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Allendorfer JB, Nenert R, Goodman AM, Kakulamarri P, Correia S, Philip NS, LaFrance WC, Szaflarski JP. Brain network entropy, depression, and quality of life in people with traumatic brain injury and seizure disorders. Epilepsia Open 2024; 9:969-980. [PMID: 38507279 PMCID: PMC11145610 DOI: 10.1002/epi4.12926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 01/29/2024] [Accepted: 02/29/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVE Traumatic brain injury (TBI) often precedes the onset of epileptic (ES) or psychogenic nonepileptic seizures (PNES) with depression being a common comorbidity. The relationship between depression severity and quality of life (QOL) may be related to resting-state network complexity. We investigated these relationships in adults with TBI-only, TBI + ES, or TBI + PNES using Sample Entropy (SampEn), a measure of physiologic signals complexity. METHODS Adults with TBI-only (n = 60), TBI + ES (n = 21), or TBI + PNES (n = 56) completed the Beck Depression Inventory-II (BDI-II; depression symptom severity) and QOL in Epilepsy (QOLIE-31) assessments and underwent resting-state functional magnetic resonance imaging (rs-fMRI). SampEn values derived from six resting state functional networks were calculated per participant. Effects of group, network, and group-by-network-interactions for SampEn were investigated with a mixed-effects model. We examined relationships between BDI-II, QOL, and SampEn of each of the networks. RESULTS Groups did not differ in age, but there was a higher proportion of women with TBI + PNES (p = 0.040). TBI + ES and TBI-only groups did not differ in BDI-II or QOLIE-31 scores, while the TBI + PNES group scored worse on both measures. The fixed effects of the model revealed significant differences in SampEn values across networks (lower SampEn for the frontoparietal network compared to other networks). The likelihood ratio test for group-by-network-interactions was significant (p = 0.033). BDI-II was significantly negatively associated with Overall QOL scale scores in all groups, and significantly negatively associated with network SampEn values only in the TBI + PNES group. SIGNIFICANCE Only TBI + PNES had significant relationships between depression symptom severity and network SampEn values indicating that the resting state network complexity is related to depression severity in this group but not in TBI + ES or TBI-only. PLAIN LANGUAGE SUMMARY The brain has a complex network of internal connections. How well these connections work may be affected by TBI and seizures and may underlie mental health symptoms including depression; the worse the depression, the worse the quality of life. Our study compared brain organization in people with TBI, people with epilepsy after TBI, and people with nonepileptic seizures after TBI. Only people with nonepileptic seizures after TBI showed a relationship between how organized their brain connections were and how bad was their depression. We need to better understand these relationships to develop more impactful, effective treatments.
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Affiliation(s)
- Jane B. Allendorfer
- Department of NeurologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Department of NeurobiologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- UAB Epilepsy CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Rodolphe Nenert
- Department of NeurologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Adam M. Goodman
- Department of NeurologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- UAB Epilepsy CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Pranav Kakulamarri
- Department of NeurologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Stephen Correia
- VA RR&D Center for Neurorestoration and NeurotechnologyVA Providence Healthcare SystemProvidenceRhode IslandUSA
| | - Noah S. Philip
- VA RR&D Center for Neurorestoration and NeurotechnologyVA Providence Healthcare SystemProvidenceRhode IslandUSA
- Department of Psychiatry and Human BehaviorBrown UniversityProvidenceRhode IslandUSA
| | - W. Curt LaFrance
- VA RR&D Center for Neurorestoration and NeurotechnologyVA Providence Healthcare SystemProvidenceRhode IslandUSA
- Department of Psychiatry and Human BehaviorBrown UniversityProvidenceRhode IslandUSA
- Department of NeurologyBrown UniversityProvidenceRhode IslandUSA
- Division of Neuropsychiatry and Behavioral NeurologyRhode Island HospitalProvidenceRhode IslandUSA
| | - Jerzy P. Szaflarski
- Department of NeurologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Department of NeurobiologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- UAB Epilepsy CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Department of NeurosurgeryUniversity of Alabama at BirminghamBirminghamAlabamaUSA
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Inderyas M, Thapaliya K, Marshall-Gradisnik S, Barth M, Barnden L. Subcortical and default mode network connectivity is impaired in myalgic encephalomyelitis/chronic fatigue syndrome. Front Neurosci 2024; 17:1318094. [PMID: 38347875 PMCID: PMC10859529 DOI: 10.3389/fnins.2023.1318094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/27/2023] [Indexed: 02/15/2024] Open
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex chronic condition with core symptoms of fatigue and cognitive dysfunction, suggesting a key role for the central nervous system in the pathophysiology of this disease. Several studies have reported altered functional connectivity (FC) related to motor and cognitive deficits in ME/CFS patients. In this study, we compared functional connectivity differences between 31 ME/CFS and 15 healthy controls (HCs) using 7 Tesla MRI. Functional scans were acquired during a cognitive Stroop color-word task, and blood oxygen level-dependent (BOLD) time series were computed for 27 regions of interest (ROIs) in the cerebellum, brainstem, and salience and default mode networks. A region-based comparison detected reduced FC between the pontine nucleus and cerebellum vermis IX (p = 0.027) for ME/CFS patients compared to HCs. Our ROI-to-voxel analysis found significant impairment of FC within the ponto-cerebellar regions in ME/CFS. Correlation analyses of connectivity with clinical scores in ME/CFS patients detected associations between FC and 'duration of illness' and 'memory scores' in salience network hubs and cerebellum vermis and between FC and 'respiratory rate' within the medulla and the default mode network FC. This novel investigation is the first to report the extensive involvement of aberrant ponto-cerebellar connections consistent with ME/CFS symptomatology. This highlights the involvement of the brainstem and the cerebellum in the pathomechanism of ME/CFS.
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Affiliation(s)
- Maira Inderyas
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
| | - Kiran Thapaliya
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
| | - Sonya Marshall-Gradisnik
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
| | - Markus Barth
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD, Australia
| | - Leighton Barnden
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
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Barnden L, Thapaliya K, Eaton-Fitch N, Barth M, Marshall-Gradisnik S. Altered brain connectivity in Long Covid during cognitive exertion: a pilot study. Front Neurosci 2023; 17:1182607. [PMID: 37425014 PMCID: PMC10323677 DOI: 10.3389/fnins.2023.1182607] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Debilitating Long-Covid symptoms occur frequently after SARS-COVID-19 infection. Methods Functional MRI was acquired in 10 Long Covid (LCov) and 13 healthy controls (HC) with a 7 Tesla scanner during a cognitive (Stroop color-word) task. BOLD time series were computed for 7 salience and 4 default-mode network hubs, 2 hippocampus and 7 brainstem regions (ROIs). Connectivity was characterized by the correlation coefficient between each pair of ROI BOLD time series. We tested for HC versus LCov differences in connectivity between each pair of the 20 regions (ROI-to-ROI) and between each ROI and the rest of the brain (ROI-to-voxel). For LCov, we also performed regressions of ROI-to-ROI connectivity with clinical scores. Results Two ROI-to-ROI connectivities differed between HC and LCov. Both involved the brainstem rostral medulla, one connection to the midbrain, another to a DM network hub. Both were stronger in LCov than HC. ROI-to-voxel analysis detected multiple other regions where LCov connectivity differed from HC located in all major lobes. Most, but not all connections, were weaker in LCov than HC. LCov, but not HC connectivity, was correlated with clinical scores for disability and autonomic function and involved brainstem ROI. Discussion Multiple connectivity differences and clinical correlations involved brainstem ROIs. Stronger connectivity in LCov between the medulla and midbrain may reflect a compensatory response. This brainstem circuit regulates cortical arousal, autonomic function and the sleep-wake cycle. In contrast, this circuit exhibited weaker connectivity in ME/CFS. LCov connectivity regressions with disability and autonomic scores were consistent with altered brainstem connectivity in LCov.
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Affiliation(s)
- Leighton Barnden
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
| | - Kiran Thapaliya
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
- Centre for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - Natalie Eaton-Fitch
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
| | - Markus Barth
- Centre for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD, Australia
| | - Sonya Marshall-Gradisnik
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
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Komaroff AL, Lipkin WI. ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature. Front Med (Lausanne) 2023; 10:1187163. [PMID: 37342500 PMCID: PMC10278546 DOI: 10.3389/fmed.2023.1187163] [Citation(s) in RCA: 69] [Impact Index Per Article: 69.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023] Open
Abstract
Some patients remain unwell for months after "recovering" from acute COVID-19. They develop persistent fatigue, cognitive problems, headaches, disrupted sleep, myalgias and arthralgias, post-exertional malaise, orthostatic intolerance and other symptoms that greatly interfere with their ability to function and that can leave some people housebound and disabled. The illness (Long COVID) is similar to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) as well as to persisting illnesses that can follow a wide variety of other infectious agents and following major traumatic injury. Together, these illnesses are projected to cost the U.S. trillions of dollars. In this review, we first compare the symptoms of ME/CFS and Long COVID, noting the considerable similarities and the few differences. We then compare in extensive detail the underlying pathophysiology of these two conditions, focusing on abnormalities of the central and autonomic nervous system, lungs, heart, vasculature, immune system, gut microbiome, energy metabolism and redox balance. This comparison highlights how strong the evidence is for each abnormality, in each illness, and helps to set priorities for future investigation. The review provides a current road map to the extensive literature on the underlying biology of both illnesses.
