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Abstract Details

Correlating Neuroimaging Changes to Fatigue and Cognitive Dysfunction in ME/CFS
Autoimmune Neurology
P10 - Poster Session 10 (8:00 AM-9:00 AM)
1-006
Determine neurostructural alterations seen on imaging in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).
The neuroimmune condition known as myalgic encephalomyelitis (ME) is a chronic, complicated, and incapacitating condition marked by extreme fatigue that becomes worse with physical or mental activity and is not alleviated by rest. Because of its increased incidence post COVID-19 a better understanding was necessary as it cannot be easily explained. Our study aims to find common neurological factors through imaging that can be linked or that show a particular pattern in patient groups.
We conducted a systematic literature review following PRISMA protocols. PubMed database was searched using the keywords Imaging, and ME/CFS. 40 studies resulted, we evaluated age, gender, imaging technique, brain area affected, and neurostructural changes.
We included 12 studies reporting 652 patients with a mean age of 44.3 years. Of those 428 (65.6%) were diagnosed with ME/CFS using the Fukuda criteria, the remaining were healthy controls. Of which 84.5% were female. Studies used the 3T MRI scanner, applying techniques such as diffusion tensor imaging (DTI), arterial spin labeling (ASL), magnetic resonance spectroscopy (MRS), and functional MRI (fMRI). 5 studies (42%) reported predominantly white matter changes (decreased connectivity), 2 (16%) grey matter changes (volume reductions), and 5 (42%) presenting changes in both. Predominating areas affected include the cingulate gyrus (33%), pre-frontal cortex (58%), precentral gyrus (66%), corpus callosum (16%), cerebellum (25%), basal ganglia (42%), hippocampus (25%), thalamus (42%), and brainstem (25%). 2 studies (16%) presented higher BOLD (blood oxygen level dependent) signals in affected patients when compared to healthy individuals.

These widespread alterations demonstrate multifocal changes correlated to patient fatigue and cognitive dysfunction. The individualistic manner of this condition raises concern for standardized management of patients. Instead, we can use this as an extended diagnostic tool to personalize care for individuals affected.

Authors/Disclosures
Marcos Saint-Felix
PRESENTER
Mr. Saint-Felix has nothing to disclose.
Karla M. Rodriguez Manso Ms. Rodriguez Manso has nothing to disclose.