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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Distinct white matter alteration patterns in post-infectious and gradual onset chronic fatigue syndrome revealed by
Qiang Yu1, Richard A Kwiatek2, Peter Del Fante2
1Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, 4575, Australia. qyu@usc.edu.au.
Abstract:
While post-infectious (PI-ME/CFS) and gradual onset (GO-ME/CFS) myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) manifest similar symptoms, it has long been suspected that different disease processes underlie them. However, the lack of biological evidence has left this question unanswered. In this study, how white matter microstructural changes in PI-ME/CFS and GO-ME/CFS patients were investigated. PI-ME/CFS and GO-ME/CFS patients were recruited based on consensus diagnoses made by two experienced clinicians and compared their diffusion MRI features with those of rigorously matched healthy controls (HCs) with sedentary lifestyles. PI-ME/CFS participants showed significantly higher axial diffusivity (AD) in several association and projection fibres compared to HCs. Higher AD in PI-ME/CFS was significantly related to worse physical health. In contrast, GO-ME/CFS participants exhibited significantly decreased AD in the corpus callosum. Lower AD in GO-ME/CFS was significantly associated with worse mental health in commissural and projection fibres. No significant group differences were found for fractional anisotropy, mean diffusivity, or radial diffusivity. Distinct patterns of AD alterations in PI-ME/CFS and GO-ME/CFS provide neurophysiological evidence of different disease processes and highlight the heterogeneities of ME/CFS.
Insights
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) shows distinct white matter changes depending on onset. Post-infectious ME/CFS has higher axial diffusivity, while gradual onset ME/CFS shows decreased axial diffusivity, indicating different disease processes.
Area of Science:
- Neuroscience
- Medical Imaging
- Pathophysiology
Background:
- Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex illness with suspected differing underlying pathologies based on onset type.
- Post-infectious ME/CFS (PI-ME/CFS) and gradual onset ME/CFS (GO-ME/CFS) present similar symptoms, but biological evidence for distinct disease processes has been lacking.
Purpose of the Study:
- To investigate and compare white matter microstructural changes in PI-ME/CFS and GO-ME/CFS patients using diffusion MRI.
- To identify neurophysiological differences that could explain the heterogeneity observed in ME/CFS.
Main Methods:
- Diffusion MRI was used to analyze white matter microstructural features in patients diagnosed with PI-ME/CFS and GO-ME/CFS.
- Patients were compared against rigorously matched healthy controls (HCs) with sedentary lifestyles.
- Axial diffusivity (AD), fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) were assessed.
Main Results:
- PI-ME/CFS patients exhibited significantly higher AD in association and projection fibers compared to HCs, correlating with worse physical health.
- GO-ME/CFS patients showed significantly decreased AD in the corpus callosum, associated with worse mental health.
- No significant differences in FA, MD, or RD were observed between the groups.
Conclusions:
- Distinct patterns of altered axial diffusivity in PI-ME/CFS and GO-ME/CFS provide neurophysiological evidence for different underlying disease processes.
- These findings highlight the significant heterogeneity within ME/CFS, suggesting distinct pathophysiological mechanisms based on disease onset.
