Re: MRI findings (was /Amygdala / Incline Outcome)

[Guest guest]

FWIW, regarding white matter hyperintensities found in CFS patients,

a recent study in lupus patients also found hyperintensities, and

they were associated with fatigue:

http://www.ncbi.nlm.nih.gov/pubmed/17872980

What's most interesting is that in both the CFS and Lupus studies,

these hyperintensities were mainly found in patients that didn't have

depression:

http://www.ncbi.nlm.nih.gov/pubmed/10567042

What this seems to possibly say is that there are 2 groups of fatigue

patients, those which are associated with hyperintensities, and those

which are associated with abnormalities that could cause depression,

i.e. such as deficits of neurotransmitters such as serotonin.

- Mark

> MRI BRAIN SCANS. The MRI findings have been described as objective

> evidence of central nervous system damage, something that only an

> agency determined to subvert CFS patients could ignore. Indeed the

> researchers ¡®frequently saw areas of abnormal signal intensity in

the

> white matter of the central nervous system " of CFS patients. The

> meaning of those abnormal signal intensities were, however,

unclear.

> In a few patients they were able to correlate problems in, say,

> vision with abnormalities in the visual cortex but in most they

were

> not. The fact that ¡®similar white matter changes were found in

many

> disease and conditions (multiple sclerosis, Alzheimer¡¯s,

metastatic

> disease, post- chemotherapy, trauma, viral infection, etc.)¡¯

> suggested some pathology was at work but left the cause of it

> unclear.

>

> Problematically while significantly more CFS patients demonstrated

> these abnormalities than the healthy controls a significant

> percentage (20%) of the healthy controls had them as well. The

> researchers noted that this was not unexpected

> stating " such..areas..can also be seen in apparently health people

of

> all ages " .

>

> A further problem involved linking these areas to the actual

disease

> since they occurred in different areas in different patients. While

> they suggested that at least some patients were ¡®experiencing a

> genuine but as yet undefined pathologic process " they concluded

that

> the significance of these ¡®incidental¡¯ areas ¡®is not known¡¯.

>

> The significance of the MRI findings was muddied by a lower rate of

> MRI abnormalities in the New England cohort of patients and by the

> fact that they were not found in all the patients. Suggestions that

> these abnormalities increased with age did not help clarify

matters.

> Finally, since the clinical significance of the tests was unclear

> they did not recommend the routine use of MRI in CFS patients. It

was

> clear the authors thought they might be onto something but were

> unsure what it was.

>

> Medical Community¡¯s Response. At least nine studies will examine

MRI

> findings in CFS between 1990 and 2000. All will display variable

> findings; a 1993 study found abnormalities in 27% of CFS patients;

> a1994 study in 50%; another found them in 32% of CFS patients (and

a

> statistically equal numbers of controls). The inability to find

> abnormalities in all or at times in a majority of CFS patients or

to

> find them in specific areas of the brain will continue to leave the

> scientific community unclear as to their significance.

>

> The Present. Things will change for the better around 2000 as

> researchers refine their techniques and imaging technology

improves.

> Dr. Natelson¡¯s finding of increased central nervous system

> abnormalities in CFS patients without mood disorders as opposed to

> those with mood disorders will help to increase interest in this

> area. Functional MRI¡¯s and other brain imaging techniques now

> consistently show abnormalities in certain parts of the brains of

CFS