Task related cerebral blood flow changes of patients with chronic fatigue syndrome, 2018, Staud et al

Task related cerebral blood flow changes of patients with chronic fatigue syndrome: an arterial spin labeling study
Roland Staud,Jeff Boissoneault,Jason G. Craggs,Song Lai &Michael E. Robinson
Received 05 Dec 2017, Accepted 13 Mar 2018, Published online: 20 Mar 2018

ABSTRACT
Purpose: One hallmark of chronic fatigue syndrome (ME/CFS) is task related worsening of fatigue. Global brain hypoperfusion, abnormal regional activation, and altered functional connectivity of brain areas associated with cognition and memory have been reported but remain controversial.

Methods: We enrolled 17 female participants fulfilling the CDC Criteria for ME/CFS and 16 matched healthy controls (HC). Using a 3T-Phillips Achieva MRI-scanner, pseudo-continuous arterial spin-labeling (pCASL), was used to study the dynamics of regional cerebral blood flow (rCBF) and their relationship to mental fatigue in ME/CFS patients and HC during a demanding cognitive task, i.e. modified Paced-Auditory-Serial-Addition-Testing (PASAT).

Results: ME/CFS subjects reported more fatigue than HC at baseline (p < .01). Global brain perfusion of ME/CFS and HC subjects was similar at rest. The PASAT resulted in significantly increased fatigue in ME/CFS participants and HC. Although not different between groups, overall CBF significantly increased over the first 3 min of the PASAT and then decreased thereafter. Regional CBF (rCBF) changes were significantly different between groups during the post-task recovery period. Whereas improvement of fatigue of ME/CFS subjects was associated with decreased rCBF in both superior temporal gyri (STG), precuneus, and fusiform gyrus, it was associated with increased rCBF in the same areas in HC.

Conclusions: Our results suggest that ME/CFS is associated with normal global CBF at rest and during a strenuous task (PASAT); however rCBF of several brain regions associated with memory, goal-oriented attention, and visual function was differentially associated with recovery from fatigue in ME/CFS patients and HC.

KEYWORDS: Arterial spin labeling, regional cerebral blood flow, chronic fatigue

Link: https://www.tandfonline.com/doi/abs/10.1080/21641846.2018.1453919?journalCode=rftg20&

 

Another study finding reduced cerebral blood flow in certain areas after exertion.

What I find from personal experience is that there's an acute response to exertion where I get very dizzy and sheet white, but this resolves and then there's a different response a day or three later, which is more flu-like. So I'm wondering if these brain changes only occur during a very small window, which might account for contradictory studies?

Obviously, this is all anecdote, but I'm interested in hearing if other people think this is important too?

 

That is how I see it as well, the reduced blood flow is not the whole story when you crash but only the initial state of things, and then the brain during this hypoperfusion "crisis" sends signals which trigger all kinds of responses.

Something I have read is that one of those immediate responses would be an adrenaline surge to increase blood flow to the brain, without much success it seems and afterwards our weak bodies can not withstand this adrenaline. So you start crashing, systems shut down, etc. (would that adrenaline surge also trigger an immune reaction when there is one or is the immune response independent, I have no idea)

 

I can certainly hear my heart making a squelching sound in my ears afterwards, while I'm dizzy. Whether it's adrenaline or just the heart struggling to get blood where it's needed (or both), it definitely feels like a lack of blood in the brain.

 

I have a similar 2-stage response, with stage 2 being much, much worse.
I suspect you're right: research results will differ dependent on when measurements are taken in that sequence of responses.

 

I wonder what this could mean?

Have these findings been replicated?

(Don't have access to the paper.)