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SPECT imaging of the brain: comparison of findings in patients with Chronic Fatigue Syndrome (CFS), AIDS dementia complex, & major unipolar depression

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OBJECTIVE. Chronic fatigue syndrome is an illness of unknown

origin that begins abruptly with a flulike state and has

symptoms suggesting both a chronic viral encephalitis and an

affective disorder. We compared single-photon emission

computed tomography (SPECT) scans of patients with chronic

fatigue syndrome with those of patients with AIDS dementia

complex and unipolar depression.

SUBJECTS AND METHODS. We used

99mTc-hexamethylpropyleneamine oxime to examine 45 patients

with chronic fatigue syndrome, 27 patients with AIDS dementia

complex, and 14 patients with major unipolar depression. Scans

of 38 healthy persons were used as controls. Comparison of

regional defects between groups, as well as midcerebral uptake

indexes (an objective measure of global radionuclide uptake),

was performed by using analysis of variance with the

Student-Newman-Keuls option. Correlation between the number of

regional defects and the midcerebral uptake index was

determined by using the Spearman rank-correlation test.

RESULTS. Patients with AIDS dementia complex had the largest

number of defects (9.15 per patient) and healthy patients had

the fewest defects (1.66 per patient). Patients with chronic

fatigue syndrome and depression had similar numbers of defects

per patient (6.53 and 6.43, respectively). In all groups,

defects were located predominantly in the frontal and temporal

lobes. The midcerebral uptake index was found to be

significantly lower (p < .002) in the patients with chronic

fatigue syndrome (.667) and patients with AIDS dementia

complex (.650) than in patients with major depression (.731)

or healthy control subjects (.716). Also, a significant

negative correlation was found between the number of defects

and midcerebral uptake index in patients with chronic fatigue

syndrome and AIDS dementia complex, but not in depressed

patients or control subjects.

CONCLUSION. These findings are

consistent with the hypothesis that chronic fatigue syndrome

may be due to a chronic viral encephalitis; clinical

similarities between chronic fatigue syndrome and depression

may be due to a similar distribution and number of defects in

the two disorders.

Schwartz RB, Komaroff AL, Garada BM, Gleit M, Doolittle TH, Bates

DW,Vasile RG, Holman BL

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