A systematic review of neurological impairments in myalgic encephalomyelitis/ chronic fatigue syndrome using neuroimaging techniques.
Maksoud, Rebekah, du Preez, Stanley, Eaton-Fitch, Natalie et al. · PloS one · 2020 · DOI
Quick Summary
This review examined 55 studies that used brain imaging techniques to look for physical differences in the brains of people with ME/CFS compared to healthy people. The researchers found evidence that ME/CFS affects how the nervous system works, including changes in brain structure and blood flow. However, the findings weren't consistent across all studies, meaning scientists still don't have a complete picture of what's happening in the brain.
Why It Matters
This is the first comprehensive systematic review consolidating neuroimaging evidence for ME/CFS, providing an important bridge between patient symptoms and measurable brain changes. Establishing objective neurological biomarkers through neuroimaging could validate ME/CFS as a biological illness and guide future diagnostic and therapeutic strategies.
Observed Findings
Changes in gray matter and white matter volumes in ME/CFS patients
Abnormalities in cerebral blood flow patterns
Altered functional connectivity within brain networks
EEG activity changes suggesting disrupted sleep and brain activity patterns
Morphological changes in brain structures associated with autonomic function
Inferred Conclusions
The autonomic nervous system is widely disrupted in ME/CFS, detectable through multiple neuroimaging modalities
Neurological and structural brain changes are associated with ME/CFS and may contribute to symptom manifestation
Investigated neuroimaging findings show potential for understanding ME/CFS pathophysiology but require standardization and replication
Remaining Questions
Why do neuroimaging findings vary significantly across studies, and what methodological standards could improve consistency?
Are observed brain changes the cause of ME/CFS symptoms or a consequence of prolonged illness?
Which specific neurological markers could serve as objective diagnostic criteria for ME/CFS?
What This Study Does Not Prove
This review does not prove that observed brain changes cause ME/CFS symptoms, as most studies are correlational rather than causal. The inconsistency of findings across studies means no single neurological marker has been established as a definitive diagnostic feature of ME/CFS. The review also cannot explain why neuroimaging changes occur or whether they are primary pathological processes or secondary responses to illness.