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Prefrontal Structure Varies as a Function of Pain Symptoms in Chronic Fatigue Syndrome.

RogerBlack

Senior Member
Messages
902
https://www.ncbi.nlm.nih.gov/pubmed/27817843
BACKGROUND:
Chronic fatigue syndrome (CFS) is characterized by severe fatigue persisting for ≥6 months and leading to considerable impairment in daily functioning. Neuroimaging studies of patients with CFS have revealed alterations in prefrontal brain morphology. However, it remains to be determined whether these alterations are specific for fatigue or whether they relate to other common CFS symptoms (e.g., chronic pain, lower psychomotor speed, and reduced physical activity).

METHODS:
We used magnetic resonance imaging to quantify gray matter volume (GMV) and the N-acetylaspartate and N-acetylaspartylglutamate/creatine ratio (NAA/Cr) in a group of 89 women with CFS. Building on previous reports, we tested whether GMV and NAA/Cr in the dorsolateral prefrontal cortex are associated with fatigue severity, pain, psychomotor speed, and physical activity, while controlling for depressive symptoms. We also considered GMV and NAA/Cr differences between patients with CFS and 26 sex-, age-, and education-matched healthy controls.

RESULTS:
The presence of pain symptoms was the main predictor of both GMV and NAA/Cr in the left dorsolateral prefrontal cortex of patients with CFS. More pain was associated with reduced GMVs and NAA/Cr, over and above the effects of fatigue, depressive symptoms, physical activity, and psychomotor speed. In contrast to previous reports and despite a large representative sample, global GMV did not differ between the CFS and healthy control groups.

CONCLUSIONS:
CFS, as diagnosed by Centers for Disease Control and Prevention criteria, is not a clinical entity reliably associated with reduced GMV. Individual variation in the presence of pain, rather than fatigue, is associated with neuronal alterations in the dorsolateral prefrontal cortex of patients with CFS.

Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
 
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3,263
There's lots of talk about Grey matter volume (GMV) in the neuroscience literature these days. Lots of scary studies about how playing too many computer games will reduce your GMV and conversely, how CBT/mindfulnes or whatever will increase it.

Grey matter volume - it sounds so permanent. But if you measure a single person's GMV in any area, it will very likely change from Time A to Time B. Whatever that person does. The larger and more systematically a person changes what they read/hear/see/feel, what activities they do, etc., the more GMV will change. Some regions might show an increase, others a decrease. This doesn't really mean anything. It just means there's been a change in the usage of different pathways.

GMV (at least when measured across time in a single person) is dynamic and constantly changing. This best way to think of this is that every experience alters our brain ever so slightly, and GMV is no exception.

People in pain show some GMV reductions in regions that might be involved in pain perception (even that part's not certain). Its totally unsurprising that there are some changes - the onset of chronic pain is a big change in a person's life, and of course its going to affect your brain. Pain changes a lot of other things too besides the pain experience- it can interfere with your concentration, limit your activity levels. Also, to adapt to it, you might also subtly change your mental activity and focus. Any of these things could decrease your GMV in a particular region. Some regions could even show increased GMV (study authors usually play these down because they are hard to explain).

And in fact, what you do see is that when the pain is relieved, the changes are reversed too. Here's a study that demonstrates exactly this.

So bottom line? Grey matter volume studies sound really profound, like they're going to give us all the answers we've been looking for. But until we understand more about what it is we are measuring, they are really not telling us a whole lot.

Achtung/Beware: Beware of GMV studies that are designed to "prove" a strongly held ideology - for example, ones that demonstrate CBT or mindfulness can increase your GMV, or that playing computer games or using your phone too much will reduce it. Chances are the researchers have carefully cherry picked the areas of GMV gain/loss, and probably brushed over any regions where the effects went in the opposite direction.
 

RogerBlack

Senior Member
Messages
902
Of taxi driver candidates, trying to learn a massive amount of geography
https://www.ncbi.nlm.nih.gov/pubmed/22169537
In those who qualified, acquisition of an internal spatial representation of London was associated with a selective increase in gray matter (GM) volume in their posterior hippocampi and concomitant changes to their memory profile. No structural brain changes were observed in trainees who failed to qualify or control participants. We conclude that specific, enduring, structural brain changes in adult humans can be induced by biologically relevant behaviors engaging higher cognitive functions

The brain is quite plastic, as above, and assumptions that changes are 'permanent' may often be unjustified.
For example, it seems quite obvious that if you've been (for example) a taxi driver, and get CFS, because you're not practicing that skill any more, the brain resources used slowly get repurposed.
You will of course need to re-learn some of the lost skill, more and more as you're away from it for longer, if you are 'cured'.

Annoyingly, I can't find any research on teh above paper testing people who have passed the knowledge, but been not driving taxis for x years.
 
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2,125
interesting article:
http://www.meresearch.org.uk/information/publications/structural-and-functional-neuroimaging/

and another:
https://www.masscfids.org/more-reso...educed-brain-gray-matter-in-patients-with-cfs

"here is some research that lends credence to the effect of reduced physical activity on the amount of gray matter in the brain. However, interestingly, in this study illness duration was not found to affect the gray matter decrease in the CFS subjects. This would, obviously, suggest that the reduction of gray matter in the CFS subjects was not due to reduced physical activity."
 
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Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
And in fact, what you do see is that when the pain is relieved, the changes are reversed too. Here's a study that demonstrates exactly this.

Indeed.

There seems to be a bias along the lines of: We found an association between X and Z, Z is bad therefore X is bad. But X might be a positive/beneficial adaptation to Z - yet this seems to be rarely considered in the discussion of such findings.

"here is some research that lends credence to the effect of reduced physical activity on the amount of gray matter in the brain. However, interestingly, in this study illness duration was not found to affect the gray matter decrease in the CFS subjects. This would, obviously, suggest that the reduction of gray matter in the CFS subjects was not due to reduced physical activity."

I don't follow what you are saying?

Physical activity doesn't necessarily correlate with illness duration.

Neither could it be a marker for deconditioning - if you stop exercising to high intensity, your body adjusts (cardiovascular deconditioning) to your new level of activity over a period of months. (and cardiovascular deconditioning is only really a problem when you try to exercise at high intensity - over 80% of maximum heart rate)
 
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3,263
There seems to be a bias along the lines of: We found an association between X and Z, Z is bad therefore X is bad. But X might be a positive/beneficial adaptation to Z - yet this seems to be rarely considered in the discussion of such findings.
Yea, there's a whole cultural overlay going on. CBT/mindfulness = good (a few decades ago, it might have been the virtues of labour and productivity). Using new technology = bad (in the 60s and 70s, it was TV that was rotting our kids' brains, and before that, pop music, and earlier, jazz and comic books).
 
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Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
Yea, there's a whole cultural overlay going on. CBT/mindfulness = good (a few decades ago, it might have been the virtues of labour and productivity). Using new technology = bad (in the 60s and 70s, it was TV that was rotting our kids' brains, and before that, pop music, and earlier, jazz and comic books).

Internet forums are rotting your brain! :nervous:
 
Messages
2,125
I don't follow what you are saying?
That's not what I am saying it come's from the link I posted. I think it is to argue against the suggestion that was put forward that the reduction was due to lack of physical activity ie along the same lines as deconditioning.