Free-water-corrected diffusion and adrenergic/muscarinic antibodies in myalgic encephalomyelitis/chronic fatigue syndrome, 2023, Kimura et al.

[SNT Gatchaman]

Free-water-corrected diffusion and adrenergic/muscarinic antibodies in myalgic encephalomyelitis/chronic fatigue syndrome
Yukio Kimura; Wakiro Sato; Norihide Maikusa; Miho Ota; Yoko Shigemoto; Emiko Chiba; Elly Arizono; Hiroyuki Maki; Isu Shin; Keiko Amano; Hiroshi Matsuda; Takashi Yamamura; Noriko Sato

Background and Purpose:
Free-water-corrected diffusion tensor imaging (FW-DTI), a new analysis method for diffusion MRI, can indicate neuroinflammation and degeneration. There is increasing evidence of autoimmune etiology in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). We used FW-DTI and conventional DTI to investigate microstructural brain changes related to autoantibody titers in patients with ME/CFS.

Methods:
We prospectively examined 58 consecutive right-handed ME/CFS patients who underwent both brain MRI including FW-DTI and a blood analysis of autoantibody titers against β1 adrenergic receptor (β1 AdR-Ab), β2 AdR-Ab, M3 acetylcholine receptor (M3 AchR-Ab), and M4 AchR-Ab. We investigated the correlations between these four autoantibody titers and three FW-DTI indices—free water (FW), FW-corrected fractional anisotropy (FAt), and FW-corrected mean diffusivity—as well as two conventional DTI indices—fractional anisotropy (FA) and mean diffusivity. The patients’ age and gender were considered as nuisance covariates. We also evaluated the correlations between the FW-DTI indices and the performance status and disease duration.

Results:
Significant negative correlations between the serum levels of several autoantibody titers and DTI indices were identified, mainly in the right frontal operculum. The disease duration showed significant negative correlations with both FAt and FA in the right frontal operculum. The changes in the FW-corrected DTI indices were observed over a wider extent compared to the conventional DTI indices.

Conclusions:
These results demonstrate the value of using DTI to assess the microstructure of ME/CFS. The abnormalities of right frontal operculum may be a diagnostic marker for ME/CFS.

Link (Journal of Neuroimaging, Paywall)

 

[SNT Gatchaman]

patients meeting the Fukuda criteria, the Canadian Criteria, and the International Consensus Criteria

Not clear if that's truly an AND or an OR. No controls.

58 patients (mean ± standard deviation age, 35.6 ± 12.5 years; 44 females, 14 males) were included

Undergoing a blood analysis of autoantibody titers within 30 days of the MRI.

Their β1 AdR-Ab, β2 AdR-Ab, M3 AchR-Ab, and M4 AchR-Ab titers were determined by CellTrend

Hmm.

DTI [Diffusion Tensor Imaging] may not reflect specific tissue characteristics, since DTI assumes a single tissue for each voxel and is affected by free water (FW) contamination such as that provided by extracellular fluid.

Therefore, FW-corrected DTI (FW-DTI) has been proposed as a method that can remove the influence of FW on the diffusion properties of brain tissue.

We hypothesized that an FW-DTI analysis would show detailed areas of impairment that are associated with autoantibody titers against adrenergic/muscarinic receptors, which could be disease markers for ME/CFS. We conducted the present study to investigate the neuroinflammatory changes associated with autoantibody titers against adrenergic/muscarinic receptors in ME/CFS patients. We sought to detect microstructural abnormalities in ME/CFS patients by using FW-DTI metrics and compare these findings with those obtained by conventional DTI measures.

 

[Sid]

Recently there was a study that showed that these autoantibodies occur in normal controls at the same rate as patients.

This DTI study has no controls and is studying a concept that’s already been debunked.