Yu Qiang, Kwiatek Richard A, Del Fante Peter, Bonner Anya, Calhoun Vince D, Bateman Grant A, Yamamura Takashi, Shan Zack Y
Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, 4575, Australia.
Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, 55 Park Pl NE, 18th Floor, Atlanta, GA, 30303, USA.
Sci Rep. 2025 Jul 7;15(1):24256. doi: 10.1038/s41598-025-09379-z.
While post-infectious (PI-ME/CFS) and gradual onset (GO-ME/CFS) myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) manifest similar symptoms, it has long been suspected that different disease processes underlie them. However, the lack of biological evidence has left this question unanswered. In this study, how white matter microstructural changes in PI-ME/CFS and GO-ME/CFS patients were investigated. PI-ME/CFS and GO-ME/CFS patients were recruited based on consensus diagnoses made by two experienced clinicians and compared their diffusion MRI features with those of rigorously matched healthy controls (HCs) with sedentary lifestyles. PI-ME/CFS participants showed significantly higher axial diffusivity (AD) in several association and projection fibres compared to HCs. Higher AD in PI-ME/CFS was significantly related to worse physical health. In contrast, GO-ME/CFS participants exhibited significantly decreased AD in the corpus callosum. Lower AD in GO-ME/CFS was significantly associated with worse mental health in commissural and projection fibres. No significant group differences were found for fractional anisotropy, mean diffusivity, or radial diffusivity. Distinct patterns of AD alterations in PI-ME/CFS and GO-ME/CFS provide neurophysiological evidence of different disease processes and highlight the heterogeneities of ME/CFS.
虽然感染后型（PI-ME/CFS）和渐发型（GO-ME/CFS）的肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）表现出相似的症状，但长期以来人们一直怀疑它们有着不同的发病机制。然而，由于缺乏生物学证据，这个问题一直没有答案。在本研究中，我们调查了PI-ME/CFS和GO-ME/CFS患者的白质微观结构变化。根据两名经验丰富的临床医生的共识诊断招募了PI-ME/CFS和GO-ME/CFS患者，并将他们的扩散磁共振成像特征与久坐不动生活方式的严格匹配的健康对照（HCs）进行比较。与HCs相比，PI-ME/CFS参与者在几条联合纤维和投射纤维中表现出显著更高的轴向扩散率（AD）。PI-ME/CFS中较高的AD与较差的身体健康显著相关。相比之下，GO-ME/CFS参与者在胼胝体中表现出显著降低的AD。GO-ME/CFS中较低的AD与连合纤维和投射纤维中较差的心理健康显著相关。在分数各向异性、平均扩散率或径向扩散率方面未发现显著的组间差异。PI-ME/CFS和GO-ME/CFS中AD改变的不同模式为不同的发病机制提供了神经生理学证据，并突出了ME/CFS的异质性。
