Uit onderzoek van dr.
Zeineh, dr. Montoya
en anderen komen een aantal hersenafwijkingen naar voren:
1.
De witte hersen-massa is zowel in de linker- als de rechterhersenhelft significant minder in vergelij-
king met gezonde proefpersonen. Dit werd eerder door anderen
(klik hier en
hier) ook al vastgesteld.
De "witte stof",
deel van het centraal zenuwstelsel dat de axonen, de gemyeliniseerde uitlopers
(axons) van zenuwcellen omvat, zorgt voor de informatieoverdracht, terwijl de
"grijze stof",
dat de cel-lichamen van de neuronen, de dendrieten en de korte axonen bevat, de informatieverwerking verzorgt.
De afname van de witte hersen-massa wordt door de auteurs in verband gebracht met
inflammatie.
2.
Tevens vonden de onderzoekers afwijkingen
in de rechter arcuate fasciculus,
een bundel zenuwvezels die het bovenste/achterste deel van de temporale kwab en de onderste/achterste deel van de frontale kwab in de hersenen verbindt, en
bij rechtshandigen in de rechter inferior longitudinal fasciculus,
die de temporale kwabben met de
occipitale of achterhoofdskwabben verbindt.
De afwijkingen in de rechter arcuate fasciculus waren direct gerelateerd met de ernst van de ziekte.
NB: De arcuate fasciculus verbindt in de linkerhelft van rechtshandigen twee essentiële taalgebieden,
de functie van de arcuate fasciculus in de rechterhersenhelft van rechtshandigen is nog onduidelijk.
3.
Ook vonden de onderzoekers een verdikking van de grijze hersenmassa aan beide uiteinden van de
arcuate fasciculus en aan één uiteinde van de inferior longitudinal fasciculus, de occipitale kwabben.
Volgens de onderzoekers kan de combinatie van de laatste twee afwijkingen geen toeval zijn.
De onderzoekers vonden geen afwijkingen m.b.t. de doorbloeding van de hersenen.
Dit in tegenstelling tot eerdere studies (zie bijvoorbeeld
hier,
hier en hier).
...
Alle gevonden hersenafwijkingen zullen ongetwijfeld met gedragstherapie op te lossen zijn...
In de media
(klik op logo voor het bijbehorende artikel):
Study finds brain abnormalities in chronic fatigue patients
Radiology researchers have discovered that
the brains of patients with chronic fatigue syndrome have
diminished white matter and white matter abnormalities in the right hemisphere.
An imaging study by Stanford University School of Medicine investigators
has found distinct differences between the brains of
patients with chronic fatigue syndrome and those of healthy people.
...
“Using a trio of sophisticated imaging methodologies, we found that
CFS patients’ brains diverge from those of healthy subjects in at least three distinct ways,”
Zeineh said.
...
Three key findings
The analysis yielded three noteworthy results, the researchers said.
First, an MRI showed that overall white-matter content of CFS patients’ brains,
compared with that of healthy subjects’ brains, was reduced.
The term “white matter” largely denotes the long, cablelike nerve tracts
carrying signals among broadly dispersed concentrations of “gray matter.”
The latter areas specialize in processing information, and
the former in conveying the information from one part of the brain to another.
That finding wasn’t entirely unexpected, Zeineh said.
CFS is thought to involve chronic inflammation,
quite possibly as a protracted immunological response
to an as-yet unspecified viral infection.
Inflammation, meanwhile, is known to take a particular toll on white matter.
But a second finding was entirely unexpected.
Using an advanced imaging technique - diffusion-tensor imaging,
which is especially suited to assessing the integrity of white matter -
Zeineh and his colleagues identified
a consistent abnormality in a particular part of a nerve tract
in the right hemisphere of CFS patients’ brains.
This tract, which connects two parts of the brain called the frontal lobe and temporal lobe,
is called the right arcuate fasciculus,
and in CFS patients it assumed an abnormal appearance.
Furthermore, there was a fairly strong correlation
between the degree of abnormality in a CFS patient’s right arcuate fasciculus and
the severity of the patient’s condition,
as assessed by performance on a standard psychometric test used to evaluate fatigue.
...
Bolstering these observations was the third finding:
a thickening of the gray matter at the two areas of the brain
connected by the right arcuate fasciculus in CFS patients, compared with controls.
Its correspondence with the observed abnormality in the white matter
joining them makes it unlikely that the two were chance findings, Zeineh said.
Although these results were quite robust, he said, they will need to be confirmed.
...
The Stanford scientists are in the planning stages of a substantially larger study.
http://med.stanford.edu/news/all-news/2014/10/study-finds-brain-abnormalities-in-chronic-fatigue-patients.html
Right arcuate fasciculus abnormality in chronic fatigue syndrome.
Radiology. 2014 Oct 29. doi: 10.1148/radiol.14141079.
ZeinehMM, Kang J, Atlas SW, Raman MM, Reiss AL, Norris JL, Valencia I, Montoya JG.
Purpose
To identify whether patients with chronic fatigue syndrome (CFS) have
differences in gross brain structure, microscopic structure, or brain perfusion
that may explain their symptoms.
Materials and Methods
Fifteen patients with CFS were identified by means of retrospective review
with an institutional review board–approved waiver of consent and waiver of authorization.
Fourteen age- and sex-matched control subjects provided informed consent
in accordance with the institutional review board and HIPAA.
All subjects underwent 3.0-T volumetric T1-weighted magnetic resonance (MR) imaging,
with two diffusion-tensor imaging (DTI) acquisitions and arterial spin labeling (ASL).
Open source software was used
to segment supratentorial gray and white matter and cerebrospinal fluid
to compare gray and white matter volumes and cortical thickness.
DTIdata were processed with automated fiber quantification,
which was used to compare piecewise fractional anisotropy (FA) along 20 tracks.
For the volumetric analysis,
a regression was performed to account for
differences in age, handedness, and total intracranial volume, and
for the DTI, FA was compared piecewise along tracks by using an unpaired t test.
The open source software segmentation was used
to compare cerebral blood flow as measured with ASL.
Results
In the CFS population,
FA was increased in the right arcuate fasciculus (P = .0015), and
in right-handers,
FA was also increased in the right inferior longitudinal fasciculus (ILF) (P = .0008).
In patients with CFS,
right anterior arcuate FA increased with disease severity (r = 0.649, P = .026).
Bilateral white matter volumes were reduced in CFS
(mean ± standard deviation, 467 581 mm3 ± 47 610 for patients vs
504 864 mm3 ± 68 126 for control subjects, P = .0026), and
cortical thickness increased in both right arcuate end points,
the middle temporal (T = 4.25) and precentral (T = 6.47) gyri, and
one right ILF end point, the occipital lobe (T = 5.36).
ASL showed no significant differences.
Conclusion
Bilateral white matter atrophy is present in CFS.
No differences in perfusion were noted.
Right hemispheric increased FA
may reflect degeneration of crossing fibers or
strengthening of short-range fibers.
Right anterior arcuate FA may serve as a biomarker for CFS.
http://pubs.rsna.org/doi/suppl/10.1148/radiol.14141079
Met dank aan Manja!
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