Article Index

Studies of the brain

Dr. Komaroff remarked that many interesting studies of the brain were presented at the conference, even though he did not go into too much detail on these. Some of the many brain abnormalities included reductions in grey matter and white matter (IH Treasaden) and decreased activation of basal ganglia (i.e., typically in the caudate and globus pallidus) in CFS and other fatiguing, neurological illnesses using advanced functional magnetic resonance (fMRI) techniques (AH Miller).

Other remarkable research alluded to by Dr. Miller (not part of the abstracts presented at the conference) was the ability to experimentally induce fatigue and reduce activation in basal ganglia, in humans, with the infusion of pro-inflammatory cytokines. Symptoms of CFS have long been associated with pro-inflammatory cytokines produced in, or getting through the brain blood-barrier, and into the central nervous system.

Another study of the brain assessed blood flow in patients with CFS, those with major depressive disorder, and healthy controls. Cerebral blood flow to certain regions of the brain was notably reduced in CFS when compared to healthy controls and no significant differences were found in values between CFS and major depressive disorder (JP Dyke).

Though this pilot study was felt to be intriguing, Dr. Komaroff said it needs to be reproduced, because a small study like this is prone to the beta error problem (i.e., the problem in finding real differences in small studies is difficult). The measurement of tissue blood flow in the brain has greatly advanced, and this technology is now widely available and may allow for better assessment and treatment of patients. But how this technology will be ultimately used needs to be worked out.