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Longitudinal MRI study in CFS patient: a CDC criteria study

Discussion in 'Latest ME/CFS Research' started by shrewsbury, Mar 21, 2010.

  1. shrewsbury

    shrewsbury member

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    Longitudinal MRI shows no cerebral abnormality in chronic fatigue syndrome

    Fred Springfield posted this to co-cure March 20 2010

    (if: The conclusions that "scientists" jump to in studies often appears to be supremely subjective and far beyond the reach of the data. This is an example of that to me. I actually find it quite frightening.)

    Longitudinal MRI shows no cerebral abnormality in chronic fatigue syndrome.

    Journal: Br J Radiol. 2010 Mar 11. [Epub ahead of print]

    Authors: Perrin R, Embleton K, Pentreath VW, Jackson A.

    Affiliation: Imaging Science and Biomedical Engineering, Department of Medicine, University of Manchester, Oxford Road, Manchester M13 9PT, UK.

    NLM Citation: PMID: 20223910


    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 DWMH, 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.
  2. Kati

    Kati Patient in training

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    Would love to hear Dr Hyde's point of view on this- he seems to know a lot in terms of SPECT and MRI.
  3. HowToEscape?

    HowToEscape? Senior Member

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    The bolded sentence appears to imply only that MRI, at least as used in the study, is not a good CF diagnostic tool for the patient population they tested. Knowing what tests are not reliably connected to a CFID diagnosis is valuable - otherwise, one could be mislead by dozens of normal test results.

    Other reports I've seen indicate decreased blood and brain volume and brain abnormalities in us folks, but few have had such tests. What's different about this study and those that do find abnormalities - did they use something other than MRI? Different patient population? Different stage of disease?
  4. Dolphin

    Dolphin Senior Member

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    Here are the last three paragraphs. The last one makes the point you make:

  5. Koan

    Koan Be the change.

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    Must say, I really hope this is right! The thought of brain atrophy is very scary.

    especially given the way my brain has been working - rather, not working - over the past little while.

    They must have actually done fMRIs or MRAs as I do not believe much can be determined re blood and CFS flow on a standard brain MRI. Certainly not on the old T2 weighted MRI I had that revealed more than a dozen hyperintensities in deep white matter.

    I hope this is true.

    ETA Thanks for more info Tom, that addresses my question concerns about the limitations of standard MRI, I think -- well, actually, I can't.

    And, thanks If for another great find!
  6. Alesh

    Alesh Senior Member

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    During the course of my illness the doctors found the following:
    1. EEG: It is normal. You suffer from somatoform disorder.
    2. CT: It is normal. You suffer from somatoform disorder.
    3. MRI: It is normal. You suffer from somatoform disorder.
    4. SPECT/CT: The scan of your brain looks like that of a moribund patient with Alzheimer disease but we don't know why. You suffer from somatoform disorder.
  7. hvs

    hvs Senior Member

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    Sorry: have to dismiss any study coming out of the UK until they can prove to me that they're studying a legitimate patient pool.
    Wish they'd studied VO2 max and repeated treadmill test--and among legitimate subjects--not psychiatrist-approved...
  8. Koan

    Koan Be the change.

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    Very true hvs! I am very quick to accept anything that says my brain isn't shrinking!

    :D
  9. dannybex

    dannybex Senior Member

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    I agree. Plus it's such a tiny patient and cohort sample.
  10. Koan

    Koan Be the change.

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    Does this mean my brain is shrinking?
  11. guest

    guest Guest

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    :
    :D :D :D
  12. gracenote

    gracenote All shall be well . . .

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    I don't know Koan. But I think
    your sense of humor is growing!!!
  13. Koan

    Koan Be the change.

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    Well, when I'm here

    my heart sure is!

    :hug:
  14. Dolphin

    Dolphin Senior Member

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    Here's the info on the participants for what it's worth:

  15. Gerwyn

    Gerwyn Guest

    not cfs patients so no reason for abnormalities
  16. Kati

    Kati Patient in training

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    http://bjr.birjournals.org/cgi/content/full/83/989/419

    Longitudinal MRI shows no cerebral abnormality in chronic fatigue syndrome

    Another waste of funds from the British government?
  17. oerganix

    oerganix Senior Member

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    Reeves Disease

    Possibly very valuable.;)

    Proves you can't find Reeves Disease with MRI. You need a psychiatrist to find it.:D

    Now, if you do brain scans with Dopler Imaging, you can differentiate ME/CFS brains, but you can't have that in UK...doing these kinds of tests only encourages false illness beliefs. :eek:
  18. Esther12

    Esther12 Senior Member

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    I thought it was only functional MRIs that were thought to pick things up with CFS anyway? They did try to exclude patients with depression and anxiety. We wouldn't be slagging the study if they had found something! It was such a small group, and using CDC criteria, so it's far from definitive, but I think this paper looks okay to me. It would be great if they'd discovered some easily treatable problem, but negative results can be helpful too.
  19. Jerry S

    Jerry S Senior Member

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    They did use Fukuda and screen for depressive and anxiety states. However, the authors state, "None of the CFS patients was considered to be from the extreme end of the symptomatic spectrum (i.e. bedridden or with intense sensitivity to any external stimuli)."

    Fukuda, also, does not require that post-exertional malaise be present.
  20. Dolphin

    Dolphin Senior Member

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