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Affiliation(s)
- Anthony L. Komaroff
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - W. Ian Lipkin
- Center for Infection and Immunity, Mailman School of Public Health, Vagelos College of Physicians and Surgeons of Columbia University, New York, NY, United States
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Wirth KJ, Löhn M. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Comorbidities: Linked by Vascular Pathomechanisms and Vasoactive Mediators? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050978. [PMID: 37241210 DOI: 10.3390/medicina59050978] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/07/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is often associated with various other syndromes or conditions including mast cell activation (MCA), dysmenorrhea and endometriosis, postural tachycardia (POTS) and small fiber neuropathy (SFN). The causes of these syndromes and the reason for their frequent association are not yet fully understood. We previously published a comprehensive hypothesis of the ME/CFS pathophysiology that explains the majority of symptoms, findings and chronicity of the disease. We wondered whether some of the identified key pathomechanisms in ME/CFS are also operative in MCA, endometriosis and dysmenorrhea, POTS, decreased cerebral blood flow and SFN, and possibly may provide clues on their causes and frequent co-occurrence. Our analysis indeed provides strong arguments in favor of this assumption, and we conclude that the main pathomechanisms responsible for this association are excessive generation and spillover into the systemic circulation of inflammatory and vasoactive tissue mediators, dysfunctional β2AdR, and the mutual triggering of symptomatology and disease initiation. Overall, vascular dysfunction appears to be a strong common denominator in these linkages.
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Affiliation(s)
- Klaus J Wirth
- Institute of General Pharmacology and Toxicology, University Hospital Frankfurt am Main, Goethe-University, Theodor-Stern Kai 7, D-60590 Frankfurt am Main, Germany
| | - Matthias Löhn
- Institute of General Pharmacology and Toxicology, University Hospital Frankfurt am Main, Goethe-University, Theodor-Stern Kai 7, D-60590 Frankfurt am Main, Germany
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Fan S, Yu Y, Wu Y, Kai Y, Wang H, Chen Y, Zu M, Pang X, Tian Y. Altered brain entropy and functional connectivity patterns in generalized anxiety disorder patients. J Affect Disord 2023; 332:168-175. [PMID: 36972849 DOI: 10.1016/j.jad.2023.03.062] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 03/14/2023] [Accepted: 03/18/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is a highly prevalent disease characterized by chronic, pervasive, and intrusive worry. Previous resting-state functional MRI (fMRI) studies on GAD have mainly focused on conventional static linear features. Entropy analysis of resting-state functional magnetic resonance imaging (rs-fMRI) has recently been adopted to characterize brain temporal dynamics in some neuropsychological or psychiatric diseases. However, the nonlinear dynamic complexity of brain signals has been rarely explored in GAD. METHODS We measured the approximate entropy (ApEn) and sample entropy (SampEn) of the resting-state fMRI data from 38 GAD patients and 37 matched healthy controls (HCs). The brain regions with significantly different ApEn and SampEn values between the two groups were extracted. Using these brain regions as seed points, we also investigated whether there are differences in whole brain resting-state function connectivity (RSFC) pattern between GADs and HCs. Correlation analysis was subsequently conducted to investigate the association between brain entropy, RSFC and the severity of anxiety symptoms. A linear support vector machine (SVM) was used to assess the discriminative power of BEN and RSFC features among GAD patients and HCs. RESULTS Compared to the HCs, patients with GAD showed increased levels of ApEn in the right angular cortex (AG) and increased levels of SampEn in the right middle occipital gyrus (MOG) as well as the right inferior occipital gyrus (IOG). Contrarily, compared to the HCs, patients with GAD showed decreased RSFC between the right AG and the right inferior parietal gyrus (IPG). The SVM-based classification model achieved 85.33 % accuracy (sensitivity: 89.19 %; specificity: 81.58 %; and area under the receiver operating characteristic curve: 0.9018). The ApEn of the right AG and the SVM-based decision value was positively correlated with the Hamilton Anxiety Scale (HAMA). LIMITATIONS This study used cross-sectional data and sample size was small. CONCLUSION Patients with GAD showed increased level of nonlinear dynamical complexity of ApEn in the right AG and decreased linear features of RSFC in the right IPG. Combining the linear and nonlinear features of brain signals may be used to effectively diagnose psychiatric disorders.
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Affiliation(s)
- Siyu Fan
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Yue Yu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Yue Wu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Yiao Kai
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Hongping Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Yue Chen
- Shanghai Fourth People's Hospital Affiliated to Tongji University, Shanghai 200081, China
| | - Meidan Zu
- Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
| | - Xiaonan Pang
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China.
| | - Yanghua Tian
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; The College of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230032, China.
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Putra HA, Park K, Yamashita F. Sex Differences in the Correlation between Fatigue Perception and Regional Gray Matter Volume in Healthy Adults: A Large-Scale Study. J Clin Med 2022; 11:jcm11206037. [PMID: 36294358 PMCID: PMC9604802 DOI: 10.3390/jcm11206037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
The relationship between fatigue perception and regional gray matter volume (rGMV) has seldom been studied in healthy adults. Therefore, this study aimed to analyze sex differences in the correlation between rGMV and fatigue perception using Chalder’s fatigue questionnaire (CFQ). The CFQ was used to analyze the sexual features of rGMV related to the degree of perceived fatigue in 2955 healthy adults (male = 1560, female = 1395) of various ages (20–89 years, median 56). A higher CFQ score denotes a higher perceived fatigue level by the participant. According to the CFQ scores in males, the volumes of the right orbital part of the inferior frontal gyrus and left precuneus were negatively correlated (i.e., smaller rGMV had a higher CFQ score), whereas the left angular gyrus was positively correlated. In females, the right inferior temporal gyrus was negative, whereas the left middle temporal gyrus and right putamen were positive (i.e., larger rGMV had a higher CFQ score). The lack of identified regions in this large-scale study between males and females might be related to sex differences in clinical or pathological fatigue morbidities. Additionally, the sex differences in the negative or positive correlations between rGMV and fatigue perception may contribute to a better understanding of the neuronal mechanism in the early stages of fatigue development.
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Affiliation(s)
- Handityo Aulia Putra
- Research Organization for Regional Alliances, Kochi University of Technology, Kochi 782-8502, Japan
- Correspondence: ; Tel.: +81-887-57-2025
| | - Kaechang Park
- Research Organization for Regional Alliances, Kochi University of Technology, Kochi 782-8502, Japan
| | - Fumio Yamashita
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Iwate 028-3694, Japan
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Shan ZY, Mohamed AZ, Andersen T, Rendall S, Kwiatek RA, Fante PD, Calhoun VD, Bhuta S, Lagopoulos J. Multimodal MRI of myalgic encephalomyelitis/chronic fatigue syndrome: A cross-sectional neuroimaging study toward its neuropathophysiology and diagnosis. Front Neurol 2022; 13:954142. [PMID: 36188362 PMCID: PMC9523103 DOI: 10.3389/fneur.2022.954142] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/30/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), is a debilitating illness affecting up to 24 million people worldwide but concerningly there is no known mechanism for ME/CFS and no objective test for diagnosis. A series of our neuroimaging findings in ME/CFS, including functional MRI (fMRI) signal characteristics and structural changes in brain regions particularly sensitive to hypoxia, has informed the hypothesis that abnormal neurovascular coupling (NVC) may be the neurobiological origin of ME/CFS. NVC is a critical process for normal brain function, in which glutamate from an active neuron stimulates Ca2+ influx in adjacent neurons and astrocytes. In turn, increased Ca2+ concentrations in both astrocytes and neurons trigger the synthesis of vascular dilator factors to increase local blood flow assuring activated neurons are supplied with their energy needs. This study investigates NVC using multimodal MRIs: (1) hemodynamic response function (HRF) that represents regional brain blood flow changes in response to neural activities and will be modeled from a cognitive task fMRI; (2) respiration response function (RRF) represents autoregulation of regional blood flow due to carbon dioxide and will be modeled from breath-holding fMRI; (3) neural activity associated glutamate changes will be modeled from a cognitive task functional magnetic resonance spectroscopy. We also aim to develop a neuromarker for ME/CFS diagnosis by integrating the multimodal MRIs with a deep machine learning framework. Methods and analysis This cross-sectional study will recruit 288 participants (91 ME/CFS, 61 individuals with chronic fatigue, 91 healthy controls with sedentary lifestyles, 45 fibromyalgia). The ME/CFS will be diagnosed by consensus diagnosis made by two clinicians using the Canadian Consensus Criteria 2003. Symptoms, vital signs, and activity measures will be collected alongside multimodal MRI. The HRF, RRF, and glutamate changes will be compared among four groups using one-way analysis of covariance (ANCOVA). Equivalent non-parametric methods will be used for measures that do not exhibit a normal distribution. The activity measure, body mass index, sex, age, depression, and anxiety will be included as covariates for all statistical analyses with the false discovery rate used to correct for multiple comparisons. The data will be randomly divided into a training (N = 188) and a validation (N = 100) group. Each MRI measure will be entered as input for a least absolute shrinkage and selection operator—regularized principal components regression to generate a brain pattern of distributed clusters that predict disease severity. The identified brain pattern will be integrated using multimodal deep Boltzmann machines as a neuromarker for predicting ME/CFS fatigue conditions. The receiver operating characteristic curve of the identified neuromarker will be determined using data from the validation group. Ethics and study registry This study was reviewed and approved by University of the Sunshine Coast University Ethics committee (A191288) and has been registered with The Australian New Zealand Clinical Trials Registry (ACTRN12622001095752). Dissemination of results The results will be disseminated through peer reviewed scientific manuscripts and conferences and to patients through social media and active engagement with ME/CFS associations.
