Ventricular cerebrospinal fluid lactate is increased in chronic fatigue syndrome compared with generalized anxiety disorder: an in vivo 3.0 T ¹H MRS imaging study

Abstract

Chronic fatigue syndrome (CFS) is a controversial diagnosis because of the lack of biomarkers for the illness and its symptom overlap with neuropsychiatric, infectious, and rheumatological disorders. We compared lateral ventricular volumes derived from tissue-segmented T(1)-weighted volumetric MRI data and cerebrospinal fluid (CSF) lactate concentrations measured by proton MRS imaging ((1)H MRSI) in 16 subjects with CFS (modified US Centers for Disease Control and Prevention criteria) with those in 14 patients with generalized anxiety disorder (GAD) and in 15 healthy volunteers, matched group-wise for age, sex, body mass index, handedness, and IQ. Mean lateral ventricular lactate concentrations measured by (1)H MRSI in CFS were increased by 297% compared with those in GAD (P < 0.001) and by 348% compared with those in healthy volunteers (P < 0.001), even after controlling for ventricular volume, which did not differ significantly between the groups. Regression analysis revealed that diagnosis accounted for 43% of the variance in ventricular lactate. CFS is associated with significantly raised concentrations of ventricular lactate, potentially consistent with recent evidence of decreased cortical blood flow, secondary mitochondrial dysfunction, and/or oxidative stress abnormalities in the disorder.

Role of Infection and Neurologic Dysfunction in Chronic Fatigue Syndrome

“…49 Nuclear magnetic spectroscopy has revealed increased lactate levels in ventricular spinal fluid in patients with CFS, compared with healthy control volunteers and control volunteers with generalized anxiety disorder and major depression. 50,51 The results of the study, including patients with major depression, did not reach statistical significance, but the number of study participants was small. Finally, a study employing liquid chromatography, mass spectrometry, and peptide sequencing of spinal fluid from patients with CFS found a group of proteins (''a proteomic signature'' of CFS) that distinguished patients with CFS from healthy control volunteers.…”

Increased ventricular lactate in chronic fatigue syndrome measured by 1H MRS imaging at 3.0 T. II: comparison with major depressive disorder

“…Ventricular CSF Lactate. In vivo levels of ventricular lactate and the ventricular CSF volume that contributed signal to the measured lactate were obtained in all subjects using, respectively, a multislice 1 H MRSI technique (14) and volumetric analysis of structural MRI data acquired using a standard 3D T 1 -weighted spoiled gradient-recalled echo (SPGRE) technique, as fully described elsewhere (3). Figure 1 shows sample spectra from a subject with MDD for voxels selected in the brain tissues ( Fig.…”

“…Toward this goal, we previously conducted a pilot study utilizing proton magnetic resonance spectroscopic imaging ( 1 H MRSI) that had compared the neurometabolic profiles of CFS with those of generalized anxiety disorder (GAD)--a relatively common neuropsychiatric disorder that shares symptom overlap with CFS--and of healthy control subjects (3). In that study, CFS was characterized by significantly elevated ventricular cerebrospinal fluid (CSF) lactate relative to the two comparison groups.…”

Majör depresif bozukluk ve yaygın anksiyete bozukluğunda malondialdehid ve E vitamini düzeyleri / Altered levels of malondialdehyde and vitamin E in major depressive disorder and generalized anxiety disorder

“…Çalışma, YAB'da oksidatif stresin artmış olabileceği tezini desteklememiştir. Ancak olgu sayısı açısından kısıtlılık içeren bu çalışma, plazma antioksidan durumunu da ölçmemektedir (15).…”