Neuroimaging characteristics of ME/CFS: a systematic review. Shan et al. 2020

Full Title:
Neuroimaging characteristics of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a systematic review.

https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-020-02506-6

 

Made a thread, trying the summarize the main conclusions of the review. Feel free to point out any mistakes

https://twitter.com/user/status/1301209122214416386


2) First, the review notes that ME/CFS is an under-recognised disease because the selected studies were small and unimpressive. The sample size of the smaller group (patients or controls) in 40 out of the 63 articles were equal to or smaller than 16.

3) Another problem: more than 80% of reviewed studies did not control for lifestyle differences. That’s a problem because physical activity levels can impact brain structures and functions.

4)The authors write “that there is a pressing need to establish a collaborative neuroimaging databank for ME/CFS”. That would allow for bigger and better controlled studies. They also propose objective measurement of physical activity in both patients and controls.

5) The most consistent finding was the following: 10/12 articles reported that ME/CFS patients either recruited additional brain regions or had a greater blood oxygenation level-dependent (BOLD) signal changes than controls for cognitive tasks where they had the same performance.

6) the authors also highlight abnormalities in the brainstem (caveat: most of these studies come from their own research group). Three studies reported hypoperfusion in the brain stem, however, two other studies didn’t.

7) Several studies reported abnormalities in cerebral blood flow (CBF) in ME/CFS patients compared to controls. This review indicates however that overall, the findings have been inconsistent. 8 reported decreased global or regional CBF in ME/CFS, 6 couldn’t find differences.

8) Other findings haven’t been replicated by multiple research groups or have shown inconsistent findings. I think there is a good rationale for more and better neuroimaging studies in ME/CFS.

 

Just because I have no biological training and wondered:

(If you don't get this meme I strongly suggest you check out Chubbyemu on Youtube, it's really good and you'll get the joke)

 

Zack Shan got a AUD1.2m grant from NHMRC in late 2019 (the first researcher to get a grant for biomedical research into ME/CFS from the Australian government for more than 10 years).
https://www.usc.edu.au/about/usc-ne...research-to-diagnose-invisible-illness-faster

He has already launched a study: https://www.usc.edu.au/sunshine-coast-mind-neuroscience-thompson-institute/research/chronic-fatigue-syndrome-me-cfs-study

 

I’m curious if anyone has compared and contrasted this review with Crawley’s recent similar review on structural and functional MRI studies?
https://bmjopen.bmj.com/content/bmjopen/10/8/e031672.full.pdf

Thread here: https://www.s4me.info/threads/using...fs-me-almutairi-et-al-2020.16560/#post-285354

 

They put more emphasis on studies that reported changes in white and grey matter volume compared to the review by Shan.

This review also problematically claims that "sMRI has shown evidence of treatment effects on brain volume" referring to the study by De Lange et al. that doesn't provide any robust evidence for this.

The main finding however, seems consistent with the review of Shan et al. because the authors write:

 

I found this article, re: neurovascular coupling, good to get an idea:

Age-Dependent Impairment of Neurovascular and Neurometabolic Coupling in the Hippocampus
Cátia F. Lourenço et al 2018 PMC6056650