Lange, G, Wang, S, DeLuca, J et al. · The American journal of medicine · 1998 · DOI
Quick Summary
This review examines how brain imaging scans can help understand ME/CFS. Researchers looked at two main types of scans: MRI scans that show the structure of the brain, and SPECT scans that show blood flow in the brain. The article discusses what these imaging techniques have revealed so far and what challenges doctors face in using them to diagnose ME/CFS.
Why It Matters
This review is important because ME/CFS patients often struggle to get diagnosed due to lack of objective tests, and brain imaging could potentially provide evidence of physical abnormalities. Understanding what neuroimaging can and cannot tell us helps both patients and doctors have realistic expectations about these tools and may guide future research toward more reliable diagnostic approaches.
Observed Findings
MRI studies have detected structural abnormalities in some CFS patients' brains
SPECT imaging shows alterations in regional cerebral blood flow in certain CFS populations
Cognitive complaints and headaches may prompt clinical referral for neuroimaging evaluation
No single imaging marker has been identified as specific to ME/CFS
Cognitive difficulties reported by patients may correspond to detectable brain imaging changes in some cases
Inferred Conclusions
Neuroimaging may provide objective evidence of brain abnormalities in some ME/CFS patients, supporting the biological basis of the condition
Current neuroimaging techniques have limitations and cannot yet serve as reliable diagnostic tools for ME/CFS due to lack of disease specificity
Future research must carefully control for confounding factors such as depression and other neurologic conditions that can produce similar imaging findings
Emerging technologies like PET imaging may offer improved diagnostic and research capabilities compared to traditional static MRI
Remaining Questions
Can any neuroimaging technique reliably distinguish ME/CFS from other conditions with similar presentations?
What This Study Does Not Prove
This review does not prove that any single neuroimaging finding can definitively diagnose ME/CFS, nor does it establish that observed brain imaging abnormalities are unique to this condition. The review also does not determine whether any imaging findings are causes of ME/CFS symptoms or merely correlates, and notes that depression and other conditions can produce similar imaging patterns, complicating interpretation.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →