Brainstem volume changes in myalgic encephalomyelitis/chronic fatigue syndrome and long COVID patients

Kiran Thapaliya; Sonya Marshall-Gradisnik; Markus Barth; Natalie Eaton-Fitch; Leighton Barnden

doi:10.3389/fnins.2023.1125208

Brainstem volume changes in myalgic encephalomyelitis/chronic fatigue syndrome and long COVID patients

Front Neurosci. 2023 Mar 2:17:1125208. doi: 10.3389/fnins.2023.1125208. eCollection 2023.

Authors

Kiran Thapaliya^{1

2}, Sonya Marshall-Gradisnik¹, Markus Barth^{2

3}, Natalie Eaton-Fitch¹, Leighton Barnden¹

Affiliations

¹ National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
² Centre for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia.
³ School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD, Australia.

Abstract

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID patients have overlapping neurological, autonomic, pain, and post-exertional symptoms. We compared volumes of brainstem regions for 10 ME/CFS (CCC or ICC criteria), 8 long COVID (WHO Delphi consensus), and 10 healthy control (HC) subjects on 3D, T1-weighted MRI images acquired using sub-millimeter isotropic resolution using an ultra-high field strength of 7 Tesla. Group comparisons with HC detected significantly larger volumes in ME/CFS for pons (p = 0.004) and whole brainstem (p = 0.01), and in long COVID for pons (p = 0.003), superior cerebellar peduncle (p = 0.009), and whole brainstem (p = 0.005). No significant differences were found between ME/CFS and long COVID volumes. In ME/CFS, we detected positive correlations between the pons and whole brainstem volumes with "pain" and negative correlations between the midbrain and whole brainstem volumes with "breathing difficulty." In long COVID patients a strong negative relationship was detected between midbrain volume and "breathing difficulty." Our study demonstrated an abnormal brainstem volume in both ME/CFS and long COVID consistent with the overlapping symptoms.

Keywords: brainstem; breathing difficulty; long COVID; magnetic resonance imaging (MRI); myalgic encephalomyelitis/chronic fatigue syndrome; pain.

Grants and funding

This research is funded by ME Research UK (SCIO Charity Number SC036942) with the financial support of The Fred and Joan Davies Bequest. Other funding bodies include: The Stafford Fox Medical Research Foundation (489798), the National Health and Medical Research Council (1199502), McCusker Charitable Foundation (49979), Ian and Talei Stewart, Buxton Foundation (4676), Henty Community (4879), Henty Lions Club (4880), Mason Foundation (47107), Mr. Douglas Stutt, Blake Beckett Trust Foundation (4579), Alison Hunter Memorial Foundation (4570), and the Change for ME Charity (4575).