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Updated: Aug 5, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Microstructural alterations in brain tissue of ME/CFS and long COVID using diffusion tensor imaging and diffusion
Tanoj Bahadur Singh1, Sonya Marshall-Gradisnik1, Leighton Barnden1
1National Center for Neuroimmunology and Emerging Diseases, Griffith University, Gold Coast, QLD, Australia.
Introduction:
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and long COVID have overlapping symptoms, such as profound fatigue, cognitive impairment, post-exertional malaise, pain and sleep disturbances that are debilitating and reduce quality of life. While Magnetic Resonance Imaging (MRI) techniques, specifically Diffusion Tensor Imaging (DTI) and Diffusion Kurtosis Imaging (DKI), have been used to investigate brain tissue microstructure in ME/CFS or long COVID, no study has yet combined these modalities to directly compare tissue microstructural differences between people living with ME/CFS and long COVID.
Methods:
We recruited 37 ME/CFS participants (Age: 43.56 ± 12.5), 19 long COVID participants (Age: 47.92 ± 13.3), and 27 healthy controls (Age: 37.9 ± 10.4). Data were acquired using a 3 Tesla (3T) Prisma MRI scanner. DTI and DKI metrics were determined using MRtrix v3.0.7 and Designer V2.0 software, respectively. Voxel-based statistical analysis of cohort differences was performed using the Statistical Parametric Mapping (SPM12) toolbox in MATLAB. Correlation analysis was performed between DTI, DKI metrics and clinical measures such as duration of illness, fatigue severity, SF36 domains and WHODAS domains.
Results:
Compared with healthy controls, individuals with ME/CFS showed microstructural alterations in the cingulum, supplementary motor areas, and parts of the corpus callosum (all p < 0.05). Long COVID participants demonstrated microstructural alterations in regions including the fusiform and precentral gyrus and in major white matter tracks (all p < 0.05). Direct comparisons between ME/CFS and long COVID revealed difference in the left corona radiata (p = 0.001).
Conclusion:
This study identifies distinct tissue microstructural alterations in ME/CFS and long COVID and offers a vital insight into the neuropathological basis of shared symptoms in both conditions.
Insights
This study reveals distinct brain microstructural differences between Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and long COVID using MRI. These findings offer insights into the neuropathology underlying shared symptoms in these conditions.
Area of Science:
- Neuroimaging
- Neurology
- Medical Research
Background:
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and long COVID share debilitating symptoms like fatigue and cognitive impairment.
- Magnetic Resonance Imaging (MRI) techniques like Diffusion Tensor Imaging (DTI) and Diffusion Kurtosis Imaging (DKI) have individually studied brain changes in ME/CFS or long COVID.
- No prior study has directly compared brain microstructural differences between ME/CFS and long COVID using combined DTI and DKI.
Purpose of the Study:
- To investigate and compare brain tissue microstructural differences between individuals with ME/CFS and long COVID.
- To utilize advanced MRI techniques (DTI and DKI) to identify distinct neuropathological alterations.
- To provide insights into the neuropathological basis of shared symptoms in ME/CFS and long COVID.
Main Methods:
- Recruited participants: 37 ME/CFS, 19 long COVID, and 27 healthy controls.
- Acquired MRI data using a 3 Tesla (3T) Prisma scanner.
- Analyzed DTI and DKI metrics using specialized software (MRtrix, Designer) and statistical analysis (SPM12 in MATLAB), correlating findings with clinical measures.
Main Results:
- ME/CFS patients showed alterations in the cingulum, supplementary motor areas, and corpus callosum compared to controls.
- Long COVID patients exhibited alterations in the fusiform and precentral gyrus, and major white matter tracks.
- Direct comparison revealed significant microstructural differences in the left corona radiata between ME/CFS and long COVID groups (p=0.001).
Conclusions:
- Distinct brain tissue microstructural alterations are identified in ME/CFS and long COVID.
- The study provides crucial insights into the neuropathological underpinnings of overlapping symptoms in these conditions.
- This research highlights the potential of advanced MRI techniques in differentiating neurological impacts of ME/CFS and long COVID.
