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Possible Brain Biomarker for ME/CFS Found

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15,786

snowathlete

Senior Member
Messages
5,374
Location
UK
My understanding is that nominal aphasia (trouble finding words) is pretty common in ME. I certainly have it, and it's worse when my other symptoms are worse.
I'm the same and I also have problems talking full stop when I am at my worst. I know what I want to say but I can't. Interesting as I had thought it was all left side but clearly it's not actually clear cut - thanks to those who posted on that above.

This study could be important, but we won't know unless someone tries to replicate it in a larger group. Not knocking the study though, I'd rather have a small study than no study.

I'd have thought brain scans might be more reliable than things like cytokine markers which fluctuate and are prone to different methods affecting results. But I don't know much about these kinds of brain scans. Anyone with more knowledge on the consistency of such scans?
 

allyann

Senior Member
Messages
418
Location
Melbourne Australia
I'm the same and I also have problems talking full stop when I am at my worst. I know what I want to say but I can't. Interesting as I had thought it was all left side but clearly it's not actually clear cut - thanks to those who posted on that above. This study could be important, but we won't know unless someone tries to replicate it in a larger group. Not knocking the study though, I'd rather have a small study than no study. I'd have thought brain scans might be more reliable than things like cytokine markers which fluctuate and are prone to different methods affecting results. But I don't know much about these kinds of brain scans. Anyone with more knowledge on the consistency of such scans?

I have trouble speaking when my symptoms are worse. I can picture the words in my head, but they are just out of reach. I try to talk and the words don't come. When I get migraines I can't speak. Twice I have ended up in an ambulance as people think I have had a stroke.
 

xchocoholic

Senior Member
Messages
2,947
Location
Florida
Thanks for the article.

This was one of my first symptoms. All of the sudden I couldn't read or comprehend anything. This has improved significantly since changing my diet but not enough. It's still very frustrating.

I wonder what Dr Perlmutter thinks about this study.

Tx .. x
 

Gijs

Senior Member
Messages
690
Why didn''t they replicate the Japanese study about microglia? That would be much better to have a real biomarker,
 

misskatniss

Senior Member
Messages
116
Location
Germany
If it replicated the differences in gray and white brain matter, it isn´t useless at all but underlines the reliability of that difference between healthy people´s and ME patients´ brains. And if the deformed right fasciculus arcuatus brings more investigation in what that is needed for, for me that´s fine. We have so little that I appreciate any piece of the puzzle. Science is trial and error, mostly, but I prefer it to the pure error of Psychobabble ;-) Although, damn it, they are right - it´s all in our heads - (sarcasm off).
 

Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
Another thing that came out of the Stanford symposium where this was measured is we have reduced cortical thickness in most places, but one place that is increased in thickness.
Not quite and I'm not sure the difference is meaningful.

Thickness.—Global cortical thickness was equivalent between populations (2.437 mm ± 0.102 in patients with CFS vs 2.418 mm ± 0.091 in control subjects; P = .932) (Table 2, Fig 1). No focal left hemispheric differences were present. However, the right hemisphere demonstrated five regions of increased cortical thickness when accounting for age and handedness, which was most notable in the younger, not the older, patients with CFS, with no regions of decreased cortical thickness (Table 2, Fig 1). No regions demonstrated cortical thickness that increased significantly with age. No significant correlations with MFI-20 were present bilaterally in the CFS group.
 

helperofearth123

Senior Member
Messages
202
This is very encouraging news, it's spreading around the web providing vindication of the physical nature of our disease which will help in future fundraising and hopefully generate more interest from researchers in relevant fields now that a lead has been found for them to follow up on.

Web links to this story:
http://www.today.com/health/chronic-fatigue-real-new-brain-scans-show-1D80250083
http://www.sfgate.com/health/article/Findings-of-brain-anomalies-may-shed-light-on-5851844.php
https://uk.news.yahoo.com/brain-abnormalities-people-chronic-fatigue-study-065104699.html
http://news.discovery.com/human/hea...lities-in-chronic-fatigue-patients-141029.htm
http://www.cbsnews.com/videos/chronic-fatigue-sufferers-have-brain-abnormality-study-says/

That's a whole lot of publicity for the cause! Good news! :)
 

Snow Leopard

Hibernating
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5,902
Location
South Australia
Thirteen of the 15 patients with CFS and 10 of 14 control subjects were right-handed. 55% were women, average age was 46.5 years and the average length of illness was 12 years.

results for diffusion-tensor imaging in right handed subjects said:
An ROC curve was calculated by using maximal FA in the anterior 10% of the right arcuate fasciculus to diagnose CFS in right-handed patients (Fig 4 shows the hypothesis-testing data set ROC). A threshold of 0.6 would be used to correctly diagnose CFS in right-handed patients in the hypothesis-generating data set, with a sensitivity, specificity, and area under the ROC curve of 81.8% (95% CI: 48.2%, 97.7%), 100% (95% CI: 69.2%, 100%), and 0.918 (95% CI: 0.696, 0.988), respectively. In the hypothesis-testing data set, the same measurements were 72.7% (95% CI: 39.0%, 94.0%), 90.0% (95% CI: 55.5%, 99.7%), and 0.891 (95% CI: 0.696, 0.98) respectively.

