Journal
FRONTIERS IN NEUROSCIENCE
Volume 15, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fnins.2021.748426
Keywords
postexertional malaise; default mode network; DMN; blood oxygenation level dependent; BOLD; fibromyalgia; chronic idiopathic fatigue; submaximal exercise
Categories
Funding
- Department of Defense Congressionally Directed Medical Research Program (CDMRP) [W81XWH-151-0679, W81-XWH-09-1-0526]
- National Institute of Neurological Disorders and Stroke (NINDS) [R21NS088138, RO1NS085131]
- NINDS NRSA [F30NS103563]
- National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH), through the Clinical and Translational Science Awards Program (CTSA), part of the Roadmap Initiative, Re-Engineering the Clinical Research Enterprise [UL1TR000101]
- Sergeant Sullivan Circle
- Barbara Cottone
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This study found that individuals with ME/CFS showed increased spontaneous activity in the medial prefrontal cortex, the anterior node of the Default Mode Network, after exercise, while controls exhibited decreased activation in this region. Overall, controls had higher BOLD signals indicating reduced global cerebral blood flow in ME/CFS.
Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is characterized by disabling fatigue and postexertional malaise. We developed a provocation paradigm with two submaximal bicycle exercise stress tests on consecutive days bracketed by magnetic resonance imaging, orthostatic intolerance, and symptom assessments before and after exercise in order to induce objective changes of exercise induced symptom exacerbation and cognitive dysfunction.Method: Blood oxygenation level dependent (BOLD) scans were performed while at rest on the preexercise and postexercise days in 34 ME/CFS and 24 control subjects. Seed regions from the FSL data library with significant BOLD signals were nodes that clustered into networks using independent component analysis. Differences in signal amplitudes between groups on pre- and post-exercise days were determined by general linear model and ANOVA.Results: The most striking exercise-induced effect in ME/CFS was the increased spontaneous activity in the medial prefrontal cortex that is the anterior node of the Default Mode Network (DMN). In contrast, this region had decreased activation for controls. Overall, controls had higher BOLD signals suggesting reduced global cerebral blood flow in ME/CFS.Conclusion: The dynamic increase in activation of the anterior DMN node after exercise may be a biomarker of postexertional malaise and symptom exacerbation in CFS. The specificity of this postexertional finding in ME/CFS can now be assessed by comparison to post-COVID fatigue, Gulf War Illness, fibromyalgia, chronic idiopathic fatigue, and fatigue in systemic medical and psychiatric diseases.
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