Brain MRI abnormalities exist in a subset of patients with Chronic Fatigue Syndrome (CFS)

Presence of MRI brain abnormalities in patients with Chronic

Fatigue Syndrome (CFS) was determined and the profile of MRI

abnormalities was compared between 39 CFS patients, 18 with

(CFS-Psych) and 21 without (CFS-No Psych) a DSM-III-R Axis I

psychiatric diagnosis since illness onset, and 19 healthy,

sedentary controls (HC). Two neuroradiologists, blind to group

membership, separately read the MR films using a detailed

protocol for rating and categorizing abnormal signal changes.

When findings were incongruent, the two neuroradiologists met

to try to reach consensus, otherwise a third neuroradiologist

evaluated the MR images and served as a tie-breaker. The

CFS-No Psych group showed a significantly larger number of

brain abnormalities on T2 weighted images than the CFS-Psych

and HC groups. Cerebral changes in the CFS-No Psych group

consisted mostly of small, punctate, subcortical white matter

hyperintensities, found predominantly in the frontal lobes. No

significant difference was found when both CFS groups were

combined and compared to the HC group. The use of

stratification techniques is an important strategy in

understanding the pathophysiology of CFS. This frontal lobe

pathology could explain the more severe cognitive impairment

previously reported in this subset of CFS patients.

Lange G, DeLuca J, Maldjian JA, Lee H, Tiersky LA, Natelson BH

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