October 29, 2014 | by Lisa Winter @ iflscience.com

Brain Abnormalities Discovered in Patients With Chronic Fatigue Syndrome

photo credit: Radiological Society of North America

Up to 4 million Americans experience Chronic Fatigue Syndrome (CFS), which are periods of extreme fatigue lasting at least 6 months. A recent study published in Radiology by lead author Michael Zeineh of the Stanford University School of Medicine found that patients with CFS have a reduced amount of white matter in their brains, as well as abnormalities in both the white and gray matter of the right hemisphere. 

CFS has been notoriously difficult to diagnose, as the symptoms are obscure and could apply to many other disorders. Though the symptoms can be intense and severely reduce quality of life, it is hard to definitively name CFS as the culprit.

“CFS is one of the greatest scientific and medical challenges of our time,” senior author Jose Montoya said in a press release. “Its symptoms often include not only overwhelming fatigue but also joint and muscle pain, incapacitating headaches, food intolerance, sore throat, enlargement of the lymph nodes, gastrointestinal problems, abnormal blood-pressure and heart-rate events, and hypersensitivity to light, noise or other sensations.”

The researchers have been involved in long-term study of 200 CFS patients in hopes of developing new effective treatments. This quest has been difficult, as the disease had not previously turned up physical markers that medication would be able to target. 

“If you don’t understand the disease, you’re throwing darts blindfolded,” Zeineh added. “We asked ourselves whether brain imaging could turn up something concrete that differs between CFS patients and healthy people’s brains. And, interestingly, it did.”

In fact, the team found three critical commonalities between the brains of CFS patients that set them apart from those without the disorder. Interestingly, the intensity of the brain abnormalities correlated with the intensity of their condition.

Compared to healthy individuals, people with CFS have a diminished amount of white matter in the brain. White matter is composed of nerve fibers, which help connect the neurons in the gray matter that actually process information. CFS is believed to be associated with inflammation, which would cause this effect.

The team also found that white matter in the right hemisphere of the brain appears abnormal in the region of the brain that connects the frontal lobe and temporal lobe, called the right arcuate fasciculus. The frontal lobe has a wide range of functions including using dopamine to regulate attention, motivation, and reward. The temporal lobe is responsible for processing sensory information, storing memories, and controlling emotions. 

In addition to the abnormal white matter, the right arcuate fasciculus was also shown to have additional gray matter among CFS patients compared to healthy individuals. 

“In addition to potentially providing the CFS-specific diagnostic 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,” Montoyaexplained.

While the team got a lot of great data from this study, further analysis is needed in order to confirm the findings. The researchers will need to fully understand the mechanism behind these abnormalities before potential treatments can be explored

 “This study was a start,” Zeineh concluded. “It shows us where to look.”