Journal
BRAIN IMAGING AND BEHAVIOR
Volume 14, Issue 2, Pages 562-572Publisher
SPRINGER
DOI: 10.1007/s11682-018-0029-4
Keywords
Neuroinflammation; Chronic fatigue syndrome; Magnetic resonance spectroscopy; Anterior cingulate; Brain temperature; Metabolites
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Funding
- National Institute of Biomedical Imaging and Bioengineering [EB016064] Funding Source: Medline
- NIAID NIH HHS [R01 AI107655] Funding Source: Medline
- NIBIB NIH HHS [R01 EB016064] Funding Source: Medline
- Solve ME/CFS Initiative [Ramsay Award] Funding Source: Medline
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Previous neuroimaging studies have detected markers of neuroinflammation in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Magnetic Resonance Spectroscopy (MRS) is suitable for measuring brain metabolites linked to inflammation, but has only been applied to discrete regions of interest in ME/CFS. We extended the MRS analysis of ME/CFS by capturing multi-voxel information across the entire brain. Additionally, we tested whether MRS-derived brain temperature is elevated in ME/CFS patients. Fifteen women with ME/CFS and 15 age- and gender-matched healthy controls completed fatigue and mood symptom questionnaires and whole-brain echo-planar spectroscopic imaging (EPSI). Choline (CHO), myo-inositol (MI), lactate (LAC), and N-acetylaspartate (NAA) were quantified in 47 regions, expressed as ratios over creatine (CR), and compared between ME/CFS patients and controls using independent-samples t-tests. Brain temperature was similarly tested between groups. Significant between-group differences were detected in several regions, most notably elevated CHO/CR in the left anterior cingulate (p < 0.001). Metabolite ratios in seven regions were correlated with fatigue (p < 0.05). ME/CFS patients had increased temperature in the right insula, putamen, frontal cortex, thalamus, and the cerebellum (all p < 0.05), which was not attributable to increased body temperature or differences in cerebral perfusion. Brain temperature increases converged with elevated LAC/CR in the right insula, right thalamus, and cerebellum (all p < 0.05). We report metabolite and temperature abnormalities in ME/CFS patients in widely distributed regions. Our findings may indicate that ME/CFS involves neuroinflammation.
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