Intra brainstem connectivity is impaired in chronic fatigue syndrome
Intra brainstem connectivity is impaired in chronic fatigue syndrome
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DOI：
10.1016/j.nicl.2019.102045
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发表时间：
2019-01-01
影响因子：
4.2
通讯作者：
Bhuta, Sandeep
中科院分区：
文献类型：
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作者：
Barnden, Leighton R.;Shan, Zack Y.;Bhuta, Sandeep
在肌痛性脑脊髓炎或慢性疲劳综合征(ME/CFS)中，异常的MRI与症状严重程度和自主神经测量的相关性表明脑干内的神经信号传导受损。在这里，我们分析功能磁共振成像的相关性，以直接测试脑干内部和来自脑干的连接。对45例ME/CFS(Fukuda标准)和27例健康对照(HC)进行静息和任务功能磁共振成像(FMRI)。我们选择了有限的脑干网状激活系统(RAS)感兴趣区(ROI)，基于先前在不同ME/CFS队列(双侧延髓嘴和中脑楔形核)、中缝背核和两个皮质下ROI(海马下托和丘脑层内核)中的结构MRI表现，据报道具有丰富的脑干连接。当分别分析HC和ME/CFs时，两组在休息和任务期间均发现显著的相关性，且任务期间的相关性比休息时更强。在ME/CFS中，延髓和中脑核团之间的联系缺失，尽管海马与这些核团的联系得到加强。当比较HC和ME/CFS的对应关系时，在延髓和楔状核之间的脑干以及脑干和海马与丘脑之间检测到ME/CFS连接缺陷，但仅在任务期间检测到。在CFS/ME中，某些RAS核之间较弱的连接与症状严重程度的增加有关。RAS神经元振荡信号促进丘脑-皮质振荡的一致性。脑干RAS连接缺陷可以解释自主神经的变化，并降低皮质振荡连贯性，这可能会损害注意力、记忆、认知功能、睡眠质量和肌肉张力，这些都是ME/CFS的症状。
In myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS), abnormal MRI correlations with symptom severity and autonomic measures have suggested impaired nerve signal conduction within the brainstem. Here we analyse fMRI correlations to directly test connectivity within and from the brainstem. Resting and task functional MRI (fMRI) were acquired for 45 ME/CFS (Fukuda criteria) and 27 healthy controls (HC). We selected limited brainstem reticular activation system (RAS) regions-of-interest (ROIs) based on previous structural MRI findings in a different ME/CFS cohort (bilateral rostral medulla and midbrain cuneiform nucleus), the dorsal Raphe nucleus, and two subcortical ROIs (hippocampus subiculum and thalamus intralaminar nucleus) reported to have rich brainstem connections. When HC and ME/CFS were analysed separately, significant correlations were detected for both groups during both rest and task, with stronger correlations during task than rest. In ME/CFS, connections were absent between medulla and midbrain nuclei, although hippocampal connections with these nuclei were enhanced. When corresponding correlations from HC and ME/CFS were compared, ME/CFS connectivity deficits were detected within the brainstem between the medulla and cuneiform nucleus and between the brainstem and hippocampus and intralaminar thalamus, but only during task. In CFS/ME, weaker connectivity between some RAS nuclei was associated with increased symptom severity. RAS neuron oscillatory signals facilitate coherence in thalamo-cortical oscillations. Brainstem RAS connectivity deficits can explain autonomic changes and diminish cortical oscillatory coherence which can impair attention, memory, cognitive function, sleep quality and muscle tone, all symptoms of ME/CFS.