Abstract
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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References
- Chronic fatigue syndrome.Ann Intern Med. 1988; 108: 387-389
- The chronic fatigue syndrome.Ann Intern Med. 1994; 121: 953-959
- Chronic fatigue syndrome.J Neurol Neurosurg Psychiatry. 1991; 54 (Editorial): 669-671
- New Trends in Nuclear Neurology and Psychiatry. John Libbey, London1993
- Current and future applications of SPECT in clinical psychiatry.J Clin Psychiatry. 1992; 53: 26-28
- Brainstem perfusion is impaired in chronic fatigue syndrome.Q J Med. 1995; 88: 767-773
- The aging brain.J Neuropsychiatry. 1989; 1: S51-S55
- Cerebral blood flow and metabolism in normal human aging, pathological aging and senile dementia.J Cereb Blood Flow Metab. 1985; 5: 1-9
- Alterations of brain glucose metabolism in cirrhotic patients with subclinical encephalopathy.Eur J Nucl Med. 1996; 23 (Abstr.): 1085
- Co-Planar Stereotactic Atlas of the Human Brain. G.T. Verlag, Stuttgart, New York1988
- Functional neuroimaging in CFS.J Chronic Fatigue Syndrome. 1995; 1: 9-20
- A chronic illness characterised by fatigue, neurologic and immunologic disorders and active human herpes virus type 6 infection.Ann Intern Med. 1992; 116: 103-113
- SPECT and MR imaging of the brain in patients with chronic fatigue syndrome.Proceedings AACFS Conference. 1994; 32 (Abstr.)
- Positron Emission Tomography and Autoradiography. Raven Press, New York1986
- Single-photon emission computed tomography (SPECT).JAMA. 1990; 263: 561-564
- Quantitative Imaging Neuroreceptors, Neurotransmitters and Enzymes. Raven Press, New York1990: 51-79
- Assessment of regional cerebral perfusion by Tc99m-HMPAO SPECT in chronic fatigue syndrome.Nucl Med Commun. 1992; 13: 767-772
- The assessment of vascular abnormalities in late life chronic fatigue syndrome by brain SPECT; comparison with late life major depressive disorder.J Chronic Fatigue Syndrome. 1995; 1: 55-79
- Neuroanatomy of depression.J Clin Psychiatry. 1993; 54: 14-20
- The frontal lobes, basal ganglia and temporal lobes as sites for schizophrenia.Schizophrenia Bull. 1990; 16: 379-391
- Evidence of dysfunction of a prefrontal-limbic network in schizophrenia.Am J Psychiatry. 1992; 149: 890-897
- Limbic system abnormalities identified in schizophrenia using positron emission tomography with fluoro-deoxyglucose and neocortical alterations with deficit syndrome.Arch Gen Psychiatry. 1992; 49: 522-530
- Patterns of cerebral blood flow in schizophrenia.Br J Psychiatry. 1992; 160: 179-186
- Cerebral glucose metabolic rates in nondepressed patients with obsessive-compulsive disorder.Am J Psychiatry. 1988; 145: 1560-1563
- Regional cerebral blood flow measured during symptom provocation in obsessive-compulsive disorder using oxygen 15-labled carbon dioxide and positron emission tomography.Arch Gen Psychiatry. 1994; 51: 62-70
- Herpes simplex virus encephalitis, neuroanatomical and neurochemical selectivity.J Neurol Sci. 1985; 71: 325-337
- Persistent illness and fatigue in adults with evidence of Epstein-Barr virus infection.Ann Intern Med. 1985; 102: 7-16
Article Info
Publication History
Published online: August 16, 2004
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© 1998 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
