Regional grey and white matter volumetric changes in myalgic encephalomyelitis (chronic fatigue syndrome): a voxel-based morphometry 3-T MRI study
B K Puri, PhD, FRCPsych1,P M Jakeman, MSc, PhD2,M Agour, MB, MRCPsych3,K D R Gunatilake, MD, MRCPsych4,K A C Fernando, MBBS, MRCPsych5,A I Gurusinghe, MBBS, PGDPsych6,I H Treasaden, MRCS, FRCPsych7,A D Waldman, PhD, MRCP1,8andP Gishen, DMRD, FRCR1
1Department of Imaging, Hammersmith Hospital, London, UK2Department of Physical Education and Sport Sciences, University of Limerick, Republic of Ireland3University of Hertfordshire, and Care Principles, Rose Lodge, Langley, West Midlands, UK4The Ridge Hill Centre, Dudley, UK5Brooklands Hospital, Birmingham, West Midlands, UK6Broadmoor Hospital, Berkshire, UK7Three Bridges Unit, WLMHT, Middlesex, UK8National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
Objective:It is not established whether myalgic encephalomyelitis/chronic fatigue syndrome (CFS) is associated with structural brain changes. The aim of this study was to investigate this by conducting the largest voxel-based morphometry study to date in CFS.
Methods:High-resolution structural 3-T cerebral MRI scanning was carried out in 26 CFS patients and 26 age- and gender-matched healthy volunteers. Voxel-wise generalised linear modelling was applied to the processed MR data using permutation-based non-parametric testing, forming clusters att > 2.3 and testing clusters for significance atp < 0.05, corrected for multiple comparisons across space.
Results:Significant voxels (p < 0.05, corrected for multiple comparisons) depicting reduced grey matter volume in the CFS group were noted in the occipital lobes (right and left occipital poles; left lateral occipital cortex, superior division; and left supracalcrine cortex), the right angular gyrus and the posterior division of the left parahippocampal gyrus. Significant voxels (p < 0.05, corrected for multiple comparisons) depicting reduced white matter volume in the CFS group were also noted in the left occipital lobe.
Conclusion:These data support the hypothesis that significant neuroanatomical changes occur in CFS, and are consistent with the complaint of impaired memory that is common in this illness; they also suggest that subtle abnormalities in visual processing, and discrepancies between intended actions and consequent movements, may occur in CFS.