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Affiliation(s)
- Zack Y. Shan
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
- *Correspondence: Zack Y. Shan
| | - Abdalla Z. Mohamed
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
| | - Thu Andersen
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
| | - Shae Rendall
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
| | - Richard A. Kwiatek
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
| | - Peter Del Fante
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
| | - Vince D. Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
| | - Sandeep Bhuta
- Medical Imaging Department, Gold Coast University Hospital, Parklands, QLD, Australia
| | - Jim Lagopoulos
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
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Xie F, Guan C, Gu Y, You Y, Yao F. Effects of the Prolong Life With Nine Turn Method (Yan Nian Jiu Zhuan) Qigong on Brain Functional Changes in Patients With Chronic Fatigue Syndrome in Terms of Fatigue and Quality of Life. Front Neurol 2022; 13:866424. [PMID: 35911899 PMCID: PMC9326262 DOI: 10.3389/fneur.2022.866424] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundChronic fatigue syndrome (CFS) is characterized by persistent fatigue, which often leads to physical and psychological damage. The Prolong Life with Nine Turn method (PLWNT) Qigong is considered as one of the complementary treatments for improving symptoms in patients with CFS. In this study, we used functional magnetic resonance imaging (fMRI) to explore the effects of PLWNT intervention on the subjects with CFS.MethodsThirty four CFS patients were randomly divided into PLWNT group and cognitive behavioral therapy (CBT) group. Both groups were taught by a highly qualified professor at the Shanghai University of Traditional Chinese Medicine once a week and were supervised online during the remaining 6 days at home, over 12 consecutive weeks. We calculated the regional rs-fMRI index amplitude of low-frequency fluctuations (ALFF) for all subjects. To study the changes of the brain network, we used the brain regions with significant differences in ALFF as the regions of interest for whole-brain functional connectivity (FC) analysis. The Multi-dimensional Fatigue Inventory 20 (MFI-20) and Short Form 36-item Health Survey (SF-36) were used for clinical symptom assessment to explore the possible correlation between the rs-fMRI indicators and clinical variations.ResultsThe ALFF values of the right superior frontal gyrus (SFG), and left median cingulate gyrus (DCG) were increased, whereas those of the left middle occipital gyrus (OG), right middle OG and left middle temporal gyrus (MTG) were decreased in PLWNT group. The FC values between the DCG and middle temporal gyrus (MTG), and those between the left OG and the right OG were enhanced. In addition, the SF-36 were positively with the left OG (r = 0.524), SFG (r = 0.517), and DCG (r = 0.533), MFI-20 were negatively with the SFG (r = −0.542) and DCG (r = −0.578). These results were all corrected by FWE (voxel level p < 0.001, cluster level p < 0.05).ConclusionCFS patients have abnormal regional spontaneous neuronal activity and abnormal functional connections between regions after PLWNT intervention. PLWNT can relieve the fatigue symptoms of CFS patients and improve their quality of life. The study was registered in the American Clinical Trial Registry (12/04/2018). Registration Number is NCT03496961.
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Affiliation(s)
- Fangfang Xie
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture and Massage, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chong Guan
- School of Acupuncture and Massage, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuanjia Gu
- School of Acupuncture and Massage, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanli You
- Department of Traditional Chinese Medicine, ChangHai Hospital, Naval Medical University, Shanghai, China
- *Correspondence: Yanli You
| | - Fei Yao
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture and Massage, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Fei Yao
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Aoun Sebaiti M, Hainselin M, Gounden Y, Sirbu CA, Sekulic S, Lorusso L, Nacul L, Authier FJ. Systematic review and meta-analysis of cognitive impairment in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Sci Rep 2022; 12:2157. [PMID: 35140252 PMCID: PMC8828740 DOI: 10.1038/s41598-021-04764-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 11/23/2021] [Indexed: 12/17/2022] Open
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is commonly associated with cognitive complaints. To bring out the neuropsychological symptomatology inherent to ME/CFS, we conducted a systematic review according to PRISMA and MOOSE guidelines of the literature through the analysis of 764 studies published between 1988 and 2019 by using PubMed Central website and Clarivate analytics platform. We performed a meta-analysis to delineate an idea of the neuropsychological profile inherent in ME/CFS. The clinical picture typically affects visuo-spatial immediate memory (g = - 0.55, p = 0.007), reading speed (g = - 0.82, p = 0.0001) and graphics gesture (g = - 0.59, p = 0.0001). Analysis also revealed difficulties in several processes inherent in episodic verbal memory (storage, retrieval, recognition) and visual memory (recovery) and a low efficiency in attentional abilities. Executive functions seemed to be little or not affected and instrumental functions appeared constantly preserved. With regard to the complexity and heterogeneity of the cognitive phenotype, it turns out that determining a sound clinical picture of ME/CFS cognitive profile must go through a neuropsychological examination allowing a complete evaluation integrating the notion of agreement between the choice and the number of tests and the complexity intrinsic to the pathology.
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Affiliation(s)
- Mehdi Aoun Sebaiti
- Neurology Department, Henri Mondor University Hospital, APHP, Créteil, France
- INSERM U955-Team Relaix, Faculty of Health, Paris Est-Creteil University, Créteil, France
- CRP-CPO, UR UPJV 7273, Université de Picardie Jules Verne, Amiens, France
| | - Mathieu Hainselin
- CRP-CPO, UR UPJV 7273, Université de Picardie Jules Verne, Amiens, France
| | - Yannick Gounden
- CRP-CPO, UR UPJV 7273, Université de Picardie Jules Verne, Amiens, France
| | - Carmen Adella Sirbu
- Central Military Emergency University Hospital, Titu Maiorescu University, Bucharest, Romania
- European Network On ME/CFS (EUROMENE), London, UK
| | - Slobodan Sekulic
- European Network On ME/CFS (EUROMENE), London, UK
- Department of Neurology, Faculty of Medicine Novi Sad, University of Novio Sad, Novio Sad, Serbia
| | - Lorenzo Lorusso
- European Network On ME/CFS (EUROMENE), London, UK
- Neurology and Stroke Unit, Neuroscience Dept - ASST- Lecco, Merate Hospital, Merate, LC, Italy
| | - Luis Nacul
- European Network On ME/CFS (EUROMENE), London, UK
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - François Jérôme Authier
- INSERM U955-Team Relaix, Faculty of Health, Paris Est-Creteil University, Créteil, France.
- European Network On ME/CFS (EUROMENE), London, UK.
- Neuromuscular Reference Center, Henri Mondor University Hospital, APHP, 51, Av. du Maréchal de Lattre de Tassigny, 94000, Créteil, France.
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11
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Nelson T, Zhang LX, Guo H, Nacul L, Song X. Brainstem Abnormalities in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Scoping Review and Evaluation of Magnetic Resonance Imaging Findings. Front Neurol 2021; 12:769511. [PMID: 34975729 PMCID: PMC8718708 DOI: 10.3389/fneur.2021.769511] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/29/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a multisystem medical condition with heterogeneous symptom expression. Currently, there is no effective cure or treatment for the standard care of patients. A variety of ME/CFS symptoms can be linked to the vital life functions of the brainstem, the lower extension of the brain best known as the hub relaying information back and forth between the cerebral cortex and various parts of the body. Objective/Methods: Over the past decade, Magnetic Resonance Imaging (MRI) studies have emerged to understand ME/CFS with interesting findings, but there has lacked a synthesized evaluation of what has been found thus far regarding the involvement of the brainstem. We conducted this study to review and evaluate the recent MRI findings via a literature search of the MEDLINE database, from which 11 studies met the eligibility criteria. Findings: Data showed that MRI studies frequently reported structural changes in the white and gray matter. Abnormalities of the functional connectivity within the brainstem and with other brain regions have also been found. The studies have suggested possible mechanisms including astrocyte dysfunction, cerebral perfusion impairment, impaired nerve conduction, and neuroinflammation involving the brainstem, which may at least partially explain a substantial portion of the ME/CFS symptoms and their heterogeneous presentations in individual patients. Conclusions: This review draws research attention to the role of the brainstem in ME/CFS, helping enlighten future work to uncover the pathologies and mechanisms of this complex medical condition, for improved management and patient care.