Starting to get interesting. The specificity of 100% is important, but 82% sensitivity is still low. They however suggest in the discussion:

Even though the hypothesis-testing data set confirms the veracity of increased FA in the right anterior arcuate, it was determined in the same subjects and cannot be considered a fully independent data set. The correlation between MFI-20 and right anterior arcuate FA was only significant in the hypothesis-generating data set, not the hypothesis-testing data set. Although this may be technically related to the reduced spatial resolution of the latter data set, the utility of arcuate FA as a disease biomarker cannot be conclusively confirmed on this study.

Also of note:

discussion said:
Our volumetry results stand in contradistinction to the literature and show reduced gray matter volumes, either globally or in the prefrontal cortices (6,7,27,33). In fact, we found that the prefrontal volumes trended toward being slightly higher in patients with CFS.

I can't really make much sense of the rest of the results at this stage.
 

snowathlete

Senior Member
Messages
5,374
Location
UK
I have trouble speaking when my symptoms are worse. I can picture the words in my head, but they are just out of reach. I try to talk and the words don't come. When I get migraines I can't speak. Twice I have ended up in an ambulance as people think I have had a stroke.
My father who had crippling migraines used to have severe speech problems with them as well as other symptoms similar to ME/CFS which has always made me wonder if we both had similar problems, presenting as two different diseases.
 

NK17

Senior Member
Messages
592
This is and should be regarded and recieved as a very important study in the field of ME/Cfs!

As some PR's members have posted above me, neurocognitive symptoms such as anomia paired with lack of concentration, short term memory problems and an overall slowing down of mental processes have been the central part of my ME manifestations from the very start.

Our intelligence per se is spared, but the mental working capacity and endurance is at times gravely incapacitated. In parallel people with MS can tell you about similar experiences.

The CNS dysfunction is certainly a manifestation of inflammation. The fact that some of us who had brain imaging studies (MRI) were found to have subcortical white matter hyperintensities means something. It should be looked for and should be accounted as a very anomalous and important finding of organic brain damage.

" ME is a measurable, diffuse, post-encephalitic illness, the illness is charaterized by:
1. Acute onset
2. Diffuse, persisting non-focal nature of the encephalopathy, and
3. The cronichity of the resulting symptoms.
These symptoms consists of the rapid exhaustion or loss of stamina of motor, sensory, intellectual and cognitive abilities.
M.E. is of infectious/autoimmune origin and less commonly of toxic/AI origin.
M.E. occurs in epidemics and sporadic cases."
- Dr. Baron Hyde

IMO what we've seen so far is just the tip of the iceberg, imaging techniques that we have at our disposition aren't still routinely used on PWME (with the exception of some ME specialists, Dr. Dan Peterson for example), but should be and should also be correlated to the specific clinical picture.

All this also makes me wonder about what we still don't see or don't look for, the NEDA Non Evident Disease Activity (to mutuate a term from the MS research field), which is very important too.

When I first came down with Infectious Mono as a teenager I went from being a straight A student to one who couldn't read a single sentence and make any sense of it in any of the languages that I spoke and still speak.

I struggled and suffered without understanding what was going on with me, through many many ups and downs I managed to finish high school, but had to repeat junior high school year. Back then there was no home schooling support in Italy and I wonder if nowadays doctors and teachers are more aware of what is the best treatment for young people with IM and/or ME: rest, rest, rest and more rest!

I managed to go to law school and graduate, it was also a brutal and grueling experience, as many of you unfortunately know and can imagine I had to follow the waxing and waning of all the physical and neurological symptoms. It was like living through pure hell!

This study fresh out of Stanford adds another very important piece to the puzzle.
 
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Snow Leopard

Hibernating
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5,902
Location
South Australia
I'm struggling to understand what the increased Fractional Anisotropy actually means. In terms of brain injury, low FA indicates axonal injury.

But high FA can suggest overcompensation, rather than simply increased functioning.
http://www.jneurosci.org/content/27/44/11960.full (increased FA in Williams Syndrome)

I think brain imaging studies are hard to control for except in twin studies (and even then...)
 
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15,786
Starting to get interesting. The specificity of 100% is important, but 82% sensitivity is still low.
100% specificity is very impressive, even in a preliminary study. It basically means that if someone has that abnormality as described, they have ME/CFS, correct? But only 82% of ME patients would have that abnormality?

If it holds up in bigger studies that would be quite a breakthrough.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Starting to get interesting. The specificity of 100% is important, but 82% sensitivity is still low. They however suggest in the discussion:

Specificity is MUCH more important for us than sensitivity. Its critical. Sensitivity would be expected to be lower because even under a tight definition it would still be a somewhat heterogeneous group. If 100% specificity could be shown in a larger replication, we might have a biomarker, provided only that other disorders don't have a similar finding.