Researchers from Stanford University conducted an imaging study and discovered distinct differences in the brains of healthy people and those with chronic fatigue syndrome. These findings can improve diagnoses and may be a step towards identifying the underlying mechanism of the condition.

Published in Radiology, the study addresses ambiguities that get in the way of properly diagnosing patients. Because of these ambiguities, many are suspected of other conditions first, even hypochondria, before finally being diagnosed as suffering from chronic fatigue syndrome.

In the United States alone, the condition affects between one and four million people. A more precise number can't be generated because of the difficulty in diagnosing chronic fatigue syndrome. While all patients share the common symptom of debilitating fatigue that lasts for at least six months, other symptoms may be present which may vary from person to person, often overlapping with other conditions.

Senior author Jose Montoya, MD, a geographic medicine and infectious diseases professor in the university, said that the combined symptoms of chronic fatigue syndrome can persist for 10 to 30 years.

"We asked ourselves whether brain imaging could turn up something concrete that differs between CFS patients' and healthy people's brains. And, interestingly, it did," explained lead author Michael Zeineh, MD, PhD, a radiology assistant professor in Stanford.

Montoya has been tracking 200 chronic fatigue syndrome patients for several years and from this group the researchers chose 15 individuals. Their brain images were compared with those from 14 other people without chronic fatigue syndrome symptoms.

Three key findings were derived from the study: that chronic fatigue syndrome patients had less white-matter content compared to healthy individuals; that a consistent abnormality in the right arcuate fasciculus is present in chronic fatigue syndrome patients; and that the gray matter joined by the right arcuate fasciculus exhibited thickening in chronic fatigue syndrome patients.

Further research is needed to confirm the findings of the study but it was a start, showing researchers where to look and focus. The Stanford team is currently planning a substantially larger study to continue their efforts.

Other co-authors for the study include: James Kang, MD, a former medical fellow; Scott Atlas, MD, former radiology professor and neuroradiology chief; Allan Reiss, MD, psychiatry and behavioral sciences and radiology professor; Mira Raman, lead scientific programmer; Jane Norris, physician assistant; and Ian Valencia, social-science research assistant.

The study received support from the CFS Fund and GE Healthcare.

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