scholarly journals Brainstem Abnormalities in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Scoping Review and Evaluation of Magnetic Resonance Imaging Findings

2021 ◽  
Vol 12 ◽  
Author(s):  
Todd Nelson ◽  
Lan-Xin Zhang ◽  
Hui Guo ◽  
Luis Nacul ◽  
Xiaowei Song
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Chronic Fatigue Syndrome ◽  
Medical Condition ◽  
Chronic Fatigue ◽  
The Body ◽  
Myalgic Encephalomyelitis ◽  
Resonance Imaging ◽  
Fatigue Syndrome ◽  
Mri Studies

Background: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a multisystem medical condition with heterogeneous symptom expression. Currently, there is no effective cure or treatment for the standard care of patients. A variety of ME/CFS symptoms can be linked to the vital life functions of the brainstem, the lower extension of the brain best known as the hub relaying information back and forth between the cerebral cortex and various parts of the body.Objective/Methods: Over the past decade, Magnetic Resonance Imaging (MRI) studies have emerged to understand ME/CFS with interesting findings, but there has lacked a synthesized evaluation of what has been found thus far regarding the involvement of the brainstem. We conducted this study to review and evaluate the recent MRI findings via a literature search of the MEDLINE database, from which 11 studies met the eligibility criteria.Findings: Data showed that MRI studies frequently reported structural changes in the white and gray matter. Abnormalities of the functional connectivity within the brainstem and with other brain regions have also been found. The studies have suggested possible mechanisms including astrocyte dysfunction, cerebral perfusion impairment, impaired nerve conduction, and neuroinflammation involving the brainstem, which may at least partially explain a substantial portion of the ME/CFS symptoms and their heterogeneous presentations in individual patients.Conclusions: This review draws research attention to the role of the brainstem in ME/CFS, helping enlighten future work to uncover the pathologies and mechanisms of this complex medical condition, for improved management and patient care.

scholarly journals Chronic fatigue syndrome in women assessed with combined cardiac magnetic resonance imaging

2016 ◽  
Vol 24 (12) ◽  
pp. 709-716 ◽  
Author(s):  
M. A. G. M. Olimulder ◽  
M. A. Galjee ◽  
L. J. Wagenaar ◽  
J. van Es ◽  
J. van der Palen ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Chronic Fatigue Syndrome ◽  
Cardiac Magnetic Resonance Imaging ◽  
Chronic Fatigue ◽  
Resonance Imaging ◽  
Fatigue Syndrome

scholarly journals High Prevalence of Perineural Cysts in Patients with Fibromyalgia and Chronic Fatigue Syndrome

Pain Medicine ◽  
2020 ◽  
Author(s):  
Mieke Hulens ◽  
Frans Bruyninckx ◽  
Wim Dankaerts ◽  
Ricky Rasschaert ◽  
Peter De Mulder ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Chronic Fatigue Syndrome ◽  
Dorsal Root Ganglia ◽  
Dorsal Root ◽  
Fluid Pressure ◽  
Chronic Fatigue ◽  
Resonance Imaging ◽  
Fatigue Syndrome

Abstract Objective Pain in fibromyalgia (FM) and chronic fatigue syndrome (CFS) is assumed to originate from central sensitization. Perineural cysts or Tarlov cysts (TCs) are nerve root dilations resulting from pathologically increased cerebrospinal fluid pressure. These cysts initially affect sensory neurons and axons in dorsal root ganglia and produce sensory symptoms (pain and paresthesia). Symptomatic TC (STC) patients often complain about widespread pain and fatigue. Consequently, STC patients may initially be diagnosed with FM, CFS, or both. The objective of this study was to document the prevalence of TCs in patients diagnosed with FM or CFS. Design A retrospective study. Setting An outpatient clinic for musculoskeletal disorders. Subjects Patients diagnosed with FM according to the 1990 American College of Rheumatology criteria or with CFS according to the 1994 Centers for Disease Control criteria were selected. Methods Review of lumbar and sacral magnetic resonance imaging scans including TCs ≥5 mm in size. Results In total, 197 patients with FM, CFS, or both underwent magnetic resonance imaging. Ninety-one percent were women. The mean age was 48.1 (±11.9) years. TCs were observed in 39% of patients, with a mean size of 11.8 (±5.2) mm. In males, the prevalence was 12%, vs. 42% in females. Conclusions In patients diagnosed with FM or CFS, the prevalence of TCs was three times higher than that in the general population. This observation supports the hypothesis that STCs, FM, and CFS may share the same pathophysiological mechanism, i.e., moderately increased cerebrospinal fluid pressure, causing irritation of neurons and axons in dorsal root ganglia.

