Grey Matter

From: <a href="https://link.springer.com/article/10.1007/s12035-017-0598-z">A Comparison of Neuroimaging Abnormalities in Multiple Sclerosis, Major Depression and Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): is There a Common Cause? | SpringerLink</a>

Several research teams utilising VBM have reported reduced global or regional GM volumes in those with CFS [<a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR185">185</a>, <a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR188">188</a>, <a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR189">189</a>, <a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR190">190</a>, <a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR191">191</a>]. Puri and fellow workers in a study consisting of 26 CFS participants and 26 age- and sex-matched healthy controls reported significantly reduced GM volume in the left and right occipital poles, left lateral occipital cortex (superior division), left supracalcrine cortex, the posterior division of the left parahippocampal gyrus and the right angular gyrus [<a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR185">185</a>]. Okada and fellow workers on the other hand reported reduced GM volume in the right prefrontal cortex [<a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR189">189</a>]. It is also worthy of note that these authors also reported that the extent of GM volume reduction in the right prefrontal cortex correlated with the severity of reported fatigue [<a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR189">189</a>]. However, it should also be noted that this was a relatively small study consisting of just 16 CFS participants and 16 healthy controls [<a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR189">189</a>].

The results reported by deLange and others appear to be particularly interesting as their studies were specifically designed to examine potential relationships between the severity of symptoms in CFS and cerebral abnormalities and the effect of cognitive-behavioural therapy (CBT) on those cerebral abnormalities respectively [<a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR190">190</a>, <a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR191">191</a>]. In the first relatively large study consisting of 28 CFS patients and 28 healthy controls, these authors reported significant reductions in global GM volume in CFS and that the extent of such reductions correlated with the degree of physical disability [<a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR190">190</a>]. In the later study, these authors also reported a global reduction in GM volume which increased significantly, albeit slightly (approximately 6%), following a course of CBT [<a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR191">191</a>]. Finally, in their longitudinal MRI study, Shan and others have recently reported a progressive decrease in WM volumes in the left inferior fronto–occipital fasciculus in a cohort of 15 CFS participants (unchanged in 10 normal controls), with decreased regional WM volumes in adjacent regions and GM volume reduction in contralateral regions over a 6-year period; these regional WM and GM volumes once again correlated with illness severity [<a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR188">188</a>].

The results reported by deLange and others appear to be particularly interesting as their studies were specifically designed to examine potential relationships between the severity of symptoms in CFS and cerebral abnormalities and the effect of cognitive-behavioural therapy (CBT) on those cerebral abnormalities respectively [<a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR190">190</a>, <a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR191">191</a>]. In the first relatively large study consisting of 28 CFS patients and 28 healthy controls, these authors reported significant reductions in global GM volume in CFS and that the extent of such reductions correlated with the degree of physical disability [<a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR190">190</a>]. In the later study, these authors also reported a global reduction in GM volume which increased significantly, albeit slightly (approximately 6%), following a course of CBT [<a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR191">191</a>]. Finally, in their longitudinal MRI study, Shan and others have recently reported a progressive decrease in WM volumes in the left inferior fronto–occipital fasciculus in a cohort of 15 CFS participants (unchanged in 10 normal controls), with decreased regional WM volumes in adjacent regions and GM volume reduction in contralateral regions over a 6-year period; these regional WM and GM volumes once again correlated with illness severity [<a title="View reference" href="https://link.springer.com/article/10.1007/s12035-017-0598-z#CR188">188</a>].