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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Evidence of White Matter Neuroinflammation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Diffusion-Based
Qiang Yu1, Kiana Kothe1, Richard A Kwiatek1
1Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia.
Abstract:
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating disorder with suspected neuroinflammatory pathophysiology. However, previous diffusion tensor imaging (DTI) studies have reported inconsistent white matter abnormalities in ME/CFS, and specific white matter inflammatory changes remain poorly characterised. This study employed an advanced diffusion-based neuroinflammation imaging (NII) model to investigate white matter neuroinflammation in ME/CFS. Diffusion MRI data from 67 ME/CFS patients (median age, 38; and 54 women) and 67 rigorously matched healthy controls (HCs) (median age 38; and 52 women) were analysed. Seven NII-derived metrics were computed: hindered water ratio (NII-HR), restricted fraction (NII-RF), fibre fraction (NII-FF), axial diffusivity (NII-AD), radial diffusivity (NII-RD), mean diffusivity (NII-MD) and fractional anisotropy (NII-FA). Conventional DTI metrics were also calculated. Tract-based spatial statistics were used to perform voxel-wise group comparisons, and multiple regression analysis was conducted to examine the relationship between NII/DTI metrics and clinical measures of mental health, physical health, sleep quality, disability, disease severity and disease duration. Compared to HCs, ME/CFS patients exhibited widespread white matter abnormalities, including significantly lower NII-HR and NII-RF, and significantly higher NII-FF, NII-AD, NII-MD and NII-FA across association, commissural and projection fibres. Additionally, some regions showed decreased NII-AD and NII-MD in ME/CFS. Lower NII-RF, NII-AD and NII-MD in ME/CFS were significantly associated with worse mental health, while lower NII-RF was also associated with a higher level of disability. Among ME/CFS patients, higher NII-FF was associated with lower disease severity. Conventional DTI showed minimal group differences and no significant clinical associations. This study provides in vivo evidence of white matter neuroinflammation in ME/CFS, characterised by cerebral edema (reduced NII-HR), cellular infiltration (reduced NII-RF) and axonal reorganisation (increased NII-FF). This suggests NII-derived indices may serve as sensitive biomarkers for neuroinflammation in ME/CFS.
Insights
Neuroinflammation imaging reveals white matter changes in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). These changes, including cerebral edema and cellular infiltration, correlate with clinical symptoms, suggesting potential biomarkers for ME/CFS neuroinflammation.
Area of Science:
- Neuroimaging
- Neurology
- Biomarkers
Background:
- Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex disorder with suspected neuroinflammatory origins.
- Previous diffusion tensor imaging (DTI) studies have yielded inconsistent findings regarding white matter abnormalities in ME/CFS.
- Specific inflammatory changes within the white matter of ME/CFS patients remain poorly understood.
Purpose of the Study:
- To investigate white matter neuroinflammation in ME/CFS using an advanced diffusion-based neuroinflammation imaging (NII) model.
- To compare NII-derived metrics between ME/CFS patients and healthy controls (HCs).
- To examine the relationship between NII metrics and clinical indicators of health and disability in ME/CFS.
Main Methods:
- Diffusion MRI data were acquired from 67 ME/CFS patients and 67 matched HCs.
- Seven NII-derived metrics (NII-HR, NII-RF, NII-FF, NII-AD, NII-RD, NII-MD, NII-FA) and conventional DTI metrics were computed.
- Voxel-wise group comparisons using tract-based spatial statistics and multiple regression analyses were performed.
Main Results:
- ME/CFS patients showed widespread white matter abnormalities compared to HCs, including lower NII-HR and NII-RF, and higher NII-FF, NII-AD, NII-MD, and NII-FA.
- Specific regions exhibited decreased NII-AD and NII-MD in ME/CFS patients.
- Lower NII-RF, NII-AD, and NII-MD were associated with poorer mental health, and lower NII-RF with higher disability.
- Higher NII-FF correlated with lower disease severity in ME/CFS patients.
- Conventional DTI revealed minimal group differences and no significant clinical associations.
Conclusions:
- This study provides in vivo evidence of white matter neuroinflammation in ME/CFS.
- NII metrics characterize neuroinflammation through cerebral edema (reduced NII-HR), cellular infiltration (reduced NII-RF), and axonal reorganisation (increased NII-FF).
- NII-derived indices show promise as sensitive biomarkers for detecting neuroinflammation in ME/CFS.
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