Neuroimage (Amst). 2013 Jan 5;2:168-73. doi: 10.1016/j.nicl.2012.12.006.
Cerebral vascular control is associated with skeletal muscle pH in chronic fatigue syndrome patients both at rest and during dynamic stimulation.
Source
Institute of Cellular Medicine & Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, United Kingdom.
Abstract
Cerebral blood flow (CBF) is maintained despite changing systemic blood pressure through cerebral vascular control, with such tight regulation believed to be under local tissue control. Chronic fatigue syndrome (CFS) associates with a wide range of symptoms, including orthostatic intolerance, skeletal muscle pH abnormalities and cognitive impairment. CFS patients are known to have reduced CBF and orthostatic intolerance associates with abnormal vascular regulation, while skeletal muscle pH abnormalities associate with autonomic dysfunction. These findings point to autonomic dysfunction as the central feature of CFS, and cerebral vascular control being influenced by factors outside of the brain, a macroscopic force affecting the stability of regional regulation. We therefore explored whether there was a physiological link between cerebral vascular control and skeletal muscle pH management in CFS. Seventeen consecutive CFS patients fulfilling the Fukuda criteria were recruited from our local CFS clinical service. To probe the static scenario, CBF and skeletal muscle pH were measured at rest using MRI and (31)P magnetic resonance spectroscopy ((31)P-MRS). To examine dynamic control, brain functional MRI was performed concurrently with Valsalva manoeuvre (VM), a standard autonomic function challenge, while (31)P-MRS was performed during plantar flexion exercise. Significant inverse correlation was seen between CBF and skeletal muscle pH at rest (r = - 0.67, p < 0.01). Prolonged cerebral vascular constriction during the sympathetic phase of VM was associated with higher pH in skeletal muscle after plantar flexion exercise (r = 0.69, p < 0.008). In conclusion, cerebral vascular control is closely related to skeletal muscle pH both at rest and after dynamic stimulation in CFS.
KEYWORDS:
31P MR spectroscopy, Arterial spin labelling (ASL), Autonomic function, Cerebral blood flow, Chronic fatigue syndrome, Dual echo fMRI
- PMID:
- 24179772
- [PubMed]
- PMCID:
- PMC3777833
2 comments:
Interesting study - no surprises though to some of us.
My ME/CFS turned out to be lyme Disease and I made a significant recovery on long term antibiotics.
I have learned much though following the information available. Lyme Disease patients show abnormal blood flow looking at the brain by using SPECT scans in 75% of cases - how many patients with Lyme or ME even get to have a SPECT scan instead you might get a CT scan or mRI which doesn't show function more structure.
http://journals.lww.com/nuclearmed/Fulltext/2012/09000/SPECT_Brain_Imaging_in_Chronic_Lyme_Disease.33.aspx
Problems with Autonomic Nervous System are common for people with Lyme Disease as well as those with ME the difference is that if it is an infection driving the Chronic illness and that infection is treated those symptoms of ANS can improve. Lyme can also affect Central nervous system and Peripheral nervous system one or tow or all three this booklet is very informative http://www.lymediseaseaction.org.uk/wp-content/uploads/2013/05/LDA003-2-web-version.pdf
At last Governments in Australia and here in UK are beginning to work with patients and patient groups. Here in Uk there was an interesting meeting held by Public Health England and hopes for better testing and better diagnosis see my blog.
CFS and orthostatic intolerance are interesting primarily for their sudden onset after stress or events, their 80% female to male imbalance and their waxing and waning symptom presentation in some. No surprises that the Norwegian study using immunosuppressive medications has had some positive results. These illnesses are most likely autoimmune or auyoimflammatory in nature - persistant infection or genetic histocompatibilty and susceptibility being the potential drivers (maybe). But who knows and at this stage of the science beware anyone who claims that they do!
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