National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
Consortium Health International for Myalgic Encephalomyelitis, Griffith University, Gold Coast, Australia.
PLoS One. 2020 Apr 30;15(4):e0232475. doi: 10.1371/journal.pone.0232475. eCollection 2020.
Myalgic encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS) is a multi-system illness characterised by a diverse range of debilitating symptoms including autonomic and cognitive dysfunction. The pathomechanism remains elusive, however, neurological and cognitive aberrations are consistently described. This systematic review is the first to collect and appraise the literature related to the structural and functional neurological changes in ME/CFS patients as measured by neuroimaging techniques and to investigate how these changes may influence onset, symptom presentation and severity of the illness.
A systematic search of databases Pubmed, Embase, MEDLINE (via EBSCOhost) and Web of Science (via Clarivate Analytics) was performed for articles dating between December 1994 and August 2019. Included publications report on neurological differences in ME/CFS patients compared with healthy controls identified using neuroimaging techniques such as magnetic resonance imaging, positron emission tomography and electroencephalography. Article selection was further refined based on specific inclusion and exclusion criteria. A quality assessment of included publications was completed using the Joanna Briggs Institute checklist.
A total of 55 studies were included in this review. All papers assessed neurological or cognitive differences in adult ME/CFS patients compared with healthy controls using neuroimaging techniques. The outcomes from the articles include changes in gray and white matter volumes, cerebral blood flow, brain structure, sleep, EEG activity, functional connectivity and cognitive function. Secondary measures including symptom severity were also reported in most studies.
The results suggest widespread disruption of the autonomic nervous system network including morphological changes, white matter abnormalities and aberrations in functional connectivity. However, these findings are not consistent across studies and the origins of these anomalies remain unknown. Future studies are required confirm the potential neurological contribution to the pathology of ME/CFS.
肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）是一种多系统疾病，其特征是存在一系列使人衰弱的症状，包括自主神经和认知功能障碍。然而，其发病机制仍难以捉摸，尽管如此，神经系统和认知异常却一直被描述。本系统评价首次收集和评估了 ME/CFS 患者的神经影像学改变，并探讨了这些改变如何影响疾病的发病、症状表现和严重程度。
通过数据库 Pubmed、Embase、MEDLINE（通过 EBSCOhost）和 Web of Science（通过 Clarivate Analytics）对 1994 年 12 月至 2019 年 8 月期间的文献进行了系统性检索。纳入的文献报告了使用磁共振成像、正电子发射断层扫描和脑电图等神经影像学技术识别的 ME/CFS 患者与健康对照组之间的神经差异。根据具体的纳入和排除标准进一步筛选文章。使用 Joanna Briggs 研究所清单对纳入的文献进行质量评估。
本综述共纳入 55 项研究。所有论文均使用神经影像学技术评估了成人 ME/CFS 患者与健康对照组之间的神经或认知差异。这些文章的结果包括灰质和白质体积、脑血流、大脑结构、睡眠、脑电图活动、功能连接和认知功能的变化。大多数研究还报告了次要测量指标，包括症状严重程度。
结果表明自主神经系统网络广泛紊乱，包括形态学变化、白质异常和功能连接异常。然而，这些发现并非在所有研究中都一致，这些异常的起源仍不清楚。需要进一步的研究来证实潜在的神经系统对 ME/CFS 病理的贡献。
