Using structural and functional MRI as a neuroimaging technique to investigate chronic fatigue syndrome/myalgic encephalopathy: a systematic review.

Observed Findings

• sMRI studies report differences in gray and white matter volume, ventricular enlargement, and hyperintensities in CFS/ME patients compared to controls
• Task-based fMRI consistently shows increased brain activation and recruitment of additional brain regions in CFS/ME patients during cognitive tasks
• During higher-load or more complex tasks, CFS/ME patients showed decreased activation in task-specific brain regions
• Three sMRI studies found no neuroanatomical differences between CFS/ME patients and healthy controls
• fMRI findings included both increased and decreased activation patterns depending on task demands

Inferred Conclusions

• Neuroimaging studies provide evidence that CFS/ME involves measurable differences in brain structure and function
• Inconsistencies in structural findings and variability in functional activation patterns may reflect the heterogeneous nature of CFS/ME or limitations in current neuroimaging methodology
• Robust study design, larger sample sizes, and patient subgrouping strategies are needed to establish a consistent neural profile or biomarker
• Current neuroimaging techniques have inherent limitations that prevent definitive characterization of the neural mechanisms underlying CFS/ME

Remaining Questions