Observer independent analysis of cerebral glucose metabolism in patients with chronic fatigue syndrome
Objectives: To evaluate cerebral glucose metabolism, assessed by 18-fluorodeoxyglucose positron emission tomography (FDG-PET), in patients with chronic fatigue syndrome (CFS), using an observer independent analytical approach; and to characterise any observed alterations by correlating them with neu...
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description | