From the Department of Radiology, Lucas Center for Imaging, Stanford University School of Medicine, 1201 Welch Rd, Room P271, Stanford, CA 94305-5488.
Radiology. 2015 Feb;274(2):517-26. doi: 10.1148/radiol.14141079. Epub 2014 Oct 29.
To identify whether patients with chronic fatigue syndrome (CFS) have differences in gross brain structure, microscopic structure, or brain perfusion that may explain their symptoms.
Fifteen patients with CFS were identified by means of retrospective review with an institutional review board-approved waiver of consent and waiver of authorization. Fourteen age- and sex-matched control subjects provided informed consent in accordance with the institutional review board and HIPAA. All subjects underwent 3.0-T volumetric T1-weighted magnetic resonance (MR) imaging, with two diffusion-tensor imaging (DTI) acquisitions and arterial spin labeling (ASL). Open source software was used to segment supratentorial gray and white matter and cerebrospinal fluid to compare gray and white matter volumes and cortical thickness. DTI data were processed with automated fiber quantification, which was used to compare piecewise fractional anisotropy (FA) along 20 tracks. For the volumetric analysis, a regression was performed to account for differences in age, handedness, and total intracranial volume, and for the DTI, FA was compared piecewise along tracks by using an unpaired t test. The open source software segmentation was used to compare cerebral blood flow as measured with ASL.
In the CFS population, FA was increased in the right arcuate fasciculus (P = .0015), and in right-handers, FA was also increased in the right inferior longitudinal fasciculus (ILF) (P = .0008). In patients with CFS, right anterior arcuate FA increased with disease severity (r = 0.649, P = .026). Bilateral white matter volumes were reduced in CFS (mean ± standard deviation, 467 581 mm(3) ± 47 610 for patients vs 504 864 mm(3) ± 68 126 for control subjects, P = .0026), and cortical thickness increased in both right arcuate end points, the middle temporal (T = 4.25) and precentral (T = 6.47) gyri, and one right ILF end point, the occipital lobe (T = 5.36). ASL showed no significant differences.
Bilateral white matter atrophy is present in CFS. No differences in perfusion were noted. Right hemispheric increased FA may reflect degeneration of crossing fibers or strengthening of short-range fibers. Right anterior arcuate FA may serve as a biomarker for CFS.
确定慢性疲劳综合征（CFS）患者的大脑整体结构、微观结构或脑灌注是否存在差异，这些差异可能可以解释他们的症状。
通过回顾性审查确定了 15 名 CFS 患者，该审查获得了机构审查委员会批准的豁免同意和授权豁免。14 名年龄和性别匹配的对照受试者根据机构审查委员会和 HIPAA 提供了知情同意。所有受试者均接受了 3.0-T 容积 T1 加权磁共振（MR）成像，包括两次扩散张量成像（DTI）采集和动脉自旋标记（ASL）。使用开源软件对幕上灰质和白质以及脑脊液进行分割，以比较灰质和白质体积和皮质厚度。使用自动纤维定量法处理 DTI 数据，该方法用于比较 20 条轨迹上的分段各向异性分数（FA）。对于体积分析，进行回归以解释年龄、利手和总颅内体积的差异，对于 DTI，使用未配对 t 检验比较轨迹上的 FA 分段。使用开源软件分割来比较 ASL 测量的脑血流。
在 CFS 人群中，右侧弓状束的 FA 增加（P =.0015），在右利手者中，右侧下纵束（ILF）的 FA 也增加（P =.0008）。在 CFS 患者中，右侧前弓状束的 FA 随疾病严重程度增加（r = 0.649，P =.026）。CFS 患者双侧白质体积减少（平均值 ± 标准差，患者为 467 581 mm³ ± 47 610，对照组为 504 864 mm³ ± 68 126，P =.0026），双侧右侧弓状束终点、颞中叶（T = 4.25）和中央前回（T = 6.47）以及右侧 ILF 终点之一的枕叶皮质厚度增加（T = 5.36）。ASL 未显示出显著差异。
CFS 患者存在双侧白质萎缩。未观察到灌注差异。右侧半球 FA 增加可能反映交叉纤维变性或短程纤维增强。右侧前弓状束 FA 可能作为 CFS 的生物标志物。