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Affiliation(s)
- Todd Nelson
- Evaluation and Research, Surrey Memorial Hospital, Fraser Health, Surrey, BC, Canada
- Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Lan-Xin Zhang
- Evaluation and Research, Surrey Memorial Hospital, Fraser Health, Surrey, BC, Canada
- Department of Human Biology, Physiology, University of Toronto, Toronto, ON, Canada
| | - Hui Guo
- Evaluation and Research, Surrey Memorial Hospital, Fraser Health, Surrey, BC, Canada
- Department of Diagnostic Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Luis Nacul
- Complex Chronic Diseases Program, BC Women's Hospital and Health Centre, Vancouver, BC, Canada
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Xiaowei Song
- Evaluation and Research, Surrey Memorial Hospital, Fraser Health, Surrey, BC, Canada
- Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
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12
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Yin T, He Z, Ma P, Sun R, Xie K, Liu T, Chen L, Chen J, Hou L, Teng Y, Guo Y, Tian Z, Xiong J, Wang F, Li S, Yang S, Zeng F. Aberrant functional brain network dynamics in patients with functional constipation. Hum Brain Mapp 2021; 42:5985-5999. [PMID: 34533251 PMCID: PMC8596972 DOI: 10.1002/hbm.25663] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/25/2021] [Accepted: 09/06/2021] [Indexed: 12/17/2022] Open
Abstract
The aberrant static functional connectivity of brain network has been widely investigated in patients with functional constipation (FCon). However, the dynamics of brain functional connectivity in FCon patients remained unknown. This study aimed to detect the brain dynamics of functional connectivity states and network topological organizations of FCon patients and investigate the correlations of the aberrant brain dynamics with symptom severity. Eighty-three FCon patients and 80 healthy subjects (HS) were included in data analysis. The spatial group independent component analysis, sliding-window approach, k-means clustering, and graph-theoretic analysis were applied to investigate the dynamic temporal properties and coupling patterns of functional connectivity states, as well as the time-variation of network topological organizations in FCon patients. Four reoccurring functional connectivity states were identified in k-means clustering analysis. Compared to HS, FCon patients manifested the lower occurrence rate and mean dwell time in the state with a complex connection between default mode network and cognitive control network, as well as the aberrant anterior insula-cortical coupling patterns in this state, which were significantly correlated with the symptom severity. The graph-theoretic analysis demonstrated that FCon patients had higher sample entropy at the nodal efficiency of anterior insula than HS. The current findings provided dynamic perspectives for understanding the brain connectome of FCon and laid the foundation for the potential treatment of FCon based on brain connectomics.
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Affiliation(s)
- Tao Yin
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Zhaoxuan He
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Key Laboratory of Sichuan Province for Acupuncture and ChronobiologyChengduSichuanChina
| | - Peihong Ma
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Ruirui Sun
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Kunnan Xie
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Tianyu Liu
- School of SportChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Li Chen
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Jingwen Chen
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Likai Hou
- Sichuan Bayi Rehabilitation CenterChengduSichuanChina
| | - Yuke Teng
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Yuyi Guo
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Zilei Tian
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Jing Xiong
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Fumin Wang
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Shenghong Li
- State Key Laboratory of Southwestern Chinese Medicine Resources/Innovative Institute of Chinese Medicine and PharmacyChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Sha Yang
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Key Laboratory of Sichuan Province for Acupuncture and ChronobiologyChengduSichuanChina
| | - Fang Zeng
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
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13
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Wirth KJ, Scheibenbogen C, Paul F. An attempt to explain the neurological symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. J Transl Med 2021; 19:471. [PMID: 34809664 PMCID: PMC8607226 DOI: 10.1186/s12967-021-03143-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/11/2021] [Indexed: 01/17/2023] Open
Abstract
There is accumulating evidence of endothelial dysfunction, muscle and cerebral hypoperfusion in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). In this paper we deduce the pathomechanisms resulting in central nervous pathology and the myriad of neurocognitive symptoms. We outline tentative mechanisms of impaired cerebral blood flow, increase in intracranial pressure and central adrenergic hyperactivity and how they can well explain the key symptoms of cognitive impairment, brain fog, headache, hypersensitivity, sleep disturbances and dysautonomia.
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Affiliation(s)
| | - Carmen Scheibenbogen
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité Universitätsmedizin Berlin, Berlin, Germany
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14
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Xin X, Long S, Sun M, Gao X. The Application of Complexity Analysis in Brain Blood-Oxygen Signal. Brain Sci 2021; 11:brainsci11111415. [PMID: 34827414 PMCID: PMC8615802 DOI: 10.3390/brainsci11111415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022] Open
Abstract
One of the daunting features of the brain is its physiology complexity, which arises from the interaction of numerous neuronal circuits that operate over a wide range of temporal and spatial scales, enabling the brain to adapt to the constantly changing environment and to perform various cognitive functions. As a reflection of the complexity of brain physiology, the complexity of brain blood-oxygen signal has been frequently studied in recent years. This paper reviews previous literature regarding the following three aspects: (1) whether the complexity of the brain blood-oxygen signal can serve as a reliable biomarker for distinguishing different patient populations; (2) which is the best algorithm for complexity measure? And (3) how to select the optimal parameters for complexity measures. We then discuss future directions for blood-oxygen signal complexity analysis, including improving complexity measurement based on the characteristics of both spatial patterns of brain blood-oxygen signal and latency of complexity itself. In conclusion, the current review helps to better understand complexity analysis in brain blood-oxygen signal analysis and provide useful information for future studies.
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15
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Gandasegui IM, Laka LA, Gargiulo PÁ, Gómez-Esteban JC, Sánchez JVL. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Neurological Entity? MEDICINA (KAUNAS, LITHUANIA) 2021; 57:1030. [PMID: 34684066 PMCID: PMC8540700 DOI: 10.3390/medicina57101030] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/02/2021] [Accepted: 09/22/2021] [Indexed: 12/18/2022]
Abstract
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a disorder of unknown physiopathology with multisystemic repercussions, framed in ICD-11 under the heading of neurology (8E49). There is no specific test to support its clinical diagnosis. Our objective is to review the evidence in neuroimaging and dysautonomia evaluation in order to support the neurological involvement and to find biomarkers serving to identify and/or monitor the pathology. The symptoms typically appear acutely, although they can develop progressively over years; an essential trait for diagnosis is "central" fatigue together with physical and/or mental exhaustion after a small effort. Neuroimaging reveals various morphological, connectivity, metabolic, and functional alterations of low specificity, which can serve to complement the neurological study of the patient. The COMPASS-31 questionnaire is a useful tool to triage patients under suspect of dysautonomia, at which point they may be redirected for deeper evaluation. Recently, alterations in heart rate variability, the Valsalva maneuver, and the tilt table test, together with the presence of serum autoantibodies against adrenergic, cholinergic, and serotonin receptors were shown in a subgroup of patients. This approach provides a way to identify patient phenotypes. Broader studies are needed to establish the level of sensitivity and specificity necessary for their validation. Neuroimaging contributes scarcely to the diagnosis, and this depends on the identification of specific changes. On the other hand, dysautonomia studies, carried out in specialized units, are highly promising in order to support the diagnosis and to identify potential biomarkers. ME/CFS orients towards a functional pathology that mainly involves the autonomic nervous system, although not exclusively.
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Affiliation(s)
- Iñigo Murga Gandasegui
- LaNCE-Neuropharm Group, Neuroscience Department, University of the Basque Country (UPV-EHU), 48940 Leioa, Bizkaia, Spain; (L.A.L.); (J.-C.G.-E.); (J.-V.L.S.)
| | - Larraitz Aranburu Laka
- LaNCE-Neuropharm Group, Neuroscience Department, University of the Basque Country (UPV-EHU), 48940 Leioa, Bizkaia, Spain; (L.A.L.); (J.-C.G.-E.); (J.-V.L.S.)
| | - Pascual-Ángel Gargiulo
- Experimental Psychology Laboratory, CONICET, Department Pathology, Universidad Nacional de Cuyo, Mendoza 5500, Argentina;
| | - Juan-Carlos Gómez-Esteban
- LaNCE-Neuropharm Group, Neuroscience Department, University of the Basque Country (UPV-EHU), 48940 Leioa, Bizkaia, Spain; (L.A.L.); (J.-C.G.-E.); (J.-V.L.S.)
- Neurodegenerative Disease Group, Biocruces Research Institute, 48903 Barakaldo, Bizkaia, Spain
| | - José-Vicente Lafuente Sánchez
- LaNCE-Neuropharm Group, Neuroscience Department, University of the Basque Country (UPV-EHU), 48940 Leioa, Bizkaia, Spain; (L.A.L.); (J.-C.G.-E.); (J.-V.L.S.)
