Brain abnormalities in myalgic encephalomyelitis/chronic fatigue syndrome: Evaluation by diffusional kurtosis imaging and neurite orientation dispersion and density imaging

Abstract

Background Diffusional kurtosis imaging (DKI) and neurite orientation dispersion and density imaging (NODDI) metrics provide more specific information regarding pathological changes than diffusion tensor imaging (DTI). Purpose To detect microstructural abnormalities in myalgic encephalomyelitis (ME) / chronic fatigue syndrome (CFS) patients by using DKI and NODDI metrics. Study Type Prospective. Population Twenty ME/CFS patients and 23 healthy controls were recruited. Field Strength/Sequence Three‐b value DWI (b‐values = 0, 1000, and 2000 sec/mm2) and 3D T1‐weighted images were at 3.0T. Assessment Mean kurtosis (MK), neurite density index (NDI), orientation dispersion index (ODI), fractional anisotropy (FA), and mean diffusivity (MD) were calculated. Statistical Testing The two‐sample t‐test analysis in SPM12 software was used to compare the differences between ME/CFS and control groups. Results In the ME/CFS patients, we observed significant FA decreases in the genu of the corpus callosum and the anterior limb of the right internal capsule (P < 0.05), but no significant difference in MD (P = 0.164); there were also significant MK decreases in the right frontal area, anterior cingulate gyrus, superior longitudinal fasciculus (SLF), and left parietal area (P < 0.05). Significant NDI decreases were observed in the right posterior cingulate gyrus, SLF, and left frontal area of the ME/CFS patients (P < 0.05). Significant ODI decreases were seen in the bilateral occipital areas, right superior temporal gyrus, the anterior limb of internal capsule, and the posterior cingulate gyrus (P < 0.05), and significant ODI increases were revealed in the bilateral occipital and right temporal areas (P < 0.05). Data Conclusion Right SLF abnormalities may be a diagnostic marker for ME/CFS. Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:818–824.

Diffusion tensor imaging reveals neuronal microstructural changes in myalgic encephalomyelitis/chronic fatigue syndrome

“…A previous DTI study reported increased FA values in the right arcuate fasciculus (Zeineh et al, 2014) and decreased FA values in the genu of the corpus callosum and right anterior limb of the internal capsule in ME/CFS patients (Kimura et al, 2019). Interestingly, we did not find any significant differences in FA that confirm these findings (Kimura et al, 2019; Zeineh et al, 2014) which could be due to the differences in b values and gradient directions (Schilling et al, 2017). It has also been shown that higher b values provides better contrast, greater sensitivity to tissue diffusivity and less T2 shine through (Burdette et al, 2001; DeLano et al, 2000).…”

“…No precise underlying causes of ME/CFS have been identified. Brain imaging has been performed using several MRI techniques to advance our understanding of the pathophysiology of ME/CFS (Barnden et al, 2015; Barnden et al, 2019; Kimura et al, 2019; Thapaliya et al, 2020; Zeineh et al, 2014). Qualitative analysis of structural imaging showed a higher percentage (78%) of abnormal brain scans in ME/CFS patients compared with healthy controls (21%) (de Lange et al, 2008).…”

“…Despite this, only two studies have used DTI techniques (FA) to study microstructural changes in ME/CFS patients (Kimura et al, 2019; Zeineh et al, 2014). The first study (Zeineh et al, 2014) showed increased FA values in the right arcuate fasciculus in ME/CFS patients whereas the second study (Kimura et al, 2019) showed a significant decrease in FA in the genu of the corpus callosum and right anterior limb of the internal capsule. These inconsistent findings in ME/CFS motivated further investigation here with the additional DTI parameters AD, MD, RD, MO and transverse eigenvalues (λ2 and λ3).…”

A systematic review of neurological impairments in myalgic encephalomyelitis/ chronic fatigue syndrome using neuroimaging techniques

“…A feature found in ME/CFS patients compared to HCs was that there was significantly lower mean kurtosis in the right superior longitudinal fasciculus. This pathway is involved in processes such as emotion, language, attention and memory and could be altered in ME/CFS patients, the study, however, is limited by sample size and the contribution of potential gender bias [79].…”

<p>Neurite orientation and dispersion density imaging: clinical utility, efficacy, and role in therapy</p>

“…80 Abnormal NODDI parameters were also reported in patients with myalgic encephalomyelitis/chronic fatigue syndrome. 81 Billiet and colleagues 82 found reduced ND in the "unidentified bright objects" in neurofibromatosis type 1. Other studies focused on perinatal encephalopathy, 83 SYN1Q555X mutation, 84 C9orf72 disease, 85 and sarcoma survivors.…”