Thapaliya Kiran, Marshall-Gradisnik Sonya, Staines Donald, Barnden Leighton
National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.
Centre for Advanced Imaging, The University of Queensland, Brisbane, Queensland, Australia.
Eur J Neurosci. 2021 Sep;54(6):6214-6228. doi: 10.1111/ejn.15413. Epub 2021 Aug 15.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients suffer from a variety of physical and neurological complaints indicating the central nervous system plays a role in ME/CFS pathophysiology. Diffusion tensor imaging (DTI) has been used to study microstructural changes in neurodegenerative diseases. In this study, we evaluated DTI parameters to investigate microstructural abnormalities in ME/CFS patients. We estimated DTI parameters in 25 ME/CFS patients who met Fukuda criteria (ME/CFS ), 18 ME/CFS patients who met International Consensus Criteria (ICC) (ME/CFS ) only and 26 healthy control (HC) subjects. In addition to voxel-based DTI-parameter group comparisons, we performed voxel-based DTI-parameter interaction-with-group regressions with clinical and autonomic measures to test for abnormal regressions. Group comparisons between ME/CFS and HC detected significant clusters (a) with decreased axial diffusivity (p = .001) and mean diffusivity (p = .01) in the descending cortico-cerebellar tract in the midbrain and pons and (b) with increased transverse diffusivity in the medulla. The mode of anisotropy was significantly decreased (p = .001) in a cluster in the superior longitudinal fasciculus region. Voxel-based group comparisons between ME/CFS and HC did not detect significant clusters. For ME/CFS and HC, DTI parameter interaction-with-group regressions were abnormal for the clinical measures of information processing score, SF36 physical, sleep disturbance score and respiration rate in both grey and white matter regions. Our study demonstrated that DTI parameters are sensitive to microstructural changes in ME/CFS and could potentially act as an imaging biomarker of abnormal pathophysiology in ME/CFS. The study also shows that strict case definitions are essential in investigation of the pathophysiology of ME/CFS.
肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）患者存在多种身体和神经方面的不适，这表明中枢神经系统在ME/CFS的病理生理学中发挥作用。扩散张量成像（DTI）已被用于研究神经退行性疾病中的微观结构变化。在本研究中，我们评估了DTI参数，以调查ME/CFS患者的微观结构异常。我们对25名符合福田标准的ME/CFS患者（ME/CFS ）、18名仅符合国际共识标准（ICC）的ME/CFS患者（ME/CFS ）和26名健康对照（HC）受试者进行了DTI参数估计。除了基于体素的DTI参数组间比较外，我们还进行了基于体素的DTI参数与组的交互回归分析，并结合临床和自主神经测量指标，以测试异常回归情况。ME/CFS组与HC组之间的组间比较发现了显著的聚类区域：（a）中脑和脑桥的皮质 - 小脑下行束中轴向扩散率降低（p = 0.001）和平均扩散率降低（p = 0.01）；（b）延髓中的横向扩散率增加。在上级纵向束区域的一个聚类中，各向异性模式显著降低（p = 0.001）。ME/CFS组与HC组之间基于体素的组间比较未发现显著聚类。对于ME/CFS组和HC组，在灰质和白质区域，DTI参数与组的交互回归在信息处理评分、SF36身体评分、睡眠障碍评分和呼吸频率等临床测量指标方面均表现异常。我们的研究表明，DTI参数对ME/CFS中的微观结构变化敏感，有可能作为ME/CFS异常病理生理学的成像生物标志物。该研究还表明，严格的病例定义对于ME/CFS病理生理学研究至关重要。
