Abstract
Background
Chronic fatigue syndrome (CFS) is characterized by severe fatigue persisting for ≥6
months and leading to considerable impairment in daily functioning. Neuroimaging studies
of patients with CFS have revealed alterations in prefrontal brain morphology. However,
it remains to be determined whether these alterations are specific for fatigue or
whether they relate to other common CFS symptoms (e.g., chronic pain, lower psychomotor
speed, and reduced physical activity).
Methods
We used magnetic resonance imaging to quantify gray matter volume (GMV) and the N-acetylaspartate and N-acetylaspartylglutamate/creatine ratio (NAA/Cr) in a group of 89 women with CFS.
Building on previous reports, we tested whether GMV and NAA/Cr in the dorsolateral
prefrontal cortex are associated with fatigue severity, pain, psychomotor speed, and
physical activity, while controlling for depressive symptoms. We also considered GMV
and NAA/Cr differences between patients with CFS and 26 sex-, age-, and education-matched
healthy controls.
Results
The presence of pain symptoms was the main predictor of both GMV and NAA/Cr in the
left dorsolateral prefrontal cortex of patients with CFS. More pain was associated
with reduced GMVs and NAA/Cr, over and above the effects of fatigue, depressive symptoms,
physical activity, and psychomotor speed. In contrast to previous reports and despite
a large representative sample, global GMV did not differ between the CFS and healthy
control groups.
Conclusions
CFS, as diagnosed by Centers for Disease Control and Prevention criteria, is not a
clinical entity reliably associated with reduced GMV. Individual variation in the
presence of pain, rather than fatigue, is associated with neuronal alterations in
the dorsolateral prefrontal cortex of patients with CFS.
Keywords
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Article Info
Publication History
Published online: August 31, 2016
Accepted:
July 26,
2016
Received in revised form:
July 22,
2016
Received:
March 24,
2016
Identification
Copyright
© Society of Biological Psychiatry, 2016.
