Article: The State of Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome Research in 2018

https://patientworthy.com/2018/06/04/state-chronic-fatigue-syndrome-research-2018/

Comments are allowed. Perhaps people could thank the author and add to the information in the article.

 

What changes do PET scans reveal?

A brief summary of Komaroff's Webinar "Hot Areas in ME/CFS Research". Thanks to the author!

 

Reduced areas of blood flow and metabolism. Such as:

'CFS patients showed a significant hypometabolism in right mediofrontal cortex (P = 0.010) and brainstem (P = 0.013) in comparison with the healthy controls. Moreover, comparing patients affected by CFS and depression, the latter group showed a significant and severe hypometabolism of the medial and upper frontal regions bilaterally (P = 0.037-0.001), whereas the metabolism of brain stem was normal. Brain 18FDG PET showed specific metabolism abnormalities in patients with CFS in comparison with both healthy controls and depressed patients. The most relevant result of our study is the brain stem hypometabolism which, as reported in a perfusion SPECT study, seems to be a marker for the in vivo diagnosis of CFS.' (This study.)

And:

'The BP(ND) values of (11)C-(R)-PK11195 in the cingulate cortex, hippocampus, amygdala, thalamus, midbrain, and pons were 45%-199% higher in CFS/ME patients than in healthy controls. In CFS/ME patients, the BP(ND) values of (11)C-(R)-PK11195 in the amygdala, thalamus, and midbrain positively correlated with cognitive impairment score, the BP(ND) values in the cingulate cortex and thalamus positively correlated with pain score, and the BP(ND) value in the hippocampus positively correlated with depression score.' (This study.)

I think there may be other neuroimaging studies that corroborate some of these findings (particularly in the brainstem), but sample size is usually very small.

 

Thank you @adambeyoncelowe! Is this meant by "changes in immune system activity"? I wonder...In my case, the thymus was found to be under-active compared to other women of my age...but I wonder how you could measure immune system activity via PET.

Is it relevant that the right side was found to be abnormal (plus brainstem), or is it more relevant that it's only one side compared to both sides in depression? How reliable is the finding?

 

I'm not sure. The areas affected appear to correlate with neurocognitive complaints (slowed activity when completing tasks, for instance) and fatigue, I think. You'd really need a neuroimaging expert. But there are lots of SPECT and a few MRI studies too.

The main contention seems to be whether these changes are secondary to inactivity and/or psychological problems (BPS argument) versus whether they cause symptoms (biomedical/neuroimmune model). The brain changes are definitely distinct from depression but beyond that, it's hard to say.