Pain Fatigue Research Alliance, Georgetown University, Washington, DC 20007-2197, USA.
Pain Fatigue Research Alliance, Georgetown University, Washington, DC 20007-2197, USA.
Life Sci. 2021 Oct 1;282:119749. doi: 10.1016/j.lfs.2021.119749. Epub 2021 Jun 29.
There is controversy about brain volumes in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (CFS) and Gulf War Illness (GWI). Subcortical regions were assessed because of significant differences in blood oxygenation level dependent signals in the midbrain between these diseases.
Magnetization-prepared rapid acquisition with gradient echo (MPRAGE) images from 3 Tesla structural magnetic resonance imaging scans from sedentary control (n = 34), CFS (n = 38) and GWI (n = 90) subjects were segmented in FreeSurfer. Segmented subcortical volumes were regressed against intracranial volume and age, then iteratively analyzed by multivariate general linear modeling with disease status, gender and demographics as independent co-variates.
The optimal model for all subjects used disease status and gender as fixed factors with independent variables eliminated after iteration. Volumes of anterior and midanterior corpus callosum were significantly larger in GWI than CFS. Gender was a significant variable for many segment volumes, and so female and male subjects were analyzed separately. CFS females had smaller left putamen, right caudate and left cerebellum white matter than control women. CFS males had larger left hippocampus than GWI males. Orthostatic status and posttraumatic distress syndrome were not significant covariates.
CFS and GWI were appropriate "illness controls" for each other. The different patterns of adjusted segment volumes suggested that sexual dimorphisms contributed to pathological changes. Previous volumetric studies may need to be reevaluated to account for gender differences. The findings are framed by comparison to the spectrum of magnetic resonance imaging outcomes in the literature.
肌痛性脑脊髓炎/慢性疲劳综合征（CFS）和海湾战争病（GWI）患者的脑容量存在争议。由于这些疾病的中脑血氧水平依赖信号存在显著差异，因此评估了皮质下区域。
从静息对照组（n=34）、CFS 组（n=38）和 GWI 组（n=90）的 3T 结构磁共振成像扫描的磁化准备快速获取梯度回波（MPRAGE）图像中，使用 FreeSurfer 对图像进行分割。将分割的皮质下体积与颅内体积和年龄进行回归，然后通过多元一般线性建模对其进行迭代分析，以疾病状态、性别和人口统计学为独立协变量。
所有受试者的最佳模型均使用疾病状态和性别作为固定因素，并在迭代后消除了独立变量。GWI 患者的前、中前胼胝体体积明显大于 CFS 患者。性别是许多节段体积的重要变量，因此分别对女性和男性受试者进行了分析。CFS 女性的左侧壳核、右侧尾状核和左侧小脑白质体积小于对照组女性。CFS 男性的左侧海马体积大于 GWI 男性。直立状态和创伤后应激障碍不是显著的协变量。
CFS 和 GWI 是彼此合适的“疾病对照”。调整后的节段体积的不同模式表明，性别二态性导致了病理变化。以前的容积研究可能需要重新评估，以考虑到性别差异。这些发现通过与文献中磁共振成像结果的频谱进行比较来阐述。
