Limbic Perfusion Is Reduced in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

Area of Science:

• Neuroscience
• Medical Imaging
• Neurology

Background:

• Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) presents with diverse debilitating symptoms, including cognitive dysfunction.
• Neurological and cognitive abnormalities are frequently reported in ME/CFS, yet regional cerebral blood flow (rCBF) remains understudied.
• Understanding brain perfusion is crucial for elucidating ME/CFS pathophysiology.

Purpose of the Study:

• To investigate regional cerebral blood flow (rCBF) differences between ME/CFS patients and healthy controls.
• To explore the association between rCBF and symptom severity in ME/CFS.
• To identify potential neurobiological underpinnings of ME/CFS.

Main Methods:

• Utilized pseudo-continuous arterial spin labeling (PCASL) on a 3T MRI scanner to measure rCBF.
• Compared rCBF in 31 ME/CFS patients and 48 healthy controls using voxel-wise and ROI-based analyses.
• Performed linear regression to correlate rCBF with ME/CFS symptom severity.

Main Results:

• ME/CFS patients demonstrated significant hypoperfusion in limbic system regions, including the anterior cingulate cortex, putamen, pallidum, and anterior ventral insula.
• Reduced rCBF in the anterior cingulate cortex was significantly associated with higher symptom severity scores in ME/CFS patients.
• Statistical significance was confirmed using uncorrected voxel-wise p ≤ 0.001 and FWE p ≤ 0.01.

Conclusions:

• Brain blood flow abnormalities in the limbic system are evident in ME/CFS patients.
• Reduced rCBF in specific brain regions may contribute to the pathogenesis of ME/CFS.
• Cerebral hypoperfusion, particularly in the anterior cingulate cortex, is linked to symptom severity in ME/CFS.