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NeuroImage. Clinical
2016;11 530-537.

Autonomic correlations with MRI are abnormal in the brainstem vasomotor centre in Chronic Fatigue Syndrome.

Leighton R Barnden, Richard Kwiatek, Benjamin Crouch, Richard Burnet, Peter Del Fante
Author Information
  1. Leighton R Barnden: Department of Nuclear Medicine, The Queen Elizabeth Hospital, Woodville, SA 5011, Australia; National Centre for NeuroImmunology and Emerging Diseases, Griffith University, Gold Coast, QLD 4222, Australia. Electronic address: l.barnden@griffith.edu.au.
  2. Richard Kwiatek: Division of Medical Subspecialities, Lyell McEwin Hospital, Elizabeth, SA 5112, Australia. Electronic address: rkwiatek@bigpond.com.
  3. Benjamin Crouch: Department of Nuclear Medicine, The Queen Elizabeth Hospital, Woodville, SA 5011, Australia. Electronic address: benjamin.crouch@health.sa.gov.au.
  4. Richard Burnet: Endocrinology Department, Royal Adelaide Hospital, Adelaide, SA 5000, Australia. Electronic address: hair77@bigpond.com.
  5. Peter Del Fante: Healthfirst Network, Woodville, SA 5011, Australia. Electronic address: peter.delfante@healthfirst.org.au.
PMID: 27114901 DOI: 10.1016/j.nicl.2016.03.017

Abstract

Autonomic changes are often associated with the chronic fatigue syndrome (CFS), but their pathogenetic role is unclear and brain imaging investigations are lacking. The vasomotor centre and, through it, nuclei in the midbrain and hypothalamus play a key role in autonomic nervous system regulation of steady state blood pressure (BP) and heart rate (HR). In this exploratory cross-sectional study, BP and HR, as indicators of autonomic function, were correlated with volumetric and T1- and T2-weighted spin-echo (T1w and T2w) brain MRI in 25 CFS subjects and 25 normal controls (NC). Steady state BP (systolic, diastolic and pulse pressure) and HR in two postures were extracted from 24 h blood pressure monitoring. We performed (1) MRI versus autonomic score interaction-with-group regressions to detect locations where regression slopes differed in the CFS and NC groups (collectively indicating abnormality in CFS), and (2) MRI regressions in the CFS and NC groups alone to detect additional locations with abnormal correlations in CFS. Significant CFS regressions were repeated controlling for anxiety and depression (A&D). Abnormal regressions were detected in nuclei of the brainstem vasomotor centre, midbrain reticular formation and hypothalamus, but also in limbic nuclei involved in stress responses and in prefrontal white matter. Group comparisons of CFS and NC did not find MRI differences in these locations. We propose therefore that these regulatory nuclei are functioning correctly, but that two-way communication between them is impaired in CFS and this affects signalling to/from peripheral effectors/sensors, culminating in inverted or magnified correlations. This single explanation for the diverse abnormal correlations detected here consolidates the conclusion for a brainstem/midbrain nerve conduction deficit inferred earlier (Barnden et al., 2015). Strong correlations were also detected in isolated NC regressions.

Keywords

1s, 1 sample 2s, 2 sample A&D, anxiety and depression Anxiety and depression Autonomic BA, Brodmann Area BP, blood pressure Blood pressure CFS, chronic fatigue syndrome Cb, cerebellum Chronic fatigue syndrome CnF, cuneiform nucleus of the reticular formation DLPF, dorsolateral prefrontal FDR, false discovery rate FWE, family wise error GM, grey matter HADS, Hospital Anxiety and Depression Scale HR, heart rate Heart rate Hypothalamus MRI Midbrain NC, normal controls Nerve conduction PCC, posterior cingulate cortex PHg, parahippocampal gyrus POTS, postural orthostatic tachycardia syndrome PP, pulse pressure Posture RAS, reticular activation system Regression SS, symptom score VBIS, voxel based iterative sensitivity Vasomotor centre WM, white matter ccP, corrected cluster P statistic diaBP, diastolic blood pressure sysBP, systolic Blood pressure uvP, uncorrected voxel P statistic

