What lies beneath: White matter microstructure in pediatric myalgic encephalomyelitis/chronic fatigue syndrome using diffusion MRI, 2023, Josev et al.

[SNT Gatchaman]

What lies beneath: White matter microstructure in pediatric myalgic encephalomyelitis/chronic fatigue syndrome using diffusion MRI
Elisha K. Josev; Jian Chen; Marc Seal; Adam Scheinberg; Rebecca C. Cole; Katherine Rowe; Lionel Lubitz; Sarah J. Knight

Recent studies in adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) suggest that changes in brain white matter microstructural organization may correlate with core ME/CFS symptoms, and represent a potential biomarker of disease. However, this has yet to be investigated in the pediatric ME/CFS population.

We examined group differences in macrostructural and microstructural white matter properties, and their relationship with clinical measures, between adolescents recently diagnosed with ME/CFS and healthy controls. Forty-eight adolescents (25 ME/CFS, 23 controls, mean age 16 years) underwent brain diffusion MRI, and a robust multi-analytic approach was used to evaluate white and gray matter volume, regional brain volume, cortical thickness, fractional anisotropy, mean/axial/radial diffusivity, neurite dispersion and density, fiber density, and fiber cross section.

From a clinical perspective, adolescents with ME/CFS showed greater fatigue and pain, poorer sleep quality, and poorer performance on cognitive measures of processing speed and sustained attention compared with controls. However, no significant group differences in white matter properties were observed, with the exception of greater white matter fiber cross section of the left inferior longitudinal fasciculus in the ME/ CFS group compared with controls, which did not survive correction for intracranial volume.

Overall, our findings suggest that white matter abnormalities may not be predominant in pediatric ME/CFS in the early stages following diagnosis. The discrepancy between our null findings and white matter abnormalities identified in the adult ME/ CFS literature could suggest that older age and/or longer illness duration influence changes in brain structure and brain–behavior relationships that are not yet established in adolescence.

Link | PDF (Journal of Neuroscience Research)

 

[SNT Gatchaman]

ME/ CFS participants aged 13–18 years were recruited through the hospital's ME/CFS Clinic and diagnosed by pediatricians specializing in ME/CFS using the Canadian Criteria adapted for pediatrics (Jason et al., 2006). Healthy adolescent controls aged 13–18 years were recruited through advertising posters around the hospital clinics and were defined as healthy if they had no history of ME/CFS or other chronic illnesses.

Exclusion criteria for both groups were (a) insufficient English, (b) presence of major depression and/or anxiety disorder, (c) history of psychosis or bipolar disorder, (d) pre-existing developmental disability or brain injury, and (e) current use of any medication that may affect brain function.

I think it would have been more enlightening to include the various neuropsychiatric diagnoses and analyse the sub-groups. A lost opportunity to inform on what might be underlying "anxiety", "psychosis" etc.

 

[Dolphin]

I think it would have been more enlightening to include the various neuropsychiatric diagnoses and analyse the sub-groups. A lost opportunity to inform on what might be underlying "anxiety", "psychosis" etc.

It would have been interesting. Though not convinced it would have been the best use of scarce ME charity funding.