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Abstract
Rationale
Chronic fatigue syndrome (CFS) is a common and burdensome illness with a poorly understood pathophysiology, though many of the characteristic symptoms are likely to be of brain origin. The use of high-field proton magnetic resonance spectroscopy (MRS) enables the detection of a range of brain neurochemicals relevant to aetiological processes that have been linked to CFS, for example, oxidative stress and mitochondrial dysfunction.
Methods
We studied 22 CFS patients and 13 healthy controls who underwent MRS scanning at 7 T with a voxel placed in the anterior cingulate cortex. Neurometabolite concentrations were calculated using the unsuppressed water signal as a reference.
Results
Compared to controls, CFS patients had lowered levels of glutathione, total creatine and myo-inositol in anterior cingulate cortex. However, when using N-acetylaspartate as a reference metabolite, only myo-inositol levels continued to be significantly lower in CFS participants.
Conclusions
The changes in glutathione and creatine are consistent with the presence of oxidative and energetic stress in CFS patients and are potentially remediable by nutritional intervention. A reduction in myo-inositol would be consistent with glial dysfunction. However, the relationship of the neurochemical abnormalities to the causation of CFS remains to be established, and the current findings require prospective replication in a larger sample.
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Details
1 University of Oxford, Psychopharmacology Research Unit, Department of Psychiatry, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948)
2 University of Manchester, Division of Informatics, Imaging and Data Science, Faculty of Medicine, Biology and Health, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407)
3 University of Oxford, Wellcome Centre for Integrative Neuroimaging, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); Purdue University, School of Health Sciences, West Lafayette, USA (GRID:grid.169077.e) (ISNI:0000 0004 1937 2197)
4 University of Manchester, Wolfson Molecular Imaging Centre, Faculty of Biology, Medicine and Health, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407)
5 University of Oxford, Nuffield Department of Medicine, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948)
6 University of Oxford, Wellcome Centre for Integrative Neuroimaging, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948)
7 University of Oxford, Psychopharmacology Research Unit, Department of Psychiatry, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); Neurosciences Building, Warneford Hospital, Oxford, UK (GRID:grid.416938.1) (ISNI:0000 0004 0641 5119)