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Autonomic correlations with MRI are abnormal in the brainstem vasomotor centre in Chronic Fatigue Syndrome.
Neuroimage Clin. 2016; 11:530-537.NC

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.

Authors+Show Affiliations

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.Division of Medical Subspecialities, Lyell McEwin Hospital, Elizabeth, SA 5112, Australia. Electronic address: rkwiatek@bigpond.com.Department of Nuclear Medicine, The Queen Elizabeth Hospital, Woodville, SA 5011, Australia. Electronic address: benjamin.crouch@health.sa.gov.au.Endocrinology Department, Royal Adelaide Hospital, Adelaide, SA 5000, Australia. Electronic address: hair77@bigpond.com.Healthfirst Network, Woodville, SA 5011, Australia. Electronic address: peter.delfante@healthfirst.org.au.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27114901

Citation

Barnden, Leighton R., et al. "Autonomic Correlations With MRI Are Abnormal in the Brainstem Vasomotor Centre in Chronic Fatigue Syndrome." NeuroImage. Clinical, vol. 11, 2016, pp. 530-537.
Barnden LR, Kwiatek R, Crouch B, et al. Autonomic correlations with MRI are abnormal in the brainstem vasomotor centre in Chronic Fatigue Syndrome. Neuroimage Clin. 2016;11:530-537.
Barnden, L. R., Kwiatek, R., Crouch, B., Burnet, R., & Del Fante, P. (2016). Autonomic correlations with MRI are abnormal in the brainstem vasomotor centre in Chronic Fatigue Syndrome. NeuroImage. Clinical, 11, 530-537. https://doi.org/10.1016/j.nicl.2016.03.017
Barnden LR, et al. Autonomic Correlations With MRI Are Abnormal in the Brainstem Vasomotor Centre in Chronic Fatigue Syndrome. Neuroimage Clin. 2016;11:530-537. PubMed PMID: 27114901.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Autonomic correlations with MRI are abnormal in the brainstem vasomotor centre in Chronic Fatigue Syndrome. AU - Barnden,Leighton R, AU - Kwiatek,Richard, AU - Crouch,Benjamin, AU - Burnet,Richard, AU - Del Fante,Peter, Y1 - 2016/03/31/ PY - 2015/11/21/received PY - 2016/03/21/revised PY - 2016/03/23/accepted PY - 2016/4/27/entrez PY - 2016/4/27/pubmed PY - 2016/12/15/medline KW - 1s, 1 sample KW - 2s, 2 sample KW - A&D, anxiety and depression KW - Anxiety and depression KW - Autonomic KW - BA, Brodmann Area KW - BP, blood pressure KW - Blood pressure KW - CFS, chronic fatigue syndrome KW - Cb, cerebellum KW - Chronic fatigue syndrome KW - CnF, cuneiform nucleus of the reticular formation KW - DLPF, dorsolateral prefrontal KW - FDR, false discovery rate KW - FWE, family wise error KW - GM, grey matter KW - HADS, Hospital Anxiety and Depression Scale KW - HR, heart rate KW - Heart rate KW - Hypothalamus KW - MRI KW - Midbrain KW - NC, normal controls KW - Nerve conduction KW - PCC, posterior cingulate cortex KW - PHg, parahippocampal gyrus KW - POTS, postural orthostatic tachycardia syndrome KW - PP, pulse pressure KW - Posture KW - RAS, reticular activation system KW - Regression KW - SS, symptom score KW - VBIS, voxel based iterative sensitivity KW - Vasomotor centre KW - WM, white matter KW - ccP, corrected cluster P statistic KW - diaBP, diastolic blood pressure KW - sysBP, systolic Blood pressure KW - uvP, uncorrected voxel P statistic SP - 530 EP - 537 JF - NeuroImage. Clinical JO - Neuroimage Clin VL - 11 N2 - 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. SN - 2213-1582 UR - https://www.unboundmedicine.com/medline/citation/27114901/Autonomic_correlations_with_MRI_are_abnormal_in_the_brainstem_vasomotor_centre_in_Chronic_Fatigue_Syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-1582(16)30058-4 DB - PRIME DP - Unbound Medicine ER -