R. Casse, P. Delfante, L.Barnden, R. Burnett, M. Kitchener, R Kwiatek
The Queen Elizabeth Hospital,
Regional cerebral bloodflow in chronic fatigue syndrome (CFS)
Chronic fatigue syndrome (CFS) is a debilitating and complex disorder characterised by profound fatigue and neuropsychiatric dysfunction. The neuropsychiatric symptoms are often associated with a mental fatigue, consisting of impaired concentration and slowness of thinking. Patients with this disorder have been studied with radionuclide cerebral perfusion scans with conflicting results. Most previous studies were performed with inhomogeneous patient populations and were not analysed with Statistical Parametric Mapping (SPM). We performed a pilot study to address these issues with Tc-99m HMPAO SPECT and a triple head gamma-camera. A uniform group of 13 female subjects (16-53y) with moderate CFS based on established criteria, pain free, not on medication and not depressed was compared with a group of 11 patients (18-60y) who were scanned for other conditions and reported as normal. Visually, a deficit in regional cerebral bloodflow (rCBF) in the medial temporal lobe was definite in 7 (5L, 1R, 1 bilateral) and equivocal in 3 CFS patients. SPM99 with proportional scaling to the global mean was applied for quantitative analysis. The location, amplitude and corrected p-value of significant focal deficits in CFS were: brainstem (19%, 0.009), left medial temporal lobe (17%, 0.004), right medial temporal lobe (22%, 0.002), frontal lobe (17%, 0.002) and anterior cingulate gyrus (12%, 0.001). These results are to be confirmed against a "true normal" group of volunteers. There appears to be objective evidence that patients with moderately severe CFS have focal cortical and brainstem hypoperfusion.
Alison Hunter Memorial Foundation
PO Box 6132 North Sydney 2059 Australia
Phone/Fax +61 2 9958 6285
All material on the site © AHMF