- Neurodegenerative Disease Group, Biocruces Research Institute, 48903 Barakaldo, Bizkaia, Spain
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16
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Thapaliya K, Marshall-Gradisnik S, Staines D, Barnden L. Diffusion tensor imaging reveals neuronal microstructural changes in myalgic encephalomyelitis/chronic fatigue syndrome. Eur J Neurosci 2021; 54:6214-6228. [PMID: 34355438 PMCID: PMC9291819 DOI: 10.1111/ejn.15413] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/01/2021] [Accepted: 08/02/2021] [Indexed: 11/26/2022]
Abstract
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/CFSFukuda ), 18 ME/CFS patients who met International Consensus Criteria (ICC) (ME/CFSICC ) 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/CFSICC 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/CFSFukuda and HC did not detect significant clusters. For ME/CFSICC 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/CFSICC 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.
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Affiliation(s)
- Kiran Thapaliya
- 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
| | - Sonya Marshall-Gradisnik
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Donald Staines
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Leighton Barnden
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
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17
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Li J, Huang M, Pan F, Li Z, Shen Z, Jin K, Zhao H, Lu S, Shang D, Xu Y, Wang J. Aberrant Development of Cross-Frequency Multiplex Functional Connectome in First-Episode, Drug-Naive Major Depressive Disorder and Schizophrenia. Brain Connect 2021; 12:538-548. [PMID: 34269608 DOI: 10.1089/brain.2021.0088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) and schizophrenia (SCH) are both characterized by neurodevelopmental abnormalities; however, transdiagnostic and diagnosis-specific patterns of such abnormalities have rarely been examined, particularly in large-scale functional brain networks via advanced multilayer network models. METHODS Here we collected resting-state functional MRI data from 45 MDD patients, 64 SCH patients and 48 healthy controls (13-45 years old), and constructed functional networks in different frequency intervals. The frequency-dependent networks were then fused by multiplex network models, followed by graph-based topological analyses. RESULTS We found that functional networks of the patients showed common neurodevelopmental abnormalities in the right ventromedial parietooccipital sulcus (opposite correlations with age to healthy controls), while functional networks of the MDD patients exhibited specific alterations in the left superior parietal lobule and right precentral gyrus with respect to cross-frequency interactions. These findings were quite different from those from brain networks within each frequency interval, which revealed SCH-specific neurodevelopmental abnormalities in the right superior temporal gyrus (opposite correlations with age to the other two groups) in 0.027-0.073 Hz, and SCH-specific alterations in the left superior temporal gyrus and bilateral insula in 0.073-0.198 Hz. Finally, multivariate analysis of age prediction revealed that the subcortical network lost predict ability in both patient groups, while the visual network exhibited additional prediction ability in the MDD patients. DISCUSSION AND CONCLUSION Altogether, these findings demonstrate transdiagnostic and diagnosis-specific neurodevelopmental abnormalities and alterations in large-scale functional brain networks between MDD and SCH, which have important implications for understanding shared and unique neural mechanisms underlying the diseases.
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Affiliation(s)
- Junle Li
- Institute for Brain Research and Rehabilitation, Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
| | - Manli Huang
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Fen Pan
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Zhen Li
- Institute for Brain Research and Rehabilitation, Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
| | - Zhe Shen
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Kangyu Jin
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Haoyang Zhao
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Shaojia Lu
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Desheng Shang
- Department of Radiology, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
| | - Yi Xu
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Jinhui Wang
- Institute for Brain Research and Rehabilitation, Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
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18
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Abreu R, Duarte JV. Quantitative Assessment of the Impact of Geometric Distortions and Their Correction on fMRI Data Analyses. Front Neurosci 2021; 15:642808. [PMID: 33767610 PMCID: PMC7985341 DOI: 10.3389/fnins.2021.642808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/15/2021] [Indexed: 11/13/2022] Open
Abstract
Functional magnetic resonance imaging (fMRI) data is typically collected with gradient-echo echo-planar imaging (GE-EPI) sequences, which are particularly prone to the susceptibility artifact as a result of B0 field inhomogeneity. The component derived from in-plane spin dephasing induces pixel intensity variations and, more critically, geometric distortions. Despite the physical mechanisms underlying the susceptibility artifact being well established, a systematic investigation on the impact of the associated geometric distortions, and the direct comparison of different approaches to tackle them, on fMRI data analyses is missing. Here, we compared two different distortion correction approaches, by acquiring additional: (1) EPI data with reversed phase encoding direction (TOPUP), and (2) standard (and undistorted) GE data at two different echo times (GRE). We first characterized the geometric distortions and the correction approaches based on the estimated ΔB0 field offset and voxel shift maps, and then conducted three types of analyses on the distorted and corrected fMRI data: (1) registration into structural data, (2) identification of resting-state networks (RSNs), and (3) mapping of task-related brain regions of interest. GRE estimated the largest voxel shifts and more positively impacted the quality of the analyses, in terms of the (significantly lower) cost function of the registration, the (higher) spatial overlap between the RSNs and appropriate templates, and the (significantly higher) sensitivity of the task-related mapping based on the Z-score values of the associated activation maps, although also evident when considering TOPUP. fMRI data should thus be corrected for geometric distortions, with the choice of the approach having a modest, albeit positive, impact on the fMRI analyses.
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Affiliation(s)
- Rodolfo Abreu
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - João Valente Duarte
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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19
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Roy AV, Thai M, Klimes-Dougan B, Schreiner MW, Mueller BA, Albott CS, Lim KO, Fiecas M, Tye SJ, Cullen KR. Brain entropy and neurotrophic molecular markers accompanying clinical improvement after ketamine: Preliminary evidence in adolescents with treatment-resistant depression. J Psychopharmacol 2021; 35:168-177. [PMID: 32643995 PMCID: PMC8569740 DOI: 10.1177/0269881120928203] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Current theory suggests that treatment-resistant depression (TRD) involves impaired neuroplasticity resulting in cognitive and neural rigidity, and that clinical improvement may require increasing brain flexibility and adaptability. AIMS In this hypothesis-generating study, we sought to identify preliminary evidence of brain flexibility correlates of clinical change within the context of an open-label ketamine trial in adolescents with TRD, focusing on two promising candidate markers of neural flexibility: (a) entropy of resting-state functional magnetic resonance imaging (fMRI) signals; and (b) insulin-stimulated phosphorylation of mammalian target of rapamycin (mTOR) and glycogen synthase-3-beta (GSK3β) in peripheral blood mononuclear cells. METHODS We collected resting-state functional magnetic resonance imaging data and blood samples from 13 adolescents with TRD before and after a series of six ketamine infusions over 2 weeks. Usable pre/post ketamine data were available from 11 adolescents for imaging and from 10 adolescents for molecular signaling. We examined correlations between treatment response and changes in the central and peripheral flexibility markers. RESULTS Depression reduction correlated with increased nucleus accumbens entropy. Follow-up analyses suggested that physiological changes were associated with treatment response. In contrast to treatment non-responders (n=6), responders (n=5) showed greater increase in nucleus accumbens entropy after ketamine, together with greater post-treatment insulin/mTOR/GSK3β signaling. CONCLUSIONS These data provide preliminary evidence that changes in neural flexibility may underlie symptom relief in adolescents with TRD following ketamine. Future research with adequately powered samples is needed to confirm resting-state entropy and insulin-stimulated mTOR and GSK3β as brain flexibility markers and candidate targets for future clinical trials. CLINICAL TRIAL NAME Ketamine in adolescents with treatment-resistant depressionURL: https://clinicaltrials.gov/ct2/show/NCT02078817Registration number: NCT02078817.
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Affiliation(s)
- Abhrajeet V Roy
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
| | - Michelle Thai
- Department of Psychology, College of Liberal Arts, University of Minnesota, Minneapolis, USA
| | - Bonnie Klimes-Dougan
- Department of Psychology, College of Liberal Arts, University of Minnesota, Minneapolis, USA
| | | | - Bryon A Mueller
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
| | - Christina Sophia Albott
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
| | - Kelvin O Lim
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
| | - Mark Fiecas
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, USA
| | - Susannah J Tye
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Kathryn R Cullen
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
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Oxidative stress caused by a dysregulated Wnt/β-catenin signalling pathway is involved in abnormal placenta formation in pregnant mice with chronic fatigue syndrome. ZYGOTE 2020; 29:122-129. [PMID: 33054899 DOI: 10.1017/s096719942000057x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Chronic fatigue syndrome (CFS) is characterized by extreme fatigue and disabling symptoms. Women with CFS often have a high risk of gynaecological problems such as irregular menstruation, endometriosis and pelvic pain and sexual dysfunction. Our previous results have shown that, in pregnant mice, CFS significantly decreased the progestational hormone level in serum, as well as learning and memory, and the function of the hypothalamus-pituitary-gonadal axis. In addition, the F1 generation also suffered from congenital hypothyroidism. At present, there has been no report about placenta formation and embryonic development in pregnant mice with CFS. The aim of the present study was to investigate the influence of CFS on the morphology, oxidative stress and Wnt/β-catenin signalling pathway during placenta formation. In this study, we found that CFS decreased the number of implantation sites for blastocysts, and increased the number of absorbed, stillborn and malformed fetuses. The morphology and structure of the placenta were abnormal in pregnant mice with CFS. Further study found that the oxidative stress in serum, uterus and placenta was increased in pregnant mice with CFS, while the levels of antioxidase were decreased. CFS also inhibited the Wnt/β-catenin signalling pathway in the placenta. These results suggested that inhibition of the Wnt/β-catenin signalling pathway and enhanced oxidative stress play an important role in abnormal placentation in pregnant mice with CFS.
