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. 2020 Apr;14(2):562-572.
doi: 10.1007/s11682-018-0029-4.

Evidence of Widespread Metabolite Abnormalities in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Assessment With Whole-Brain Magnetic Resonance Spectroscopy

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Free PMC article

Evidence of Widespread Metabolite Abnormalities in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Assessment With Whole-Brain Magnetic Resonance Spectroscopy

Christina Mueller et al. Brain Imaging Behav. .
Free PMC article

Abstract

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.

Keywords: Anterior cingulate; Brain temperature; Chronic fatigue syndrome; Magnetic resonance spectroscopy; Metabolites; Neuroinflammation.

Conflict of interest statement

Conflict of Interest: The authors declare that they have no conflict of interest.

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