Cognitive Functioning and Magnetic Resonance Imaging in Chronic Fatigue

1995 ◽  
Vol 167 (1) ◽  
pp. 86-94 ◽  
Author(s):  
Helen Cope ◽  
Amanda Pernet ◽  
Brian Kendall ◽  
Anthony David
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Cognitive Dysfunction ◽  
White Matter Lesions ◽  
Chronic Fatigue ◽  
Depressive Illness ◽  
Cerebral White Matter ◽  
Resonance Imaging ◽  
Fatigue Syndrome

BackgroundThis study examines whether cognitive dysfunction in chronic fatigue may be accounted for by depression and anxiety or is due to brain pathology evident on magnetic resonance imaging (MRI).MethodTwenty-six subjects with chronic fatigue, with and without coexisting depression, and 18 age-matched normal controls were recruited from primary care following a presumed viral illness six months previously. Comparison was made with 13 psychiatric controls with depressive illness on standardised cognitive tests. MRI determined the presence of cerebral white-matter lesions.ResultsNo substantial differences in performance were shown between subjects with chronic fatigue, most of whom met the criteria for chronic fatigue syndrome, and controls. Subjective cognitive dysfunction increased with psychopathology. White-matter lesions were found in a minority from all groups. Improvement in fatigue and depression coincided with improved performance on cognitive measures.ConclusionsSubjective complaints of cognitive impairment are a prominent feature of chronic fatigue, but objective cognitive and MRI abnormalities are not. Such complaints probably reflect psychopathology rather than a post-viral process.

scholarly journals The Enterovirus Theory of Disease Etiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Critical Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Adam J. O'Neal ◽  
Maureen R. Hanson
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Secondary Infection ◽  
Chronic Fatigue ◽  
The Body ◽  
Myalgic Encephalomyelitis ◽  
Gastrointestinal Infections ◽  
Disease Etiology ◽  
System Disease ◽  
Fatigue Syndrome ◽  
The Central Nervous System

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex, multi-system disease whose etiological basis has not been established. Enteroviruses (EVs) as a cause of ME/CFS have sometimes been proposed, as they are known agents of acute respiratory and gastrointestinal infections that may persist in secondary infection sites, including the central nervous system, muscle, and heart. To date, the body of research that has investigated enterovirus infections in relation to ME/CFS supports an increased prevalence of chronic or persistent enteroviral infections in ME/CFS patient cohorts than in healthy individuals. Nevertheless, inconsistent results have fueled a decline in related studies over the past two decades. This review covers the aspects of ME/CFS pathophysiology that are consistent with a chronic enterovirus infection and critically reviews methodologies and approaches used in past EV-related ME/CFS studies. We describe the prior sample types that were interrogated, the methods used and the limitations to the approaches that were chosen. We conclude that there is considerable evidence that prior outbreaks of ME/CFS were caused by one or more enterovirus groups. Furthermore, we find that the methods used in prior studies were inadequate to rule out the presence of chronic enteroviral infections in individuals with ME/CFS. Given the possibility that such infections could be contributing to morbidity and preventing recovery, further studies of appropriate biological samples with the latest molecular methods are urgently needed.

Review of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: an evidence-based approach to diagnosis and management by clinicians

2015 ◽  
Vol 30 (4) ◽  
Author(s):  
Alison C. Bested ◽  
Lynn M. Marshall
Keyword(s):  
Health Care ◽  
Chronic Fatigue Syndrome ◽  
Health Care Professionals ◽  
Medical Condition ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Chronic Medical Condition ◽  
Management Approach ◽  
Care Needs ◽  
Fatigue Syndrome

AbstractThis review was written from the viewpoint of the treating clinician to educate health care professionals and the public about Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). It includes: the clinical definition of ME/CFS with emphasis on how to diagnose ME/CFS; the etiology, pathophysiology, management approach, long-term prognosis and economic cost of ME/CFS. After reading this review, you will be better able to diagnose and treat your patients with ME/CFS using the tools and information provided. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, chronic medical condition characterized by symptom clusters that include: pathological fatigue and malaise that is worse after exertion, cognitive dysfunction, immune dysfunction, unrefreshing sleep, pain, autonomic dysfunction, neuroendocrine and immune symptoms. ME/CFS is common, often severely disabling and costly. The Institute of Medicine (IOM) reviewed the ME/CFS literature and estimates that between 836,000 and 2.5 million Americans have ME/CFS at a cost of between 17 and 24 billion dollars annually in the US. The IOM suggested a new name for ME/CFS and called it Systemic Exertion Intolerance Disease (SEID). SEID’s diagnostic criteria are less specific and do not exclude psychiatric disorders in the criteria. The 2010 Canadian Community Health Survey discovered that 29% of patients with ME/CFS had unmet health care needs and 20% had food insecurity – lack of access to sufficient healthy foods. ME/CFS can be severely disabling and cause patients to be bedridden. Yet most patients (80%) struggle to get a diagnosis because doctors have not been taught how to diagnose or treat ME/CFS in medical schools or in their post-graduate educational training. Consequently, the patients with ME/CFS suffer. They are not diagnosed with ME/CFS and are not treated accordingly. Instead of compassionate care from their doctors, they are often ridiculed by the very people from whom they seek help. The precise etiology of ME/CFS remains unknown, but recent advances and research discoveries are beginning to shed light on the enigma of this disease including the following contributors: infectious, genetic, immune, cognitive including sleep, metabolic and biochemical abnormalities. Management of patients with ME/CFS is supportive symptomatic treatment with a patient centered care approach that begins with the symptoms that are most troublesome for the patient. Pacing of activities with strategic rest periods is, in our opinion, the most important coping strategy patients can learn to better manage their illness and stop their post-exertional fatigue and malaise. Pacing allows patients to regain the ability to plan activities and begin to make slow incremental improvements in functionality.

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