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21
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Lukemire J, Kundu S, Pagnoni G, Guo Y. Bayesian Joint Modeling of Multiple Brain Functional Networks. J Am Stat Assoc 2020; 116:518-530. [PMID: 34262233 PMCID: PMC8274571 DOI: 10.1080/01621459.2020.1796357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 05/25/2020] [Accepted: 06/10/2020] [Indexed: 10/23/2022]
Abstract
Investigating the similarity and changes in brain networks under different mental conditions has become increasingly important in neuroscience research. A standard separate estimation strategy fails to pool information across networks and hence has reduced estimation accuracy and power to detect between-network differences. Motivated by a fMRI Stroop task experiment that involves multiple related tasks, we develop an integrative Bayesian approach for jointly modeling multiple brain networks that provides a systematic inferential framework for network comparisons. The proposed approach explicitly models shared and differential patterns via flexible Dirichlet process-based priors on edge probabilities. Conditional on edges, the connection strengths are modeled via Bayesian spike and slab prior on the precision matrix off-diagonals. Numerical simulations illustrate that the proposed approach has increased power to detect true differential edges while providing adequate control on false positives and achieves greater network estimation accuracy compared to existing methods. The Stroop task data analysis reveals greater connectivity differences between task and fixation that are concentrated in brain regions previously identified as differentially activated in Stroop task, and more nuanced connectivity differences between exertion and relaxed task. In contrast, penalized modeling approaches involving computationally burdensome permutation tests reveal negligible network differences between conditions that seem biologically implausible.
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Affiliation(s)
- Joshua Lukemire
- Department of Biostatistics and Bioinformatics, Emory University, USA
| | - Suprateek Kundu
- Department of Biostatistics and Bioinformatics, Emory University, USA
| | - Giuseppe Pagnoni
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Ying Guo
- Department of Biostatistics and Bioinformatics, Emory University, USA
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22
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Shan ZY, Barnden LR, Kwiatek RA, Bhuta S, Hermens DF, Lagopoulos J. Neuroimaging characteristics of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a systematic review. J Transl Med 2020; 18:335. [PMID: 32873297 PMCID: PMC7466519 DOI: 10.1186/s12967-020-02506-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 08/26/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Since the 1990s, neuroimaging has been utilised to study Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a debilitating illness with unknown aetiology. While brain abnormalities in ME/CFS have been identified, relatively little is known regarding which specific abnormalities are consistently observed across research groups and to what extent the observed abnormalities are reproducible. METHOD To identify consistent and inconsistent neuroimaging observations in ME/CFS, this retrospective and systematic review searched for studies in which neuroimaging was used to investigate brain abnormalities in ME/CFS in Ovid MEDLINE, PubMed (NCBI), and Scopus from January 1988 to July 2018. A qualitative synthesis of observations was performed to identify brain abnormalities that were consistently and inconsistently reported. RESULTS 63 full-text articles were included in the synthesis of results from 291 identified papers. Additional brain area recruitment for cognitive tasks and abnormalities in the brain stem are frequent observations in 11 and 9 studies using different modalities from different research teams respectively. Also, sluggish blood oxygenation level-dependent (BOLD) signal responses to tasks, reduced serotonin transporters, and regional hypometabolism are consistent observations by more than two research teams. Single observations include abnormal brain tissue properties, regional metabolic abnormalities, and association of brain measures with ME/CFS symptoms. Reduced resting cerebral blood flow and volumetric brain changes are inconsistent observations across different studies. CONCLUSION Neuroimaging studies of ME/CFS have frequently observed additional brain area recruitment during cognitive tasks and abnormalities in the brain stem. The frequent observation of additional brain area recruitment and consistent observation of sluggish fMRI signal response suggest abnormal neurovascular coupling in ME/CFS.
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Affiliation(s)
- Zack Y Shan
- Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, 4575, Australia.
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD, 4222, Australia.
| | - Leighton R Barnden
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD, 4222, Australia
| | - Richard A Kwiatek
- Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, 4575, Australia
| | - Sandeep Bhuta
- Medical Imaging Department, Gold Coast University Hospital, Parklands, QLD, 4215, Australia
| | - Daniel F Hermens
- Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, 4575, Australia
| | - Jim Lagopoulos
- Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, 4575, Australia
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de Dreu MJ, Schouwenaars IT, Rutten GJM, Ramsey NF, Jansma JM. Fatigue in brain tumor patients, towards a neuronal biomarker. NEUROIMAGE-CLINICAL 2020; 28:102406. [PMID: 32971465 PMCID: PMC7509800 DOI: 10.1016/j.nicl.2020.102406] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 01/24/2023]
Abstract
Subjective fatigue correlated with phasic alertness default mode activation in brain tumor patients. Subjective fatigue did not correlate with phasic alertness central executive activation in brain tumor patients. Default mode activation is a candidate for developing a biomarker for fatigue in brain tumor patients.
Background Many brain tumor patients suffer from fatigue which severely affects their quality of life. There is a lack of objective measurements for fatigue in brain tumor patients. We aimed to find a neurophysiological correlate for fatigue in brain tumor patients. For this purpose, we correlated brain activity associated with phasic alertness with self-reported ratings of fatigue. Methods Patients with a meningioma, a low-grade glioma or a high-grade glioma (N = 63) participated in this fMRI study. Brain activity in the central executive network (CEN) and default mode network (DMN) associated with phasic alertness was correlated with self-reported fatigue measured with the multidimensional fatigue inventory (MFI-20). Follow-up analyses were performed for MFI-20 domain scores, individual regions within CEN and DMN, and the tumor sub-groups separately. Results MFI-20 scores correlated significantly with DMN activity associated with phasic alertness, but not with CEN activity. These results were consistent for each tumor sub-group. Within the DMN, the correlations were strongest in left and right lingual cortex, left and right cuneus, and right precuneus. Discussion Self-reported fatigue in brain tumor patients was associated with objective measurements of brain activity, specifically the DMN activity related to phasic alertness. This association represents an important step in the development of a biomarker for fatigue in brain tumor patients, and possibly for other patients that suffer from fatigue.
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Affiliation(s)
- M J de Dreu
- Department of Neurosurgery, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands; Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands.
| | - I T Schouwenaars
- Department of Neurosurgery, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands; Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - G J M Rutten
- Department of Neurosurgery, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
| | - N F Ramsey
- Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - J M Jansma
- Department of Neurosurgery, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands; Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
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Washington SD, Rayhan RU, Garner R, Provenzano D, Zajur K, Addiego FM, VanMeter JW, Baraniuk JN. Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Brain Commun 2020; 2:fcaa070. [PMID: 32954325 PMCID: PMC7425336 DOI: 10.1093/braincomms/fcaa070] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/17/2020] [Accepted: 04/24/2020] [Indexed: 12/20/2022] Open
Abstract
Gulf War Illness affects 25-30% of American veterans deployed to the 1990-91 Persian Gulf War and is characterized by cognitive post-exertional malaise following physical effort. Gulf War Illness remains controversial since cognitive post-exertional malaise is also present in the more common Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. An objective dissociation between neural substrates for cognitive post-exertional malaise in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome would represent a biological basis for diagnostically distinguishing these two illnesses. Here, we used functional magnetic resonance imaging to measure neural activity in healthy controls and patients with Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome during an N-back working memory task both before and after exercise. Whole brain activation during working memory (2-Back > 0-Back) was equal between groups prior to exercise. Exercise had no effect on neural activity in healthy controls yet caused deactivation within dorsal midbrain and cerebellar vermis in Gulf War Illness relative to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome patients. Further, exercise caused increased activation among Myalgic Encephalomyelitis/Chronic Fatigue Syndrome patients within the dorsal midbrain, left operculo-insular cortex (Rolandic operculum) and right middle insula. These regions-of-interest underlie threat assessment, pain, interoception, negative emotion and vigilant attention. As they only emerge post-exercise, these regional differences likely represent neural substrates of cognitive post-exertional malaise useful for developing distinct diagnostic criteria for Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.
