Investigating the neural substrates of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) : a structural and functional MRI study

Abstract:

Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is characterised by continuous fatigue and has many diagnostic criteria. Cognitive dysfunction affects 86-94% of adults with CFS/ME.

This thesis used MRI applications to investigate brain structure and function in CFS/ME. This thesis hypothesised to find brain volume differences, functional connectivity differences in brain networks, and functional differences measured by Blood Oxygenation Level Dependant (BOLD) signal activation during working memory task performance.

The working memory paradigm was designed to investigate working memory components, processing and storage separately and combined. The relationship between fatigue and performance was assessed. This thesis’s original contribution provides evidence that the salience network might have altered resting-state functional connectivity in CFS/ME in the absence of morphological differences.

The salience network is involved in detecting and integrating salient sensory information; therefore, disruption in this network might disrupt incoming cognitive stimuli and influence other networks’ connectivity, involved in fatigue and impaired memory.

In the more demanding task, participants with CFS/ME were slower and less accurate but used the same working memory network as healthy controls. No brain volume differences, nor atrophy were found. The differences between these findings compared to previous studies might be due to different study designs, analysis methods, sample sizes with different symptoms, including illness duration, physical inactivity and sleep disturbance.

The salience network alteration could potentially have a significant role in CFS/ME, as we cannot determine cause and effect with current experimental design the association with fatigue and other CFS/ME symptoms remains unclear. Using longitudinal studies that account for neurologically relevant confounders are needed in CFS/ME to further investigate the role of salience network.

Source: Almutairi, Basim S. Investigating the neural substrates of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) : a structural and functional MRI study. PhD Thesis, University of Bristol. uk.bl.ethos.866683  https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.866683

Emotional conflict processing in adolescent chronic fatigue syndrome: A pilot study using functional magnetic resonance imaging

Abstract:

INTRODUCTION: Studies of neurocognition suggest that abnormalities in cognitive control contribute to the pathophysiology of chronic fatigue syndrome (CFS) in adolescents, yet these abnormalities remain poorly understood at the neurobiological level. Reports indicate that adolescents with CFS are significantly impaired in conflict processing, a primary element of cognitive control.

METHOD: In this study, we examine whether emotional conflict processing is altered on behavioral and neural levels in adolescents with CFS and a healthy comparison group. Fifteen adolescent patients with CFS and 24 healthy adolescent participants underwent functional magnetic resonance imaging (fMRI) while performing an emotional conflict task that involved categorizing facial affect while ignoring overlaid affect labeled words.

RESULTS: Adolescent CFS patients were less able to engage the left amygdala and left midposterior insula (mpINS) in response to conflict than the healthy comparison group. An association between accuracy interference and conflict-related reactivity in the amygdala was observed in CFS patients. A relationship between response time interference and conflict-related reactivity in the mpINS was also reported. Neural responses in the amygdala and mpINS were specific to fatigue severity.

CONCLUSIONS: These data demonstrate that adolescent CFS patients displayed deficits in emotional conflict processing. Our results suggest abnormalities in affective and cognitive functioning of the salience network, which might underlie the pathophysiology of adolescent CFS.

 

Source: Wortinger LA, Endestad T, Melinder AM, Øie MG, Sulheim D, Fagermoen E, Wyller VB. Emotional conflict processing in adolescent chronic fatigue syndrome: A pilot study using functional magnetic resonance imaging. J Clin Exp Neuropsychol. 2016 Sep 20:1-14. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/27647312