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Brain positron emission tomography (PET) in Chronic Fatigue Syndrome (CFS): preliminary data

  [ 105 votes ]   [ Discuss This Article ]
By Tirelli U, Chierichetti F, Tavio M, Simonelli C, Bianchin G, Zanco • • September 28, 1998

Chronic fatigue syndrome (CFS) has been widely studied by
neuroimaging techniques in recent years with conflicting
results. In particular, using single-photon emission computed
tomography (SPECT) and perfusion tracers, hypoperfusion has
been found in several brain regions, although the findings
vary across research centers. The objective of this study was
to investigate brain metabolism of patients affected by CFS,
using [18F]fluorine-deoxyglucose (18FDG) positron emission
tomography (PET). We performed 18FDG PET in 18 patients who
fulfilled the criteria of the working case definition of CFS.

Twelve of the 18 patients were females; the mean age was 34
+/- 15 years (range, 15-68) and the median time from CFS
diagnosis was 16 months (range, 9-138). Psychiatric diseases
and anxiety/neurosis were excluded in all CFS patients. CFS
patients were compared with a group of 6 patients affected by
depression (according to DSM IV-R) and 6 age-matched healthy
controls. The CFS patients were not taking any medication at
the time of PET, and depressed patients were drug-free for at
least 1 week before the PET examination. The PET images
examined 22 cortical and subcortical areas. CFS patients
showed a significant hypometabolism in right mediofrontal
cortex (P = 0.010) and brainstem (P = 0.013) in comparison
with the healthy controls. Moreover, comparing patients
affected by CFS and depression, the latter group showed a
significant and severe hypometabolism of the medial and upper
frontal regions bilaterally (P = 0.037-0.001), whereas the
metabolism of brain stem was normal. Brain 18FDG PET showed
specific metabolism abnormalities in patients with CFS in
comparison with both healthy controls and depressed patients.

The most relevant result of our study is the brain stem
hypometabolism which, as reported in a perfusion SPECT study,
seems to be a marker for the in vivo diagnosis of CFS.

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