Researchers have discovered convincing proof of irregularities in the brain and immune systems of individuals diagnosed with chronic fatigue syndrome (CFS), also referred to as myalgic encephalomyelitis (ME).

The results of this extensive research shed light on the underlying biological mechanisms of the condition that can lead to debilitating exhaustion. This study is groundbreaking in its revelation of a connection between imbalances in brain function and the experience of fatigue, indicating that these alterations may be a result of immune system irregularities.

According to Walter Koroshetz, the director of NINDS at NIH, individuals with ME/CFS experience genuine and debilitating symptoms, yet identifying the biological causes has proven to be a significant challenge. However, a thorough examination of a small group of individuals revealed several factors that are likely to play a role in their ME/CFS.

The research included a small group of 17 individuals and further investigation with a larger sample is necessary to establish the findings as a potential guide for future treatments. The applicability of these findings to long Covid is uncertain due to the recruitment and evaluation of patients before the pandemic. However, scientists have praised this study as a much-needed in-depth exploration into the biology of the condition.

“I am delighted to see the release of this significant paper,” stated Professor Karl Morten, who specializes in ME/CFS research at John Radcliffe Hospital, University of Oxford. He was not involved in the current study. “Although there have been various small studies indicating potential issues with specific cells, this is the first comprehensive examination of all aspects of the disease in a single patient.”

The participants in the research were chosen with great care from a group of 300 individuals and had all previously suffered from an infection before falling ill. Throughout the study, they resided at a clinic run by the National Institutes of Health for a period of one week and underwent various physical examinations.

Functional MRI brain scans revealed that individuals with ME/CFS displayed decreased activity in the temporal-parietal junction (TPJ) region, potentially leading to fatigue by interfering with decision-making processes related to exertion. The motor cortex, responsible for coordinating body movements, showed abnormal levels of activity during tasks that induced fatigue. No indications of muscle fatigue were observed.

This indicates that ME/CFS-related fatigue may stem from malfunctioning brain areas responsible for controlling the motor cortex. Additionally, changes in the brain could impact patients’ ability to handle physical exertion and how they experience feelings of fatigue.

Brian Walitt, the first author of the study published in Nature Communications and an associate research physician at NINDS, suggests that there may be a specific physiological factor causing fatigue in this group. Instead of being caused by physical exhaustion or lack of motivation, fatigue could be a result of a discrepancy between one’s perceived capabilities and their body’s actual performance.

Morten stated that finding abnormalities in brain function does not imply that patients are consciously causing their own illness or have any ability to control it. He explained that the brain can react to stimuli and affect the body, but the root cause of the malfunction is the illness itself, not the patient’s actions.

The individuals also experienced increased heart rates and it took a longer time for their blood pressure to return to normal after physical activity. There were also modifications in the patients’ T cells, which were taken from their cerebrospinal fluid, indicating that these immune cells were attempting to combat something. This may suggest that the immune system has not properly recovered after an infection or that there is an ongoing, undetected chronic infection in the body.

The writers map out a potential sequence of occurrences, beginning with a lasting immune reaction, that may result in shifts in the central nervous system. This could then impact brain chemistry and ultimately influence the performance of particular brain regions responsible for controlling movement and the perception of tiredness.

According to Avindra Nath, the clinical director at NINDS and senior author of the study, the brain is being impacted by immune activation in multiple ways, resulting in biochemical alterations and resulting effects on motor, autonomic, and cardiorespiratory function.

Scientists have embraced the results as a significant advancement in understanding the fundamental biological factors behind the illness. In the past, the absence of a definitive biological explanation has resulted in patients being disregarded, stigmatized, and forced to navigate inadequate treatment choices.

Source: theguardian.com