New brain imaging study seeks answers to mysteries of chronic fatigue and fibromyalgia

Summary: Neuroimaging Study Reveals Neurovascular Coupling Can Cause Chronic Fatigue Syndrome, Fibromyalgia, and Other Disorders

Source: Sunshine Coast University

Dynamic, bubbly and full of energy, Nadia, 24, an occupational rehabilitation consultant, was living her best life. Then fatigue set in.

Now, five years after her first symptoms of chronic fatigue appeared, she is taking part in a new brain imaging study led by the University of the Sunshine Coast looking for better and faster ways to diagnose and treat the condition. debilitating syndrome that affects more than 24 million people worldwide. .

“I find people don’t understand how someone in their twenties can be constantly tired,” says Nadia, who believes an unknown virus was the trigger for her illness.

“After recovering from this virus, I was never the same again. I never regained my energy.

With no known cause, objective diagnostic test, or treatment, UniSC’s Thompson Institute study may hold the key to finally pinpointing the neurobiological origin of chronic fatigue syndrome (CFS), as well. known as myalgic encephalomyelitis (ME).

Lead researcher Dr Zack Shan said the world’s first research is using MRI scans to track the brain activity of around 300 study participants to determine how the brain controls its blood flow to meet its energy needs. , in order to better understand the pathological process of fatigue-related diseases. .

Healthy volunteers could hold the key

In addition to ME/CFS, the study is looking for participants with long-term COVID and fibromyalgia, a chronic condition causing muscle and bone pain, as well as problems with fatigue, sleep, memory and mood.

Healthy volunteers who lead mostly sedentary lives are also key to the study, to allow researchers to compare the brain activity of people with ME/CFS and fibromyalgia to those without.

“It allows us to analyze and gain insights from the vast amount of information that brain imaging provides about how specific areas of the brain differ between people with and without fatigue,” said said Dr. Shan.

“If we can determine the factors that cause chronic fatigue syndrome, including a neuromarker or biological indicator – for both ME/CFS and fibromyalgia, we can help diagnose them faster,” he said. -he declares.

“This could benefit the design of biology-based therapeutic interventions and reduce patient frustration by providing an accepted definitive cause for their symptoms.”

Identify abnormal brain power patterns

Dr Shan said that although the causes of ME/CFS and fibromyalgia remain unresolved, the well-documented impacts, including profound fatigue, sleep disturbances and cognitive impairment, suggest that abnormal brain function plays a crucial role in the underlying disease process.

The brain accounts for 20% of the body’s total energy consumption but has a limited or non-existent energy reservoir. Normal function relies primarily on the timely adaptation of local blood flow to neural energy demand.

Researchers believe abnormalities in this process, known as neurovascular coupling, are responsible.

To test this hypothesis, participants are given cognitive tasks during their scans to measure how well their brain regulates blood flooding in response, and its relationship to fatigue severity. The scans also measure changes in chemical messages in their brains as they perform mental exercises.

Dr Shan said the results would be used to generate a brain diagram of distributed clusters that predict disease severity, potentially providing a neuromarker to predict ME/CFS fatigue conditions.

“It takes pieces off you”

After a long and frustrating road to her diagnosis, Nadia says the opportunity to help researchers better understand her condition is appealing and she encourages others to volunteer.

“This study is so important that it paves the way for CFS research,” she said.

“Overall, chronic fatigue takes so many pieces out of you. I no longer have that energy to be my normal bubbly self. I feel like I’m trying to get through every day,” she said,

More participants are needed, including people with fibromyalgia and healthy volunteers. Participation involves questionnaires, health checks such as blood pressure and wearing an activity monitor.

Those interested in participating in the ongoing study can find information here.

About this neuroimaging research news

Author: Press office
Source: Sunshine Coast University
Contact: Press Office – University of the Sunshine Coast
Image: Image is in public domain

Original research: Free access.
“Multimodal MRI of myalgic encephalomyelitis/chronic fatigue syndrome: a cross-sectional neuroimaging study towards its neuropathophysiology and diagnosis” by Zack Y. Shan et al. Frontiers in Neurology

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Summary

Multimodal MRI of myalgic encephalomyelitis/chronic fatigue syndrome: a cross-sectional neuroimaging study towards its neuropathophysiology and diagnosis

Introduction: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating disease affecting up to 24 million people worldwide, but there is no known mechanism for ME/CFS nor any objective diagnostic test . 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, have informed the hypothesis that a abnormal neurovascular coupling (CNV) could be the neurobiological origin of ME/CFS. . CNV is a process critical to normal brain function, in which glutamate from an active neuron stimulates Ca²⁺ impulses in adjacent neurons and astrocytes. In turn, the increase in Ca²⁺ concentrations in astrocytes and neurons trigger the synthesis of vascular dilator factors to increase local blood flow ensuring that activated neurons receive their energy requirements.

This study examines CNV using multimodal MRI: (1) hemodynamic response function (HRF) which represents regional changes in cerebral blood flow in response to neural activities and will be modeled from a cognitive fMRI task ; (2) respiratory response function (RRF) represents autoregulation of regional blood flow due to carbon dioxide and will be modeled from apnea fMRI; (3) glutamate changes associated with neuronal activity will be modeled from functional magnetic resonance spectroscopy of cognitive tasks. We also aim to develop a neuromarker for the diagnosis of ME/CFS by integrating multimodal MRIs with a deep machine learning framework.

Methods and analysis: This cross-sectional study will recruit 288 participants (91 ME/CFS, 61 people with chronic fatigue, 91 healthy controls with a sedentary lifestyle, 45 fibromyalgia). ME/CFS will be diagnosed by a consensus diagnosis established by two clinicians using the 2003 Canadian Consensus Criteria. Symptoms, vital signs, and activity measurements will be collected alongside multimodal MRI.

Changes in HRF, RRF, and glutamate will be compared between four groups using one-way analysis of covariance (ANCOVA). Equivalent nonparametric methods will be used for measurements that do not exhibit a normal distribution. Activity measurement, body mass index, gender, age, depression and anxiety will be included as covariates for all statistical analyzes with the false discovery rate used to correct for multiple comparisons.

The data will be randomly divided into a formation (NOT = 188) and a validation (NOT = 100) group. Each MRI measurement will be entered as an input for a least absolute reduction and selection operator – regularized principal components regression to generate a brain model of distributed clusters that predict disease severity. The identified brain pattern will be integrated using deep multimodal Boltzmann machines as a neuromarker to predict ME/CFS fatigue conditions. The receptor 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 the University of Sunshine Coast Ethics Committee (A191288) and registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12622001095752).

Dissemination of results: Results will be disseminated through peer-reviewed scientific manuscripts and conferences and to patients through social media and active engagement with ME/CFS associations.