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Affiliation(s)
- Stuart D Washington
- Department of Medicine, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA
| | - Rakib U Rayhan
- Department of Physiology and Biophysics, Howard University College of Medicine, Adams Building Rm 2420, 520 W Street NW, Washington, DC 20059, USA
| | - Richard Garner
- Department of Medicine, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA
| | - Destie Provenzano
- Department of Medicine, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA
| | - Kristina Zajur
- Department of Medicine, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA
| | - Florencia Martinez Addiego
- Department of Medicine, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA
| | - John W VanMeter
- Department of Medicine, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA.,Department of Physiology and Biophysics, Howard University College of Medicine, Adams Building Rm 2420, 520 W Street NW, Washington, DC 20059, USA.,Center for Functional and Molecular Imaging, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA
| | - James N Baraniuk
- Department of Medicine, Georgetown University Medical Center, 3900 Reservoir Rd., NW Washington, DC 20057, USA
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Thapaliya K, Marshall-Gradisnik S, Staines D, Barnden L. Mapping of pathological change in chronic fatigue syndrome using the ratio of T1- and T2-weighted MRI scans. Neuroimage Clin 2020; 28:102366. [PMID: 32777701 PMCID: PMC7417892 DOI: 10.1016/j.nicl.2020.102366] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 02/06/2023]
Abstract
Myalgic Encephalomyelitis or Chronic Fatigue Syndrome (ME/CFS) subjects suffer from a variety of cognitive complaints indicating that the central nervous system plays a role in its pathophysiology. Recently, the ratio T1w/T2w has been used to study changes in tissue myelin and/or iron levels in neurodegenerative diseases such as multiple sclerosis and schizophrenia. In this study, we applied the T1w/T2w method to detect changes in tissue microstructure in ME/CFS patients relative to healthy controls. We mapped the T1w/T2w signal intensity values in the whole brain for forty-five ME/CFS patients who met Fukuda criteria and twenty-seven healthy controls and applied both region- and voxel-based quantification. We also performed interaction-with-group regressions with clinical measures to test for T1w/T2w relationships that are abnormal in ME/CFS at the population level. Region-based analysis showed significantly elevated T1w/T2w values (increased myelin and/or iron) in ME/CFS in both white matter (WM) and subcortical grey matter. The voxel-based group comparison with sub-millimetre resolution voxels detected very significant clusters with increased T1w/T2w in ME/CFS, mostly in subcortical grey matter, but also in brainstem and projection WM tracts. No areas with decreased T1w/T2w were found in either analysis. ME/CFS T1w/T2w regressions with heart-rate variability, cognitive performance, respiration rate and physical well-being were abnormal in both gray and white matter foci. Our study demonstrates that the T1w/T2w approach is very sensitive and shows increases in myelin and/or iron in WM and basal ganglia in ME/CFS.
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Affiliation(s)
- Kiran Thapaliya
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Australia; Centre for Advanced Imaging, The University of Queensland, Australia.
| | - Sonya Marshall-Gradisnik
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Australia
| | - Don Staines
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Australia
| | - Leighton Barnden
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Australia
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Palix J, Giuliani F, Sierro G, Brandner C, Favrod J. Temporal regularity of cerebral activity at rest correlates with slowness of reaction times in intellectual disability. Clin Neurophysiol 2020; 131:1859-1865. [PMID: 32570200 DOI: 10.1016/j.clinph.2020.04.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/16/2020] [Accepted: 04/27/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Intellectual disability (ID) is described as a general slowness in behavior and an inadequacy in adaptive skills. The present study examines whether behavioral slowness in ID could originate from abnormal complexity in brain signals. METHODS Participants (N = 29) performed a reaction times (RTs) task assessing their individual information processing speeds. Half of the participants had moderate intellectual disability (intelligence quotient (IQ) < 70). Continuous electroencephalogram recording during the resting period was used to quantify brain signal complexity by approximate entropy estimation (ApEn). RESULTS For all participants, a negative correlation between RTs and IQ was found, with longer RTs coinciding with lower IQ. This behavioral slowness in ID was associated with increased temporal regularity in electrocortical brain signals. CONCLUSIONS Behavioral slowness in ID subjects is closely related to lower brain signal complexity. SIGNIFICANCE Brain signal ApEn is shown to correspond with processing speed for the first time: in ID participants, the higher the regularity in brain signals at rest, the slower RTs will be in the active state. ID should be understood as a lack of lability in the cortical transition to the active state, weakening the efficiency of adaptive behavior.
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Affiliation(s)
- Julie Palix
- Research Unit of Legal Psychiatry and Psychology, Department of Psychiatry, University Hospital Centre of Lausanne, Switzerland; Brain Electrophysiology Attention Movement Laboratory, Institute of Psychology, University of Lausanne, Switzerland; La Source School of Nursing, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland.
| | - Fabienne Giuliani
- Consultation of Liaison Psychiatry for Intellectual Disability, Community Psychiatry Service, Department of Psychiatry, University Hospital Centre of Lausanne, Switzerland
| | - Guillaume Sierro
- Brain Electrophysiology Attention Movement Laboratory, Institute of Psychology, University of Lausanne, Switzerland
| | - Catherine Brandner
- Brain Electrophysiology Attention Movement Laboratory, Institute of Psychology, University of Lausanne, Switzerland
| | - Jérôme Favrod
- La Source School of Nursing, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
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Barnden LR, Shan ZY, Staines DR, Marshall-Gradisnik S, Finegan K, Ireland T, Bhuta S. Intra brainstem connectivity is impaired in chronic fatigue syndrome. NEUROIMAGE-CLINICAL 2019; 24:102045. [PMID: 31671321 PMCID: PMC6835065 DOI: 10.1016/j.nicl.2019.102045] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/27/2019] [Accepted: 10/17/2019] [Indexed: 11/16/2022]
Abstract
RAS connectivity was detected in HC and CFS groups both during rest and task. Strong connections were active for CFS from hippocampus to midbrain and medulla. RAS connectivity was diminished in CFS in the brainstem and to the hippocampus. RAS nuclei generate oscillatory signals which facilitate thalamocortical signal coherence. Impaired RAS affects cortical coherence necessary for attention, memory and problem solving.
In myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS), abnormal MRI correlations with symptom severity and autonomic measures have suggested impaired nerve signal conduction within the brainstem. Here we analyse fMRI correlations to directly test connectivity within and from the brainstem. Resting and task functional MRI (fMRI) were acquired for 45 ME/CFS (Fukuda criteria) and 27 healthy controls (HC). We selected limited brainstem reticular activation system (RAS) regions-of-interest (ROIs) based on previous structural MRI findings in a different ME/CFS cohort (bilateral rostral medulla and midbrain cuneiform nucleus), the dorsal Raphe nucleus, and two subcortical ROIs (hippocampus subiculum and thalamus intralaminar nucleus) reported to have rich brainstem connections. When HC and ME/CFS were analysed separately, significant correlations were detected for both groups during both rest and task, with stronger correlations during task than rest. In ME/CFS, connections were absent between medulla and midbrain nuclei, although hippocampal connections with these nuclei were enhanced. When corresponding correlations from HC and ME/CFS were compared, ME/CFS connectivity deficits were detected within the brainstem between the medulla and cuneiform nucleus and between the brainstem and hippocampus and intralaminar thalamus, but only during task. In CFS/ME, weaker connectivity between some RAS nuclei was associated with increased symptom severity. RAS neuron oscillatory signals facilitate coherence in thalamo-cortical oscillations. Brainstem RAS connectivity deficits can explain autonomic changes and diminish cortical oscillatory coherence which can impair attention, memory, cognitive function, sleep quality and muscle tone, all symptoms of ME/CFS.
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Affiliation(s)
- Leighton R Barnden
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD 4222, Australia.
| | - Zack Y Shan
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD 4222, Australia; Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, QLD 4575, Australia.
| | - Donald R Staines
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD 4222, Australia.
| | - Sonya Marshall-Gradisnik
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, QLD 4222, Australia.
| | - Kevin Finegan
- Medical Imaging Department, Gold Coast University Hospital, Parklands, QLD 4215, Australia.
| | - Timothy Ireland
- Medical Imaging Department, Gold Coast University Hospital, Parklands, QLD 4215, Australia.
| | - Sandeep Bhuta
- Medical Imaging Department, Gold Coast University Hospital, Parklands, QLD 4215, Australia
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Josev EK, Malpas CB, Seal ML, Scheinberg A, Lubitz L, Rowe K, Knight SJ. Resting-state functional connectivity, cognition, and fatigue in response to cognitive exertion: a novel study in adolescents with chronic fatigue syndrome. Brain Imaging Behav 2019; 14:1815-1830. [DOI: 10.1007/s11682-019-00119-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Williams PhD MV, Cox B, Lafuse PhD WP, Ariza ME. Epstein-Barr Virus dUTPase Induces Neuroinflammatory Mediators: Implications for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Clin Ther 2019; 41:848-863. [PMID: 31040055 PMCID: PMC6525645 DOI: 10.1016/j.clinthera.2019.04.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 01/04/2023]
Abstract
PURPOSE Neuroinflammation is a common feature in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), affecting 85%-90% of all patients, yet the underlying mechanism or mechanisms responsible for the initiation and/or promotion of this process is largely unknown. Multiple reports, however, have suggested a role for Epstein-Barr virus (EBV), in particular, in ME/CFS, but its potential role, if any, in the neuroinflammatory process has not been addressed. In support of this premise, studies by our group have found that the EBV protein deoxyuridine triphosphate nucleotidohydrolase (dUTPase) induces anxiety and sickness behaviors in female mice. We also found that a small subset of patients with ME/CFS exhibited prolonged and significantly elevated neutralizing antibodies against EBV dUTPase protein in serum, which inversely correlated with ME/CFS symptoms. A larger ME/CFS case-control cohort study further confirmed that a significant percentage of patients with ME/CFS (30.91%-52.7%) were simultaneously producing antibodies against multiple human herpesviruses-encoded dUTPases and/or human dUTPase. Altogether, these findings suggest that EBV dUTPase protein may be involved in the neuroinflammatory process observed in ME/CFS. Thus, the aim of the present study was to determine whether the EBV dUTPase protein could contribute to neuroinflammation by altering the expression of genes involved with maintaining blood-brain barrier (BBB) integrity and/or modulating synaptic plasticity. METHODS With the use of human immortalized astrocytes, microglia, and cerebral microvascular endothelial cells, we conducted time-course (0-24 h) experiments with EBV dUTPase protein (10 μg/mL) to determine what effect(s) it may have on the expression of genes involved with BBB permeability, astrocytes and microglia cell function, tryptophan metabolism, and synaptic plasticity by quantitative reverse transcription polymerase chain reaction (qRT-PCR). In parallel, in vivo studies were conducted in female C57Bl/6 mice. Mice were injected by the intraperitoneal route with EBV dUTPase protein (10 μg) or vehicle daily for 5 days, and the brains were collected and processed for further qRT-PCR analysis of the in vivo effect of the dUTPase on the dopamine/serotonin and γ-aminobutyric acid/glutamate pathways, which are important for brain function, using RT2 Profiler PCR Arrays. FINDINGS EBV dUTPase protein altered the expression in vitro (12 of 15 genes and 32 of 1000 proteins examined) and in vivo (34 of 84 genes examined) of targets with central roles in BBB integrity/function, fatigue, pain synapse structure, and function, as well as tryptophan, dopamine, and serotonin metabolism. IMPLICATIONS The data suggest that in a subset of patients with ME/CFS, the EBV dUTPase could initiate a neuroinflammatory reaction, which contributes to the fatigue, excessive pain, and cognitive impairments observed in these patients.
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Affiliation(s)
- Marshall V Williams PhD
- Department of Cancer Biology and Genetics, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Brandon Cox
- Department of Cancer Biology and Genetics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - William P Lafuse PhD
- Department of Microbial Infection and Immunity, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Maria Eugenia Ariza
- Department of Cancer Biology and Genetics, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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30
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Lin C, Lee SH, Huang CM, Chen GY, Ho PS, Liu HL, Chen YL, Lee TMC, Wu SC. Increased brain entropy of resting-state fMRI mediates the relationship between depression severity and mental health-related quality of life in late-life depressed elderly. J Affect Disord 2019; 250:270-277. [PMID: 30870777 DOI: 10.1016/j.jad.2019.03.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/30/2019] [Accepted: 03/03/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Entropy analysis is a computational method used to quantify the complexity in a system, and loss of brain complexity is hypothesized to be related to mental disorders. Here, we applied entropy analysis to the resting-state functional magnetic resonance imaging (rs-fMRI) signal in subjects with late-life depression (LLD), an illness combined with emotion dysregulation and aging effect. METHODS A total of 35 unremitted depressed elderly and 22 control subjects were recruited. Multiscale entropy (MSE) analysis was performed in the entire brain, 90 automated anatomical labeling-parcellated ROIs, and five resting networks in each study participant. LIMITATIONS Due to ethical concerns, all the participants were under medication during the study. RESULTS Regionally, subjects with LLD showed decreased entropy only in the right posterior cingulate gyrus but had universally increased entropy in affective processing (putamen and thalamus), sensory, motor, and temporal nodes across different time scales. We also found higher entropy in the left frontoparietal network (FPN), which partially mediated the negative correlation between depression severity and mental components of the quality of life, reflecting the possible neural compensation during depression treatment. CONCLUSION MSE provides a novel and complementary approach in rs-fMRI analysis. The temporal-spatial complexity in the resting brain may provide the adaptive variability beneficial for the elderly with depression.
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Affiliation(s)
- Chemin Lin
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan; College of Medicine, Chang Gung University, Taoyuan County, Taiwan; Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Keelung, Taiwan
| | - Shwu-Hua Lee
- College of Medicine, Chang Gung University, Taoyuan County, Taiwan; Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan County, Taiwan
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Guan-Yen Chen
- Department of Engineering and System Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Pei-Shan Ho
- Department of Engineering and System Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Ho-Ling Liu
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yao-Liang Chen
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Tatia Mei-Chun Lee
- Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong; Laboratory of Cognitive Affective Neuroscience, The University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Science, The University of Hong Kong, Hong Kong; Institute of Clinical Neuropsychology, The University of Hong Kong, Hong Kong.
| | - Shun-Chi Wu
- Department of Engineering and System Science, National Tsing Hua University, Hsinchu, Taiwan.
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Yan R, Tao S, Liu H, Chen Y, Shi J, Yang Y, Zhu R, Yao Z, Lu Q. Abnormal Alterations of Regional Spontaneous Neuronal Activity in Inferior Frontal Orbital Gyrus and Corresponding Brain Circuit Alterations: A Resting-State fMRI Study in Somatic Depression. Front Psychiatry 2019; 10:267. [PMID: 31114515 PMCID: PMC6503088 DOI: 10.3389/fpsyt.2019.00267] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 04/08/2019] [Indexed: 11/23/2022] Open
Abstract
Background: Major depressive disorders often involve somatic symptoms and have been found to have fundamental differences from non-somatic depression (NSD). However, the neural basis of this type of somatic depression (SD) is unclear. The aim of this study is to use the amplitude of low-frequency fluctuation (ALFF) and functional connectivity (FC) analyses to examine the abnormal, regional, spontaneous, neuronal activity and the corresponding brain circuits in SD patients. Methods: 35 SD patients, 25 NSD patients, and 27 matched healthy controls were selected to complete this study. The ALFF and seed-based FC analyses were employed, and the Pearson correlation was determined to observe possible clinical relevance. Results: Compared with NSD, the SD group showed a significant ALFF increase in the right inferior temporal gyrus; a significant ALFF decrease in left hippocampus, right inferior frontal orbital gyrus and left thalamus; and a significant decrease in the FC value between the right inferior frontal orbital gyrus and the left inferior parietal cortex (p < 0.05, corrected). Within the SD group, the mean ALFF value of the right inferior frontal orbital gyrus was associated with the anxiety factor scores (r = -0.431, p = 0.010, corrected). Conclusions: Our findings suggest that abnormal differences in the regional spontaneous neuronal activity of the right inferior frontal orbital gyrus were associated with dysfunction patterns of the corresponding brain circuits during rest in SD patients, including the limbic-cortical systems and the default mode network. This may be an important aspect of the underlying mechanisms for pathogenesis of SD at the neural level.
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Affiliation(s)
- Rui Yan
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - ShiWan Tao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - HaiYan Liu
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Chen
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - JiaBo Shi
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - YuYin Yang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - RongXin Zhu
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - ZhiJian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China.,Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, China
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Hyperintense sensorimotor T1 spin echo MRI is associated with brainstem abnormality in chronic fatigue syndrome. NEUROIMAGE-CLINICAL 2018; 20:102-109. [PMID: 30497131 PMCID: PMC6309570 DOI: 10.1016/j.nicl.2018.07.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/29/2018] [Accepted: 07/10/2018] [Indexed: 01/08/2023]
Abstract
We recruited 43 Chronic Fatigue Syndrome (CFS) subjects who met Fukuda criteria and 27 healthy controls and performed 3T MRI T1 and T2 weighted spin-echo (T1wSE and T2wSE) scans. T1wSE signal follows T1 relaxation rate (1/T1 relaxation time) and responds to myelin and iron (ferritin) concentrations. We performed MRI signal level group comparisons with SPM12. Spatial normalization after segmentation was performed using T2wSE scans and applied to the coregistered T1wSE scans. After global signal-level normalization of individual scans, the T1wSE group comparison detected decreased signal-levels in CFS in a brainstem region (cluster-based inference controlled for family wise error rate, PFWE= 0.002), and increased signal-levels in large bilateral clusters in sensorimotor cortex white matter (cluster PFWE < 0.0001). Moreover, the brainstem T1wSE values were negatively correlated with the sensorimotor values for both CFS (R2 = 0.31, P = 0.00007) and healthy controls (R2 = 0.34, P = 0.0009), and the regressions were co-linear. This relationship, previously unreported in either healthy controls or CFS, in view of known thalamic projection-fibre plasticity, suggests brainstem conduction deficits in CFS may stimulate the upregulation of myelin in the sensorimotor cortex to maintain brainstem - sensorimotor connectivity. VBM did not find group differences in regional grey matter or white matter volumes. We argued that increased T1wSE observed in sensorimotor WM in CFS indicates increased myelination which is a regulatory response to deficits in the brainstem although the causality cannot be tested in this study. Altered brainstem myelin may have broad consequences for cerebral function and should be a focus of future research.
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