Chronic fatigue syndrome (CFS) is a condition that causes extreme tiredness, weakness, pain, and overall ill health. It is very difficult to diagnose as well as treat. The most common hallmark of CFS is an inability to feel rested after periods of rest and that any activity can cause a day or more of exhaustion. When chronic fatigue syndrome or earlier related conditions were first diagnosed they were more common among men and thought to be a result of the added societal pressures on males in our culture. Today, the diagnosis is much more common among women.

We don’t know much about chronic fatigue syndrome. It may have a long history in human culture in spite of not being named until the later part of the twentieth century. CFS also often has components that make it appear as an illness or a virus and, in fact, some researchers believe a virus may cause the condition. Studies of chronic fatigue syndrome continue and it is hoped that one day more answers will be readily available for patients who experience the debilitating effects of the condition.

Using functional PET imaging to aid in chronic fatigue syndrome diagnoses

In April of this year researchers at the RIKEN Center for Life Science Technologies, along with partners at Osaka City University and Kansai University, used PET imaging to determine that patients with chronic fatigue syndrome experience increased levels of inflammation within the nervous system.

This inflammation, known as neuroinflammation, has long been at the center of theories surrounding the cause of CFS but there has never been much clear evidence to support it. This study, published by the Journal of Nuclear Medicine, found that levels of neuroinflammation markers are in fact elevated in chronic fatigue syndrome patients when compared to healthy control subjects.

A PET scan, or positron emission tomography, is an imaging test that uses a radioactive tracer to search for and identify disease in the human body.

The study worked with nine people diagnosed with chronic fatigue syndrome and ten healthy people who were willing to undergo the PET scanning. They were also each asked to answer multiple questions about their overall fatigue levels, difficulty concentrating, pain, and mental well-being. The PET scan utilized a protein that is created by microglia and astrocyte cells in the body, which are known to be active in the process of neuroinflammation.

The inflammation of the nervous system was found to be higher in CFS patients than in the healthy individuals. They were also able to note that this inflammation occurred in only certain areas of the brain including the cingulate cortex, hippocampus, amygdala, thalamus, midbrain, and pons. When the inflammation was elevated in these areas it seemed to correlate with the symptoms of chronic fatigue syndrome. For example, patients who reported that they had trouble concentrating throughout the day seemed to experience neruoinflammation in the amygdala, which is involved in cognitive abilities.

Researchers expect this small study to provide the confirmation that PET scanning can be used as an objective test for patients with CFS. This could lead to more accurate diagnoses as well as the development of treatments and therapies that could provide better relief for this condition.

Clues for chronic fatigue syndrome present in brain imaging

Hot on the heels of the Japanese study, researchers at Emory University and the Center for Disease Control in Atlanta Georgia also made a breakthrough regarding the use of brain imaging for patients with CFS.

A study using brain imaging showed that patients with chronic fatigue syndrome appear to have reduced responses in the basal ganglia, a region of the brain connected with fatigue. The findings were compared with health control subjects to determine the correlation. This suggests that CFS may be associated with change in the brain that involves the brain circuits that regulate motor activity as well as motivation.

The lead author on the study, Arthur Miller, MD, noted:

“A number of previous studies have suggested that responses to viruses may underlie some cases of CFS. Our data supports the idea that the body’s immune response to viruses could be associated with fatigue by affecting the brain through inflammation. We are continuing to study how inflammation affects the basal ganglia and what effects that has on other brain regions and brain function. These future studies could help inform new treatments.”

The research began with comparing 18 chronic fatigue syndrome patients to 41 healthy volunteers. The 18 patients were recruited by a telephone survey and extensive clinical evaluations. The evaluations were conducted among hundreds of Georgia residents and the 18 final patients were chosen for the study.

Once selected, the patients and volunteers were asked to correctly guess the color of a preselected card. If they got the answer right, they would win one dollar. Once their guess was made and the card was revealed the researchers measured the blood flow to the basal ganglia. After they made a guess, the color of the card was revealed and researchers measured blood flow to this region of the brain. They were most interested in the way the brain responded to a win or loss. The patients with the highest levels of fatigue experienced the smallest changes.

Because the basal ganglia is responsible for our individual motivation, it is believed that this lack of response when faced with an activity typically designed to increase motivation could be an underlying factor in the body’s response when affected with chronic fatigue syndrome.

Both of these studies will lead to broader research on the brain and chronic fatigue syndrome.

This will allow researchers and scientists to learn more about the direct cause of the condition as well as develop more effective treatments. In the meantime, it is important for patients diagnosed with chronic fatigue syndrome to learn as much as they can about holistic ways to treat the condition and lead as normal a life as possible. CFS can be debilitating, so any method that can help someone increase their energy level and reduce their pain is considered effective even though there is not an FDA approved treatment on the market at this time.

What are your thoughts about the advancements in the study of chronic fatigue syndrome and how do you see this new research about the role of the brain and neuroinflammation in the condition?

Image by David Foltz via Flickr

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