Objective:

Determine neurostructural alterations seen on imaging in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

Background:

The neuroimmune condition known as myalgic encephalomyelitis (ME) is a chronic, complicated, and incapacitating condition marked by extreme fatigue that becomes worse with physical or mental activity and is not alleviated by rest. Because of its increased incidence post COVID-19 a better understanding was necessary as it cannot be easily explained. Our study aims to find common neurological factors through imaging that can be linked or that show a particular pattern in patient groups.

Design/Methods:

We conducted a systematic literature review following PRISMA protocols. PubMed database was searched using the keywords Imaging, and ME/CFS. 40 studies resulted, we evaluated age, gender, imaging technique, brain area affected, and neurostructural changes.

Results:

We included 12 studies reporting 652 patients with a mean age of 44.3 years. Of those 428 (65.6%) were diagnosed with ME/CFS using the Fukuda criteria, the remaining were healthy controls. Of which 84.5% were female. Studies used the 3T MRI scanner, applying techniques such as diffusion tensor imaging (DTI), arterial spin labeling (ASL), magnetic resonance spectroscopy (MRS), and functional MRI (fMRI). 5 studies (42%) reported predominantly white matter changes (decreased connectivity), 2 (16%) grey matter changes (volume reductions), and 5 (42%) presenting changes in both. Predominating areas affected include the cingulate gyrus (33%), pre-frontal cortex (58%), precentral gyrus (66%), corpus callosum (16%), cerebellum (25%), basal ganglia (42%), hippocampus (25%), thalamus (42%), and brainstem (25%). 2 studies (16%) presented higher BOLD (blood oxygen level dependent) signals in affected patients when compared to healthy individuals.

Conclusions: