Grey and white matter differences in CFS - A voxel-based morphometry study.

[Countrygirl]

https://www.ncbi.nlm.nih.gov/pubmed/29021956



Neuroimage Clin. 2017 Sep 28;17:24-30. doi: 10.1016/j.nicl.2017.09.024. eCollection 2018.

Grey and white matter differences in Chronic Fatigue Syndrome - A voxel-based morphometry study.
Finkelmeyer A1, He J2, Maclachlan L3, Watson S1, Gallagher P1, Newton JL4, Blamire AM5.
Author information

Abstract
OBJECTIVE:
Investigate global and regional grey and white matter volumes in patients with Chronic Fatigue Syndrome (CFS) using magnetic resonance imaging (MRI) and recent voxel-based morphometry (VBM) methods.

METHODS:
Forty-two patients with CFS and thirty healthy volunteers were scanned on a 3-Tesla MRI scanner. Anatomical MRI scans were segmented, normalized and submitted to a VBM analysis using randomisation methods. Group differences were identified in overall segment volumes and voxel-wise in spatially normalized grey matter (GM) and white matter (WM) segments.

RESULTS:
Accounting for total intracranial volume, patients had larger GM volume and lower WM volume. The voxel-wise analysis showed increased GM volume in several structures including the amygdala and insula in the patient group. Reductions in WM volume in the patient group were seen primarily in the midbrain, pons and right temporal lobe.

CONCLUSION:
Elevated GM volume in CFS is seen in areas related to processing of interoceptive signals and stress. Reduced WM volume in the patient group partially supports earlier findings of WM abnormalities in regions of the midbrain and brainstem.

KEYWORDS:
Amygdala; Chronic Fatigue Syndrome; Insula; Midbrain; Voxel-based morphometry



10.1016/j.nicl.2017.09.024

 

[Countrygirl]

There is also this from 2016:

J Magn Reson Imaging. 2016 Nov;44(5):1301-1311. doi: 10.1002/jmri.25283. Epub 2016 Apr 28.
Progressive brain changes in patients with chronic fatigue syndrome: A longitudinal MRI study.
Shan ZY1, Kwiatek R2, Burnet R3, Del Fante P4, Staines DR5, Marshall-Gradisnik SM5, Barnden LR5.
Author information

Abstract
PURPOSE:
To examine progressive brain changes associated with chronic fatigue syndrome (CFS).

MATERIALS AND METHODS:
We investigated progressive brain changes with longitudinal MRI in 15 CFS and 10 normal controls (NCs) scanned twice 6 years apart on the same 1.5 Tesla (T) scanner. MR images yielded gray matter (GM) volumes, white matter (WM) volumes, and T1- and T2-weighted signal intensities (T1w and T2w). Each participant was characterized with Bell disability scores, and somatic and neurological symptom scores. We tested for differences in longitudinal changes between CFS and NC groups, inter group differences between pooled CFS and pooled NC populations, and correlations between MRI and symptom scores using voxel based morphometry. The analysis methodologies were first optimized using simulated atrophy.

RESULTS:
We found a significant decrease in WM volumes in the left inferior fronto-occipital fasciculus (IFOF) in CFS while in NCs it was unchanged (family wise error adjusted cluster level P value, PFWE < 0.05). This longitudinal finding was consolidated by the group comparisons which detected significantly decreased regional WM volumes in adjacent regions (PFWE< 0.05) and decreased GM and blood volumes in contralateral regions (PFWE < 0.05). Moreover, the regional GM and WM volumes and T2w in those areas showed significant correlations with CFS symptom scores (PFWE < 0.05).

CONCLUSION:
The results suggested that CFS is associated with IFOF WM deficits which continue to deteriorate at an abnormal rate. J. Magn. Reson. Imaging 2016;44:1301-1311.

© 2016 The Authors Journal of Magnetic Resonance Imaging published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.

KEYWORDS:
chronic fatigue syndrome; inferior fronto-occipital fasciculus; longitudinal MRI; voxel based morphometry

See this:

https://www.ncbi.nlm.nih.gov/pmc/?term=27123773[PMID]&report=imagesdocsum

 

[Binkie4]

I 'liked' your post @Countrygirl, but its content is alarming especially when one senses capacities diminishing.

 

[Countrygirl]

I 'liked' your post @Countrygirl, but its content is alarming especially when one senses capacities diminishing.

Yes, I know @Binkie4 .

My heart sank when I saw in my medical notes of last year my GP's note to the nurse: This patient is at high risk of dementia....................with the last word written in capitals and with starts either side. Not a happy thought, is it......and she has no knowledge of how ME impacts our cognitive abilities. The risk is through uncontrollably spiking blood pressure.

 

[Binkie4]

@Countrygirl- thank you for the information about BP. I began treatment for high BP just over a year ago and it seems reasonably controlled although I do have readings that are suddenly inexplicably high but then reduce to normal. I think I will replace my BP monitor. I have had it a long time but did have it recalibrated a couple of years ago. At the moment I think equipment unreliability might be a factor. My memory is significantly worse. I am sorry about what your doctor wrote.

 

[Countrygirl]

@Countrygirl- thank you for the information about BP. I began treatment for high BP just over a year ago and it seems reasonably controlled although I do have readings that are suddenly inexplicably high but then reduce to normal. I think I will replace my BP monitor. I have had it a long time but did have it recalibrated a couple of years ago. At the moment I think equipment unreliability might be a factor. My memory is significantly worse. I am sorry about what your doctor wrote.

@Binkie4 Thank you for your kind words.

While I had the usual severe hypotension associated with ME I developed sudden bouts of malignant hypertension where the BP, in my case, tripled within seconds. It causes major organ damage. Then I also began to have stage 3 hypertension as well as the malignant bouts and recently temporally lost the sight in one eye as a result and it has affected my heart, leading to crescendo angina and also caused Meniere's as it damages the vestibular system.

I saw Dr Willy Weir and he told me that other of his (long-term?) patients are also developing these dangerous abrupt spikes in BP.

It would be interesting if there could be a research project on us long-timers to see how
the pattern of our BP changes before we become daisy fodder.

 

[perrier]

This is all very alarming.....please someone send something cheery....

 

[John Mac]

This is already being discussed here:
http://forums.phoenixrising.me/inde...n-chronic-fatigue-syndrome.54788/#post-915301

 

[charles shepherd]

MEA Review: Grey and white matter differences in chronic fatigue syndrome | 19 October 2017

A recent study reported differences in brain structure in people with chronic fatigue syndrome (ME/CFS). This was not the first paper to report such aberrations, but it was the first to reportincreased Grey Matter volume compared to healthy controls.

Rather than attempt to place all of our review on this blog, we have made it available to view online or download as a pdf. file.

The full review is a lay explanation of this study, of other research in this area, and it includes an overview of brain pathology and explains how these findings might affect functionality. Some extracts from the review are shown below, beginning with a summary from Dr Shepherd.


Introductionary comment from Dr Charles Shepherd, Hon Medical Adviser, ME Association:

This study was carried out in Newcastle by Professor Julia Newton and colleagues – a team who have not only achieved a long and distinguished record in ME/CFS research but also have access to patients who have been very carefully assessed from a clinical point of view. So, the results should be taken seriously.

As has been pointed out in this review, three of the main criticisms of previous neuroimaging studies involving people with ME/CFS is that the numbers involved have often been far too small; there has been a lack of information from other control groups that would be relevant in addition to the use of healthy controls; and that different imaging techniques have been used. So, not surprisingly, the results are not always consistent.

Despite these caveats, these results clearly add weight to the findings from previous neuroimaging studies describing white matter abnormalities in ME/CFS but also raise the possibility of grey matter involvement in ME/CFS.

There are several possible explanations for these findings but no clear answer has emerged in the paper. Are they a primary feature of ME/CFS? Or are they secondary to other factors – e.g. duration of illness, decrease in activity, severity of fatigue – that are related to having ME/CFS? The only way to find out is through further research into what is clearly an interesting aspect of neuropathology in ME/CFS.

A fully referenced summary of all the key findings from both functional and structural neuroimaging studies in ME/CFS can be found in the Research section of the ME Association ‘An Exploration of the Key Clinical Issues’ available from our online shop.




Full MEA review here:

http://www.meassociation.org.uk/201...oxel-based-morphometry-study-19-october-2017/

Dr Charles Shepherd
Hon Medical Adviser, MEA

 

[boolybooly]

Thanks @charles shepherd the review is very helpful, especially with all the handy links. Food for thought.

The question it raises for me is to what extent these areas of the brain are expanding as opposed to not shrinking, considering the 5% decrease in TIV and 8% decrease in WM, which suggests significant loss of WM is a major contributor to the reduction of TIV.

It certainly is a muse for my experiences though, considering the strange experiences I have had regarding language, hyperacusis, light sensitivity, emotional lability and the increase in areas associated with internal self awareness which I feel reflects a necessary and natural recourse when seeking a way to cope and try to manage the affects of the illness. Also the decrease in WM echoes my sense that parts of my character and ability have been disappearing since onset.

Agree with the point about the potential for confirmation bias in dwelling on the amygdala. I think all the areas identified deserve equal consideration.

 

[Marky90]

This is all very alarming.....please someone send something cheery....

I had something really fun to share

One moment
Erm..

I..

I..

Think I forgot