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Brainstem volume changes in myalgic encephalomyelitis/chronic fatigue syndrome and long COVID patients (Thapaliya et al, 2023)

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600
Abstract

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID patients have overlapping neurological, autonomic, pain, and post-exertional symptoms. We compared volumes of brainstem regions for 10 ME/CFS (CCC or ICC criteria), 8 long COVID (WHO Delphi consensus), and 10 healthy control (HC) subjects on 3D, T1-weighted MRI images acquired using sub-millimeter isotropic resolution using an ultra-high field strength of 7 Tesla. Group comparisons with HC detected significantly larger volumes in ME/CFS for pons (p = 0.004) and whole brainstem (p = 0.01), and in long COVID for pons (p = 0.003), superior cerebellar peduncle (p = 0.009), and whole brainstem (p = 0.005). No significant differences were found between ME/CFS and long COVID volumes. In ME/CFS, we detected positive correlations between the pons and whole brainstem volumes with “pain” and negative correlations between the midbrain and whole brainstem volumes with “breathing difficulty.” In long COVID patients a strong negative relationship was detected between midbrain volume and “breathing difficulty.” Our study demonstrated an abnormal brainstem volume in both ME/CFS and long COVID consistent with the overlapping symptoms.

https://www.frontiersin.org/articles/10.3389/fnins.2023.1125208/full
 

Wishful

Senior Member
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Alberta
Needs further research to figure out why the volume is increased. Different fluid levels? Larger or more glial cells? My guess is glial cells, since they can probably adjust their size quite rapidly, which would fit the rapid switching of temporary remissions.
 
Messages
600
Needs further research to figure out why the volume is increased. Different fluid levels? Larger or more glial cells? My guess is glial cells, since they can probably adjust their size quite rapidly, which would fit the rapid switching of temporary remissions.
I havent read too deep here but sounds like there wasnt a correlation with fatigue? It correlated with pain but what about fatigue...
 
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79
Does increased size means more neuronal and functional connections? Maybe the brain is trying to reorganize itself 'a little' to ensure proper functioning of some damaged pathway which triggered disease.
Or it's reaction to chronic hypoperfusion/altered neurometabolic processes?
 

Wishful

Senior Member
Messages
5,684
Location
Alberta
It correlated with pain but what about fatigue...

Fatigue is tricky for science, because there's still no way to reliably measure it, or even define it. ME has a "fatigue-like" symptom, which is equally hard to measure and define.
 

Wishful

Senior Member
Messages
5,684
Location
Alberta
Does increased size means more neuronal and functional connections?

My guess is "no", based on temporary remissions. You won't get massive changes in number of neurons over the space of less than an hour. As I understand it, glial cells can change their dimensions reasonably quickly, and extend their processes extremely quickly. Picture microglia shooting out and retracting thin "tentacles" in the time frame of microseconds (I think that's the time frame) to scan their surroundings. I'm not sure how that relates to overall volume change though.
 
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600
Quote from the paper

Voxel-based morphometry (VBM) reported a decrease in the pons and midbrain volume and an increase in the amygdala and insula volumes in ME/CFS patients (Finkelmeyer et al., 2018)

So pons volume was found smaller in Finkelmeyer but bigger in this new study.
 

overtheedge

Senior Member
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258
According to the book Behave: The biology of humans at our best and worst Lawmakers in Washington DC started taking PTSD much more seriously as a disease after it was found that veterans with ptsd had their hippocampus shrunken by the condition as well as changes in the size of the amygdala
 

Violeta

Senior Member
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2,895
"Cerebral edema, or brain swelling, is an increase of pressure in your head that may disrupt the blood-brain barrier. It is the body's way of responding to trauma, stroke, or infection"
 

Rufous McKinney

Senior Member
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13,251
"Cerebral edema, or brain swelling, is an increase of pressure in your head that may disrupt the blood-brain barrier. It is the body's way of responding to trauma, stroke, or infection"

YES

Possibilities-

increased brain stem volume could mean that brain tissue has dropped? (fallen, due to laxity of connective tissue)

swollen brain: more volume means swollen

Squeezed: all this swollen tissue has to fit into the same physical space as unswollen brain.

I feel my lower brain is being sQUEEZEd and my frontal brain and eyes are all SQUEEZEd most every day.

I think this is fascinating because it includes a major symptom often ignored: our air hunger and the lack of oxygen I seem to constantly feel despite breathing.
 

Rufous McKinney

Senior Member
Messages
13,251
Fatigue is tricky for science, because there's still no way to reliably measure it, or even define it. ME has a "fatigue-like" symptom, which is equally hard to measure and define.

Also true for this study: using very general subjective scales to rank pain and breathing difficulty. And patient severity.

My own subjective opinions about how I feel at any given moment aren't very reliable.
 

Violeta

Senior Member
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2,895
What could one do to reduce swelling in the brain?
swollen brain: more volume means swollen

Squeezed: all this swollen tissue has to fit into the same physical space as unswollen brain.

I feel my lower brain is being sQUEEZEd and my frontal brain and eyes are all SQUEEZEd most every day.

I think this is fascinating because it includes a major symptom often ignored: our air hunger and the lack of oxygen I seem to constantly feel despite breathing.

Good point that it causes oxygen deprivation.

"What is cerebral edema?
Cerebral edema is also known as brain swelling. It’s a life-threatening condition that causes fluid to develop in the brain.
This fluid increases the pressure inside of the skull — more commonly referred to as intracranial pressure (ICP). Increased ICP can reduce brain blood flow and decrease the oxygen your brain receives. The brain needs an uninterrupted flow of oxygen to function properly.
Swelling is the body’s response to injury. It can sometimes be treated with medication and rest.
Brain swelling can be very difficult to treat. It can also cause irreversible damage. The swelling can occur throughout the brain or in certain areas. Left untreated, cerebral edema can be fatal."
 

Violeta

Senior Member
Messages
2,895
Oh my

Encephalitis is irritation and swelling (inflammation) of the brain, most often due to infections.
...
Other viruses that cause encephalitis include:
  • Adenovirus.
  • Coxsackievirus.
  • Cytomegalovirus.
  • Eastern equine encephalitis virus.
  • Echovirus.
  • Japanese encephalitis, which occurs in Asia.
  • West Nile virus.