Psychopharmacology Research Unit, Department of Psychiatry, University of Oxford, Oxford, UK.
Division of Informatics, Imaging and Data Science, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK.
Psychopharmacology (Berl). 2022 Jan;239(1):163-171. doi: 10.1007/s00213-021-05986-6. Epub 2021 Oct 5.
Chronic fatigue syndrome (CFS) is a common and burdensome illness with a poorly understood pathophysiology, though many of the characteristic symptoms are likely to be of brain origin. The use of high-field proton magnetic resonance spectroscopy (MRS) enables the detection of a range of brain neurochemicals relevant to aetiological processes that have been linked to CFS, for example, oxidative stress and mitochondrial dysfunction.
We studied 22 CFS patients and 13 healthy controls who underwent MRS scanning at 7 T with a voxel placed in the anterior cingulate cortex. Neurometabolite concentrations were calculated using the unsuppressed water signal as a reference.
Compared to controls, CFS patients had lowered levels of glutathione, total creatine and myo-inositol in anterior cingulate cortex. However, when using N-acetylaspartate as a reference metabolite, only myo-inositol levels continued to be significantly lower in CFS participants.
The changes in glutathione and creatine are consistent with the presence of oxidative and energetic stress in CFS patients and are potentially remediable by nutritional intervention. A reduction in myo-inositol would be consistent with glial dysfunction. However, the relationship of the neurochemical abnormalities to the causation of CFS remains to be established, and the current findings require prospective replication in a larger sample.
慢性疲劳综合征（CFS）是一种常见且负担沉重的疾病，其病理生理学尚未完全阐明，尽管许多特征性症状可能源于大脑。高磁场质子磁共振波谱（MRS）的应用能够检测到一系列与 CFS 相关的脑神经化学物质，例如氧化应激和线粒体功能障碍，这些物质与病因过程有关。
我们研究了 22 名 CFS 患者和 13 名健康对照者，他们在 7T 磁共振扫描仪上进行了 MRS 扫描，在前扣带回皮质放置了一个体素。使用未抑制的水信号作为参考，计算神经代谢物的浓度。
与对照组相比，CFS 患者在前扣带回皮质中的谷胱甘肽、总肌醇和肌酸水平降低。然而，当使用 N-乙酰天冬氨酸作为参考代谢物时，只有 CFS 参与者的肌醇水平仍然显著降低。
谷胱甘肽和肌酸的变化与 CFS 患者存在氧化和能量应激一致，并且可能通过营养干预得到纠正。肌醇的减少与神经胶质功能障碍一致。然而，神经化学异常与 CFS 的病因之间的关系仍有待确定，目前的发现需要在更大的样本中进行前瞻性复制。