References

  1. Semin Arthritis Rheum. 2013 Oct;43(2):279-87 [PMID: 23838093]
  2. Neuroimage. 2009 Sep;47(3):937-45 [PMID: 19464376]
  3. Eur J Clin Invest. 2012 Feb;42(2):186-94 [PMID: 21749371]
  4. Neuroimage. 2009 Sep;47(3):795-803 [PMID: 19446637]
  5. Clin Sci (Lond). 2010 Jan;118(2):125-35 [PMID: 19469714]
  6. Hum Brain Mapp. 2010 Apr;31(4):539-49 [PMID: 19777579]
  7. J Neurosci. 2008 Nov 5;28(45):11642-9 [PMID: 18987200]
  8. NMR Biomed. 2011 Dec;24(10):1302-12 [PMID: 21560176]
  9. Neuroimage. 2006 Jun;31(2):754-65 [PMID: 16488626]
  10. Acta Psychiatr Scand. 1983 Jun;67(6):361-70 [PMID: 6880820]
  11. J Affect Disord. 2007 Apr;99(1-3):237-40 [PMID: 17007934]
  12. NMR Biomed. 2015 Mar;28(3):404-13 [PMID: 25702943]
  13. J Intern Med. 2010 Apr;267(4):394-401 [PMID: 20433583]
  14. Int J Psychophysiol. 2004 Aug;53(3):171-82 [PMID: 15246671]
  15. Pediatrics. 2007 Jul;120(1):e129-37 [PMID: 17606539]
  16. Neuroimage. 2009 Sep;47(3):922-36 [PMID: 19410652]
  17. BMC Gastroenterol. 2004 Dec 26;4:32 [PMID: 15619332]
  18. Neuroimage. 2009 Sep;47(3):821-35 [PMID: 19465137]
  19. Neuroimmunomodulation. 2002-2003;10(3):134-41 [PMID: 12481153]
  20. Auton Neurosci. 2007 Dec 30;137(1-2):94-101 [PMID: 17851136]
  21. Neurology. 1993 Jan;43(1):132-7 [PMID: 8423877]
  22. J Intern Med. 2011 Oct;270(4):327-38 [PMID: 21777306]
  23. Neuroimage. 2004 Jun;22(2):676-87 [PMID: 15193596]
  24. J Hypertens. 2013 Aug;31(8):1502-16 [PMID: 23811995]
  25. Exp Brain Res. 2010 Jul;204(1):71-8 [PMID: 20502886]
  26. QJM. 2007 Aug;100(8):519-26 [PMID: 17617647]
  27. Eur J Clin Invest. 2014 May;44(5):516-26 [PMID: 24601948]
  28. J Intern Med. 2013 May;273(5):501-10 [PMID: 23206180]
  29. J Physiol. 2000 Feb 15;523 Pt 1:259-70 [PMID: 10673560]
  30. Neuroimage. 2009 Feb 1;44(3):812-9 [PMID: 18996207]
  31. Neuroimage. 2013 Apr 15;70:59-65 [PMID: 23287526]
  32. Neuroimage. 2012 Jan 2;59(1):168-80 [PMID: 21777680]
  33. J Intern Med. 2013 May;273(5):498-500 [PMID: 23331489]
  34. PLoS One. 2012;7(11):e49518 [PMID: 23166694]
  35. Psychosom Med. 2005 Jan-Feb;67(1):31-9 [PMID: 15673621]
  36. Neuroimage Clin. 2013 Jan 05;2:168-73 [PMID: 24179772]

MeSH Term

Adult
Anxiety
Autonomic Nervous System
Blood Pressure
Brain Stem
Cross-Sectional Studies
Depression
Fatigue Syndrome, Chronic
Female
Gray Matter
Heart Rate
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Male
Middle Aged
Psychiatric Status Rating Scales
Regression Analysis
White Matter
Young Adult
Journal Article Research Support, Non-U.S. Gov't
Article has an altmetric score of 91

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