From British Journal of Radiology 2011, doi:10.1259/bjr/93889091, 29 November 2011 (e-published before print).
Regional grey and white matter volumetric changes in myalgic encephalomyelitis (chronic fatigue syndrome): a voxel-based morphometry 3-T MRI study
B K Puri, PhD, FRCPsych(1), P M Jakeman, MSc, PhD(2)2, M Agour, MB, MRCPsych(3), K D R Gunatilake, MD, MRCPsych(4), K A C Fernando, MBBS, MRCPsych(5), A I Gurusinghe, MBBS, PGDPsych(6), I H Treasaden, MRCS, FRCPsych(7), A D Waldman, PhD, MRCP1,(8) and P Gishen, DMRD, FRCR(1)
(1) Department of Imaging, Hammersmith Hospital, London, UK (2) Department of Physical Education and Sport Sciences, University of Limerick, Republic of Ireland (3) University of Hertfordshire, and Care Principles, Rose Lodge, Langley, West Midlands, UK (4) The Ridge Hill Centre, Dudley, UK (5) Brooklands Hospital, Birmingham, West Midlands, UK (6) Broadmoor Hospital, Berkshire, UK (7) Three Bridges Unit, WLMHT, Middlesex, UK (8) National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
Objective: It is not established whether myalgic encephalomyelitis/chronic fatigue syndrome (CFS) is associated with structural brain changes. The aim of this study was to investigate this by conducting the largest voxel-based morphometry study to date in CFS.
Methods: High-resolution structural 3-T cerebral MRI scanning was carried out in 26 CFS patients and 26 age- and gender-matched healthy volunteers. Voxel-wise generalised linear modelling was applied to the processed MR data using permutation-based non-parametric testing, forming clusters at t > 2.3 and testing clusters for significance at p < 0.05, corrected for multiple comparisons across space.Results: Significant voxels (p < 0.05, corrected for multiple comparisons) depicting reduced grey matter volume in the CFS group were noted in the occipital lobes (right and left occipital poles; left lateral occipital cortex, superior division; and left supracalcrine cortex), the right angular gyrus and the posterior division of the left parahippocampal gyrus. Significant voxels (p < 0.05, corrected for multiple comparisons) depicting reduced white matter volume in the CFS group were also noted in the left occipital lobe.Conclusion: These data support the hypothesis that significant neuroanatomical changes occur in CFS, and are consistent with the complaint of impaired memory that is common in this illness; they also suggest that subtle abnormalities in visual processing, and discrepancies between intended actions and consequent movements, may occur in CFS.
I look forward to reading articles by all those journalists who wrote lengthy and misleading diatribes during the “death threats” episode, about these structural brain changes demonstrated by MRI……pigs may fly..
Indeed, this is heartening news! My structural changes have not prevented me from noticing a wee typo, CS instead of CFS, sorry I am like the police, but thought you would want to know. 😉
Too right, thanks Nasim.
I would like to read the full paper. This does sound very promising though doesn’t it?
It would be useful to have important findings of this kind disseminated directly to GP’s via their College. I am not convinced that the majority, left to their own devices and with busy workloads, will come across this article unless their attention is directed to it. Many do not have time to keep up with the BMJ let alone specialist publications.
Just last month an otherwise perfectly intelligent GP in his mid 40’s, who is a neighbour of mine, asked my advice about how to deal with ME patients as he knew I had had the illness for some time. He admitted that when ME patients came to him he ‘tried not to get involved’. Quite how that is supposed to help patients of any sort I am not sure. I do not think we can consider his attitude to be unique.
Hearing his comment was a sad moment. It seems that in spite of all the hard work of the MEA and others, patient experience relates that basic information is still not getting through to many GP’s about ME and that attitudes on the ground remain, in many quarters, unhelpful and at worst, actually suspicious of ME patients as many still appear to be unaware of the physical nature and severity of this illness. (Please do set up a poll to clarify this if you are not sure about the accuracy of this comment!)
Finding a way to pass this kind of helpful research finding from Prof Puri and colleagues on directly to them could help immensely. Otherwise we are simply preaching to the converted on this (otherwise very helpful) site.
Absolutely right, Jackie. The problem of getting relevant information into the doctors’ heads, as it were, is huge simply because of their work-load and competition for their time. My partner is an information-skills trainer at the library of our local hospital/medical school, and provides training in helping all health-related employees, including local GP surgeries, with internet searches. Anyone who has ever seen the multitude of papers that are available on Pubmed will understand what a vast volume of stuff there is, and this is only one of many databases. He finds that the majority of the staff he teaches really aren’t aware of how to search properly, and they often book on a course and then can’t turn up because of sudden work committments.
I don’t know what the answer is; I think things will only change when somehow or other both the BMJ and the Lancet have emblazoned as headlines on their front covers, a selection of the most up-to-date and undisputable findings re ME, such as this latest by Prof Puri, and all the national newspapers and the Beeb too! Don’t hold your breath though.
Thanks for this very helpful feedback Sasha.
I take encouragement from the fact that the GP in question did in fact take the time and trouble to ask for help having recognised a gap in his existing knowledge base and feeling that the current situation is unsatisfactory.
Sadly with only 10 minutes to fill him in on the current research status of ME and without being able to point him in the direction of a diagnostic test at the present time, I don’t think the world changed. I have high hopes though that it will and can.