Brain Changes Point to Root of Chronic Fatigue in Study
By Michelle Fay CortezOct 29, 2014 5:00 AM GMT+0100
Brain scans may identify people with chronic fatigue syndrome, a finding that might point toward potential treatment targets for the mysterious ailment marked by unrelenting exhaustion, researchers said.
A small study using advanced imaging techniques showed chronic fatigue patients had less white matter than a healthy comparison group, as well as structural variations in the right hemisphere of the brain. The finding released today in the journal Radiology is one of the first that shows a concrete difference in people with the condition, which is currently diagnosed only by ruling out other ailments.
More work is needed to understand why the changes occur and determine whether they can be used to help fashion treatments for the ailment that affects as many as 4 million Americans, the researchers said. The findings may offer relief to patients who can struggle for years to get a diagnosis and are often told the cause is psychological, said lead researcher Michael Zeineh.
“We wanted to see what’s going on with chronic fatigue syndrome in the brain,” Zeineh, an assistant professor of radiology at Stanford University School of Medicine, said in a telephone interview. “We know these patients are suffering and traditional methods don’t show anything.”
The researchers examined brain scans of 15 patients and compared the results with 14 healthy people the same age and gender without the condition. The decrease in white matter makes sense because some scientists believe the disease stems from chronic inflammation. Inflammation can harm white matter, the brain tissue composed of nerve fibers that carry signals and connect the brain’s different regions.
They also got abnormal readings when they looked at the right arcuate fasciculus, which connects the brain’s frontal lobe and the temporal lobe. They found the greater the abnormality, the more severe the patient’s condition. In addition, the brain’s gray matter in the two spots where the nerve tract connected was thicker than in comparison group, the study found.
“In addition to potentially providing the CFS-specific biomarker we’ve been desperately seeking for decades, these findings hold the promise of identifying the area or areas of the brain where the disease has hijacked the central nervous system,” said Jose Montoya, a Stanford professor of infectious diseases and geographic medicine and senior author of the paper.
It’s too soon for patients to seek out individual brain scans to diagnose the disease, Zeineh said. The researchers don’t know enough about what the changes mean, or even the role of the right arcuate fasciculus in the disease, he said.
The next steps include replicating the findings among larger groups of patients and tracking them over time to see if the results change, he said. Eventually scans may be used by researchers trying to find treatments for the disease, he said.
“This has a lot of potential for future research studies, and even further exploration of what’s going on with chronic fatigue syndrome,” Zeineh said. “What it could mean down the road, we really don’t know. This is the first big step in terms of seeing some definitive abnormalities in the brain underlying chronic fatigue syndrome.”