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Grey and white matter differences in Chronic Fatigue Syndrome

Cheesus

Senior Member
Messages
1,292
Location
UK
Grey and white matter differences in Chronic Fatigue Syndrome – A voxel-based morphometry study

Andreas Finkelmeyer, Jiabao He, Laura Maclachlan, Stuart Watson, Peter Gallagher, Julia L. Newton, Andrew M. Blamire

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.

https://ac.els-cdn.com/S22131582173...t=1507028636_13ca61427e7329ca4d260300b33ddba1
 
Messages
80
What would a grey/white-shift ostensibly lead to (in general, and in the areas in question specifically)?
 

aimossy

Senior Member
Messages
1,106
Although I am not keen on the conclusion terms I hope someone who knows more about this sort of work may be able to break down the study further because this was a larger size study at over 40 people not including controls.

It seems like they can make up any conclusions they want with these sort of studies? But I am not sure.
 
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13,774
I never take the time to look at the details of studies like this, but surely it would have been handy to have an ill-health control group too? Groups with different experiences wil tend to have used their brains in different ways.
 

NelliePledge

Senior Member
Messages
807
@Woolie any thoughts on this one??

I have not the foggiest idea what this is telling us - they should have to put a plain english summary for the public explaining their findings
 

TiredSam

The wise nematode hibernates
Messages
2,677
Location
Germany
physical cause of psychosomatic symptoms
Now that is an oxymoron @Wonko @BruceInOz . Couldn't they just cut out the middle man and say "physical cause of symptoms"? Or are they seriously suggesting that a physical cause leads to a psychosomatic response that causes physical symptoms? Sounds like someone's slipped an unnecessary layer of bullshit in there.
 
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3,263
Oooh, a neuro study for me!

Opens with a nice summary of the current mess we're in:
Previous studies on volumetric brain differences in CFS are scarce and have produced inconsistent findings.
So to sum up: at their best, findings either show nothing or are all over the place. Who smells nothing to see here?

Now for the current study. Talk about cherry picking! They found higher grey matter volumes in a whole range of areas, both left and right hemisphere, and in areas involved in things as diverse as memory, knowledge, visual processing. But the Abstrast only mentions the areas that might fit with a psychosomatic account: "The voxel-wise analysis showed increased GM volume in several structures including the amygdala and insula in the patient group."

They also found some reductions in white matter volume in the patient group in the midbrain, pons and right temporal lobe.

Oh, and then after the cherry picking, here comes the psychobabble:
Previous models of CFS have hypothesised a role for the amygdala in the pathophysiology of the condition (Gupta, 2002; Wyller et al., 2009). Its general role is perhaps best described as a salience and valence detector (Benarroch, 2015). It evaluates whether or not incoming sensations are of potential consequence for the equilibrium of the organism (salience) and whether any such disturbances are negative or positive (valence). The observed GM changes in the amygdala, together with the changes seen in the insula, could therefore suggest altered processing and evaluation, particularly of interoceptive signals in patients with CFS with consequences for both autonomic responses and cognitive/affective processing.
Man, cognitive neuroscience is in the shit. We just wade in, look at the areas where we see differences (reliable or not) and then work which ones we can shoehorned into our exisiting narrative.

I throw up my hands in despair.
 
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Messages
3,263
What would a grey/white-shift ostensibly lead to (in general, and in the areas in question specifically)?
Hard to know. Could be pure artefact, due to the particularly individuals they chose for the two groups (obviously you can only compared across groups in this kind of study). Or some of it could be measurement artefact. Some people have been saying lately that the algorithms we used to measure white and grey matter volume may be vulnerable to nuisance variables, like the degree of blood perfusion in an area.

I don't think its real, given that everyone's results are all over the place. That, and the fact that many outcomes are nil results. My conclusion: nothing to see here, folks. Time to look elsewhere.
 
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Messages
3,263
It seems like they can make up any conclusions they want with these sort of studies? But I am not sure.
Yes to that!
I never take the time to look at the details of studies like this, but surely it would have been handy to have an ill-health control group too? Groups with different experiences wil tend to have used their brains in different ways.
Yes, absolutely. Or you risk measuring the results of a sedentary life.
 
Messages
3,263
@Woolie do you have an example (hypothetical or otherwise) of what a good study showing white / grey matter volume reductions might look like?
1. A metanalysis of the existing evidence, which would show there are no reliable differences.

2. A review of same, concluding there is little evidence of systematic volume differences, and that we need to look elsewhere for evidence of abnormalities in MECFS (beyond the brain, that is).

3. (If you must), a new study with more than 100 MECFS patients and two groups of carefully matched controls: chronic disease controls (I might pick RA) and healthy sedentary people. Activity levels matched across groups. VBM. Any group differences should also be supported by correlational analyses showing the abnormality is related to ME severity and/or duration (an important check that it is the ME driving the differences, not bad group selection). FULL reporting of the results in the paper and in the abstract; no cherry picking the regions believed to play a role in somatisation/emotion.
 

Marky90

Science breeds knowledge, opinion breeds ignorance
Messages
1,253
Thanks for your thoughts Woolie. It would not surprise me if the brain was causative to some degree, but neither would really anything else either. We really are in the shadowlands
 

Mary

Moderator Resource
Messages
17,293
Location
Southern California
@Woolie - I'm not a scientist and really appreciate your take on this study. But I'm wondering - if there really are differences in gray and white matter in the brains of ME/CFS patients compared to normal controls, couldn't this be used in a positive way for us to show a physical basis for ME/CFS, much as the MRI finally convinced the medical world that MS was real based on the showing of demyelination in the brains of MS patients?

I get that the above study could be used by the BPS school as further evidence for proof of ME/CFS as a psychosomatic disorder, but it couldn't it be used to prove the opposite as well?