Research: Exercise–induced changes in cerebrospinal fluid miRNAs in Gulf War Illness, Chronic Fatigue Syndrome and sedentary control subjects | 11 November 2017

November 11, 2017


 


Press release, Georgetown University Medical Centre (GUMC), 10 November 2017.

Brain chemistry profiles shows chronic fatigue syndrome and gulf war illness as unique disorders

Researchers at Georgetown University Medical Center have found distinct molecular signatures in two brain disorders long thought to be psychological in origin — chronic fatigue syndrome (CFS) and Gulf War Illness (GWI).

In addition, the work supports a previous observation by GUMC investigators of two variants of GWI. The disorders share commonalities, such as pain, fatigue, cognitive dysfunction and exhaustion after exercise.

Their study, published in Scientific Reports, lays groundwork needed to understand these disorders in order to diagnosis and treat them effectively, says senior investigator, James N. Baraniuk, MD, professor of medicine at Georgetown University School of Medicine. Narayan Shivapurkar, PhD, assistant professor of oncology at the medical school, worked with Baraniuk on the research.

The changes in brain chemistry — observed in levels of miRNAs that turn protein production on or off — were seen 24 hours after riding a stationary bike for 25 minutes.

“We clearly see three different patterns in the brain’s production of these molecules in the CFS group and the two GWI phenotypes,” says Baraniuk.

 

“This news will be well received by patients who suffer from these disorders who are misdiagnosed and instead may be treated for depression or other mental disorders.”

Chronic fatigue syndrome affects between 836,000 and 2.5 million Americans, according to a National Academy of Medicine report. The disorder was thought to be psychosomatic until a 2015 review of 9,000 articles over 64 years of research pointed to unspecified biological causes. Still, no definitive diagnosis or treatment is available.

Gulf War Illness has developed in more than one-fourth of the 697,000 veterans deployed to the 1990-1991 Persian Gulf War, Baraniuk and his colleagues have reported in earlier work.

Gulf War veterans were exposed to combinations of nerve agents, pesticides and other toxic chemicals that may have triggered the chronic pain, cognitive, gastrointestinal and other problems, Baraniuk says. Although the mechanisms remain unknown, the study provides significant insights into brain chemistry that can now be investigated.

This study focused on spinal fluid of CFS, GWI and control subjects who agreed to have a lumbar puncture. Spinal taps before exercise showed miRNA levels were the same in all participants.

In contrast, miRNA levels in spinal fluid were significantly different after exercise. The CFS, control and two subtypes of GWI groups had distinct patterns of change.

For example, CFS subjects who exercised had reduced levels of 12 different mRNAs, compared to those who did not exercise.

The miRNA changes in the two GWI subtypes add to other differences caused by exercise. One subgroup developed jumps in heart rate of over 30 beats when standing up that lasted for two to three days after exercise.

Magnetic resonance imaging showed they had smaller brainstems in regions that control heart rate, and did not activate their brains when doing a cognitive task.

In contrast, the other subgroup did not have any heart rate or brainstem changes, but did recruit additional brain regions to complete a memory test. The two groups were as different from each other as they were from the control group.

Finding two distinct pathophysiological miRNA brain patterns in patients reporting Gulf War disease “adds another layer of evidence to support neuropathology in the two different manifestations of Gulf War disease,” he says.

Baraniuk adds that miRNA levels in these disorders were different from the ones that are altered in depression, fibromyalgia, and Alzheimer’s disease, further suggesting CFS and GWI are distinct diseases.

 


Read more:

  1. The research was published in Nature, Scientific Reports: ‘Exercise – induced changes in cerebrospinal fluid miRNAs in Gulf War Illness, Chronic Fatigue Syndrome and sedentary control subjects'.
  2. The UK version of the Daily Mail covers the news: ‘Chronic fatigue syndrome is NOT all in the mind- but caused by changes in brain chemistry, a study finds'.
  3. Psychology Today have published an article featuring this latest research, which also discusses other findings that exercise is not a panacea for ME/CFS.
  4. You can also visit the website of Professor Baranuik's Chronic Pain and Fatigue Research Centre at Georgetown University.

 

2 thoughts on “Research: Exercise–induced changes in cerebrospinal fluid miRNAs in Gulf War Illness, Chronic Fatigue Syndrome and sedentary control subjects | 11 November 2017”

  1. “This news will be well received by patients who suffer from these disorders who are misdiagnosed and instead may be treated for depression or other mental disorders.”

    I wonder if Professor Simon Wessely still thinks the PACE trial is “a thing of beauty”, like a beautiful ocean liner on a “prosperous voyage”.
    https://www.nationalelfservice.net/other-health-conditions/chronic-fatigue-syndrome/the-pace-trial-for-chronic-fatigue-syndrome-choppy-seas-but-a-prosperous-voyage/

  2. Thank you for this wonderful news. In 2011 Professor S Atkin and his team did research which showed the link to Gulf War Syndrome and pituitary failure. http://niceguidelines.blogspot.co.uk/2011/09/hull-hospital-pioneers-gulf-war.html.

    In 2006, I was diagnosed with CFS for my health problems back to the 80s. In 2012, Professor Atkin’s team diagnosed me with lymphocytic hypophysitis. Following an MRI scan, I have an enlarged pituitary gland with convex superior border in keeping with pituitary hyperplasia. Plus a minimally deviated stalk. I have been prescribed, thyroxine, hydrocortisone and growth hormone for my deficient hormones, life has improved greatly.

    There is an interesting article on Phoenix Rising’s website, linking my condition with the Gulf War victims.http://forums.phoenixrising.me/index.php?threads/gulf-war-syndrome-8-out-of-11-victims-tested-have-incredibly-rare-pituitary-disease.11330/

    Since 2008, I have been in contact with the Parliamentary and Health Service Ombudsman (PHSO) to express my concerns about the diagnosis of ME/CFS when a patient has pituitary problems. More recently I have also been in contact with the Care Quality Commission (CQC)

    When NICE was deciding whether to review CG 53 I contacted them, one of the points raised was about para 1.4.6.1 – the drugs that should not be used for the treatment of CFS/ME are all prescribed for pituitary problems. I asked for an explanation why:
    1.Patients who take these medications for known disorders which can cause fatigue have a diagnosis of ME/CFS?
    2. Hypothalamic/pituitary/adrenal conditions are not shown as “red flag” conditions?

    NICE responded they were not responsible for regulating the standard of care provided by individual NHS organisations. It was not their job to address concerns about misdiagnosis.

    It is time someone insisted the PHSO/CQC take action to ensure patients diagnosed with ME/CFS receive proper testing for pituitary problems, hopefully then like me many people will start to get their lives back.

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