Friday 25th January 2019
Welcome to the Sixteenth Emerge Australia Media and Research Digest!
The fortnightly summary of media and research about Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
1 – A compromised paraventricular nucleus within a dysfunctional hypothalamus: A novel neuro-inflammatory paradigm for ME/CFS
Authors: Mackay, A. & Tate, W.
Researchers have proposed that inflammation in the hypothalamus may provide an explanation for the onset and wide-ranging symptoms of ME/CFS.
The hypothalamus is an area located at the base of the brain which controls numerous bodily functions including blood pressure, body temperature, appetite, and the release of hormones. The hypothalamus para-ventricular nucleus (PVN) is a cluster of neurons in the hypothalamus which is responsible for the “[absorption] and processing of multiple, incoming and convergent stress signals”. If the PVN is affected by neuro-inflammation, this could explain ME/CFS patients’ hypersensitivity to various stressors.
Triggers such as viral infections, toxin exposure, or traumatic events could target the PVN when ME/CFS patients are vulnerable. Disruption in its neural pathways could explain many ME/CFS symptoms. An unidentified factor may be responsible for the initial and ongoing neuroinflammation in the brain which causes ME/CFS.
2 – The link between idiopathic intracranial hypertension, Fibromyalgia, and Chronic Fatigue Syndrome: Exploration of a shared pathophysiology
Authors: Hulens, M., Rasschaert, R., Vansant, G., Bruyninckx, F., & Dankaerts, W.
The pathological mechanisms that cause both Fibromyalgia (FM) and Chronic Fatigue Syndrome (CFS) are currently insufficiently understood. FM and CFS share very similar symptoms with idiopathic intracranial hypertension (IICH), a condition characterised by an increase in intracranial pressure (ICP) due to an unknown cause. This literature review explores common symptoms between the conditions and links the symptoms to the hypothesis that increased intracranial and spinal fluid pressure may be the mechanism that initiates the multitude of symptoms in both conditions.
3 – Functional status and well-being in people with Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome compared with people with multiple sclerosis and healthy controls
Authors: Kingdon, C., Bowman, E., Curran, H., Nacul, L., & Lacerda, E.
This study compares the functional status and well-being of people with ME/CFS with people diagnosed with multiple sclerosis (MS), as well as healthy controls. The authors utilised the Medical Outcomes Survey Short Form-36 v2 (SF-36v2) as well as a bespoke questionnaire to determine the comparison between the three groups.
The results determined that people affected by ME/CFS scored significantly lower across all SF-36v2 areas than people with MS and the healthy controls. The study found from the bespoke questionnaire that people with ME/CFS are more likely to lose their jobs after becoming ill than people with MS, as well as have their income decrease markedly. Overall the economic cost to society of ME/CFS should be a powerful motivator for policymakers to encourage better funding of research to discover the cause of, and establish effective treatments for, this disease.
4 – Red blood cell deformability is diminished in patients with Chronic Fatigue Syndrome
Authors: Saha, A., Schmidt, B., Wilhelmy, J., Nguyen, V., Abugherir, A., Do, J., … Ramasubramanian, A.
Recent research has detailed the stark difference in red blood cells between ME/CFS patients and healthy controls.
In a healthy control, red blood cells (RBC) have a discoid shape and can deform arbitrarily which enables them to travel through micro-vessels for optimal oxygenation of cells. The shape and size of the cells are known to change in response to oxidative and inflammatory stresses.
Californian researchers have shown through a series of tests that ME/CFS patients have much stiffer red blood cells and that the lack of deformity may partly explain the pain and fatigue experienced by ME/CFS patients due to impaired tissue oxygenation. These results may provide the opportunity for a diagnostic test which involves a finger-prick blood sample combined with other clinical presentations.
5 – Evidence of widespread metabolite abnormalities in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Assessment with whole-brain magnetic resonance spectroscopy
Authors: Mueller, C., Lin, J., Sheriff, S., Maudsley, A. & Younger, J.
Previous neuroimaging research led by Dr Jarred Younger discovered markers for neuroinflammation in patients with ME/CFS. This follow-up study has broadened the scope of the examination to include the brain in its entirety.
The study involved 15 ME/CFS patients and matching controls, using Magnetic Resonance Spectroscopy (MRI) to measure brain metabolites linked to inflammation and brain temperature. The study found brain temperature in ME/CFS patients was higher in multiple regions (right insula, putamen, frontal cortex, thalamus and the cerebellum).
The results indicate that there are “metabolite and temperature abnormalities in ME/CFS patients in widely distributed regions” and the findings “may indicate that ME/CFS involves neuroinflammation.”
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