Trial Report Distinct white matter alteration patterns in post-infectious and gradual onset chronic fatigue syndrome revealed by diffusion MRI, 2025, Yu et al

[John Mac]

Abstract​

While post-infectious (PI-ME/CFS) and gradual onset (GO-ME/CFS) myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) manifest similar symptoms, it has long been suspected that different disease processes underlie them.
However, the lack of biological evidence has left this question unanswered.
In this study, how white matter microstructural changes in PI-ME/CFS and GO-ME/CFS patients were investigated.
PI-ME/CFS and GO-ME/CFS patients were recruited based on consensus diagnoses made by two experienced clinicians and compared their diffusion MRI features with those of rigorously matched healthy controls (HCs) with sedentary lifestyles.
PI-ME/CFS participants showed significantly higher axial diffusivity (AD) in several association and projection fibres compared to HCs.
Higher AD in PI-ME/CFS was significantly related to worse physical health.
In contrast, GO-ME/CFS participants exhibited significantly decreased AD in the corpus callosum.
Lower AD in GO-ME/CFS was significantly associated with worse mental health in commissural and projection fibres.
No significant group differences were found for fractional anisotropy, mean diffusivity, or radial diffusivity.
Distinct patterns of AD alterations in PI-ME/CFS and GO-ME/CFS provide neurophysiological evidence of different disease processes and highlight the heterogeneities of ME/CFS.

Distinct white matter alteration patterns in post-infectious and gradual onset chronic fatigue syndrome revealed by diffusion MRI - Scientific Reports

While post-infectious (PI-ME/CFS) and gradual onset (GO-ME/CFS) myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) manifest similar symptoms, it has long been suspected that different disease processes underlie them. However, the lack of biological evidence has left this question...

www.nature.com

 

[Creekside]

I can't judge whether these are valid findings or just seeing patterns in random noise, but I certainly expect there to be differences in brain architecture after long-term suffering from symptoms. Perhaps there would be similar patterns from other chronic diseases or body damage. With the right technology, you might be able to look at brain scans and say "This person has a foot injury. That person has chronic constipation." etc.

 

[Utsikt]

Activity levels for all participants were monitored by the Actigraph GT3X-BT device (ActiGraph LLC., United States) for 14 days, seven days before and after MRI scans.

I can’t find the data for this when I search for «activ». Has anyone spotted it somewhere?

 

[forestglip]

I can’t find the data for this when I search for «activ». Has anyone spotted it somewhere?

It's the MET rate metric:

Furthermore, the metabolic equivalents (MET) rate of the task from the Actigraph data was calculated using the Freedson Adult (1998) algorithm by ActiLife® software to measure the activity level for each participant.

There are no significant differences in age (p = 0.67), BMI (p = 0.82), MET rate (p = 0.10), or MRI scan time (p = 0.55) between the PI-ME/CFS patients and HCs.

There are no significant differences in age (p = 0.75), BMI (p = 0.27), MET rate (p = 0.09), and MRI scan time (p = 0.57) between the GO-ME/CFS patients and HCs.

Supplementary Table S7 (Appendix B.1) shows that PI-ME/CFS and GO-ME/CFS patients are effectively equivalent in terms of demographic characteristics and behavioural assessments, with no significant differences observed in sex, age, BMI, MET rate, or any clinical scores.

 

[Utsikt]

It's the MET rate metric:

Thank you!

I wonder what they actually measured.

And I’m always surprised when I see that moderate patients do as much physical activity as unfit, sedentary healthy people. But I started at the lower end of moderate and got worse, so my perspective might be very skewed.