction. Recent work from our laboratory and others utilizing arterial spin labeling functional magnetic resonance imaging (ASL) indicated that ME/CFS patients have lower resting state regional cerebral blood flow (rCBF) in several brain areas associated with memory, cognitive, affective, and motor function. This hypoperfusion may underlie ME/CFS pathogenesis and may result in alterations of functional relationships between brain regions. The current report used ASL to compare functional connectivity of regions implicated in ME/CFS between patients and healthy controls (HC).

Methods
Participants were 17 ME/CFS patients (Mage = 48.88 years, SD = 12) fulfilling the 1994 CDC criteria and 17 age/sex matched HC (Mage = 49.82 years, SD = 11.32). All participants underwent T1-weighted structural MRI as well as a 6-min pseudo-continuous arterial spin labeling (pCASL) sequence, which quantifies CBF by magnetically labeling blood as it enters the brain. Imaging data were preprocessed using SPM 12 and ASL tbx, and seed-to-voxel functional connectivity analysis was conducted using the CONN toolbox. All effects noted below are significant at p < 0.05 with cluster-wise FDR correction for multiple comparisons.

Results
ME/CFS patients demonstrated greater functional connectivity relative to HC in bilateral superior frontal gyrus, ACC, precuneus, and right angular gyrus to regions including precuneus, right postcentral gyrus, supplementary motor area, posterior cingulate gyrus, and thalamus. In contrast, HC patients had greater functional connectivity than ME/CFS in ACC, left parahippocampal gyrus, and bilateral pallidum to regions including right insula, right precentral gyrus, and hippocampus. Connectivity of the left parahippocampal gyrus correlated strongly with overall clinical fatigue of ME/CFS patients.

Conclusion
This is the first ASL based connectivity analysis of patients with ME/CFS. Our results demonstrate altered functional connectivity of several regions associated with cognitive, affective, memory, and higher cognitive function in ME/CFS patients. Connectivity to memory related brain areas (para-hippocampal gyrus) was correlated with clinical fatigue ratings, providing supporting evidence that brain network abnormalities may contribute to ME/CFS pathogenesis.
 

Never Give Up

Collecting improvements, until there's a cure.
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That's intriguing. I have no idea what these acronyms and procedures are and no time right now to hunt them down. Anyone care to translate? Also what is known about previous work and institutional affiliations of these authors? What about the journal's reputation? Never heard of it. Thank you!
 

Gemini

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. Also what is known about previous work and institutional affiliations of these authors?

Citation indicates corresponding author Roland Staud is at the University of Florida, Department of Medicine, Gainesville,FL...

Imaging from their Department of Radiation Oncology & Human Imaging Core of the Clinical & Translational Science Institute

Previous ME/CFS research involves CNS "Evidence for Fatigue Pathways in Patients with Chronic Fatigue Syndrome" Pain, April 2015:

www.ncbi.nlm.nih.gov/pubmed/25659069

and Brain Connect, November 2015:

www.ncbi.nlm.nih.gov/pubmed/26449441

Edit: Adding background re: Dr. Staud's field "Rheumatology/Clinical Immunology" perhaps of interest to @Jonathan Edwards:

http://rheumatology.medicine.ufl.edu/about-us/division-faculty/roland-staud-m-d/
 
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Research 1st

Severe ME, POTS & MCAS.
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Recent work from our laboratory and others utilizing arterial spin labeling functional magnetic resonance imaging (ASL) indicated that ME/CFS patients have lower resting state regional cerebral blood flow (rCBF) in several brain areas associated with memory, cognitive, affective, and motor function. This hypoperfusion may underlie ME/CFS pathogenesis and may result in alterations of functional relationships between brain regions. The current report used ASL to compare functional connectivity of regions implicated in ME/CFS between patients and healthy controls (HC).

Thank you for posting the study Kyla. For PWME stuck in the adhesive grip of Psychiatry, brain imaging studies is what we need to demonstrate a crippling neurological disease. (Hence the MRC funded the PACE trial to show the patients were mentally ill, and didn't spend £5 million of UK tax payers money on brain imaging studies).

Think how many years of patients lives having to suffer unable to 'think' correctly and feeling faint 24/7 (with normal BP) have been wasted by the reckless mismanagement of PWME by self reported 'fatigue'; defining CFS/ME. It is now 2016 and yet reduced brain blood flow (hypoperfusion) was demonstrated, way back in 1995 in, UK by Dr Costa.

So we knew this 21 years ago, and NOTHING had been done about it by NIH, CDC, HSS, UK Department of Health and so forth.

It's absolutely scandalous we're messing around debating CBT GET and the PACE scandal, when PWME have an observable brain blood flow dysfunction, of which other papers exist as well...and still the funding to follow this up, is zero.

See this historic paper from the UK (before 'CFS/ME' existed, and ME was ME) as an example.

QJM. 1995 Nov;88(11):767-73.
Brainstem perfusion is impaired in chronic fatigue syndrome.
Costa DC1, Tannock C, Brostoff J.
Author information

Abstract
We looked for brain perfusion abnormalities in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). An initial pilot study revealed widespread reduction of regional brain perfusion in 24 ME/CFS patients, compared with 24 normal volunteers. Hypoperfusion of the brainstem (0.72 +/- 0.05 vs. 0.80 +/- 0.04, p < 0.0001) was marked and constant.

We then tested whether perfusion to the brainstem in ME/CFS patients differs from that in normals, patients with major depression, and others with epilepsy. Data from a total of 146 subjects were included in the present study: 40 normal volunteers, 67 patients with ME/CFS (24 in the pilot study, 16 with no psychiatric disorders, 13 with ME/CFS and depression, 14 with ME/CFS and other psychiatric disorders), 10 epileptics, 20 young depressed patients and 9 elderly depressed individuals. Brain perfusion ratios were calculated using 99Tcm-hexamethylpropylene amine oxime (99Tcm-HMPAO) and single-photon emission tomography (SPET) with a dedicated three-detector gamma camera computer/system (GE Neurocam).

Brain-stem hypoperfusion was confirmed in all ME/CFS patients. Furthermore, the 16 ME/CFS patients with no psychiatric disorders and the initial 24 patients in the pilot study showed significantly lower brainstem perfusion (0.71 +/- 0.03) than did depressed patients (0.77 +/- 0.03; ANOVA, p < 0.0001).

Patients with ME/CFS have a generalized reduction of brain perfusion, with a particular pattern of hypoperfusion of the brainstem.