Progressive brain changes in patients with chronic fatigue syndrome: A longitudinal MRI study.
To examine progressive brain changes associated with chronic fatigue syndrome (CFS).



We investigated progressive brain changes with longitudinal MRI in 15 CFS and 10 normal controls (NCs) scanned twice 6 years apart on the same 1.5 Tesla (T) scanner. MR images yielded gray matter (GM) volumes, white matter (WM) volumes, and T1- and T2-weighted signal intensities (T1w and T2w). Each participant was characterized with Bell disability scores, and somatic and neurological symptom scores. We tested for differences in longitudinal changes between CFS and NC groups, inter group differences between pooled CFS and pooled NC populations, and correlations between MRI and symptom scores using voxel based morphometry. The analysis methodologies were first optimized using simulated atrophy.



We found a significant decrease in WM volumes in the left inferior fronto-occipital fasciculus (IFOF) in CFS while in NCs it was unchanged (family wise error adjusted cluster level P value, PFWE< 0.05). This longitudinal finding was consolidated by the group comparisons which detected significantly decreased regional WM volumes in adjacent regions (PFWE< 0.05) and decreased GM and blood volumes in contralateral regions (PFWE< 0.05). Moreover, the regional GM and WM volumes and T2w in those areas showed significant correlations with CFS symptom scores (PFWE< 0.05).



The results suggested that CFS is associated with IFOF WM deficits which continue to deteriorate at an abnormal rate. J. Magn. Reson. Imaging 2016;44:1301-1311.
National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, Australia. z.shan@griffith.edu.au.
Zack Y
ZY
Shan
Division of Medical Subspecialities, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia.
Richard
R
Kwiatek
Endocrinology department, Royal Adelaide Hospital, Adelaide, Australia.
Richard
R
Burnet
Healthfirst Network, Woodville, Australia.
Peter
P
Del Fante
National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, Australia.
Donald R
DR
Staines
National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, Australia.
Sonya M
SM
Marshall-Gradisnik
National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, Australia.
Leighton R
LR
Barnden
D000328:Adult; D000375:Aging / Q000473:pathology*; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D018450:Disease Progression; D015673:Fatigue Syndrome, Chronic / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008137:Longitudinal Studies; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology
chronic fatigue syndrome; inferior fronto-occipital fasciculus; longitudinal MRI; voxel based morphometry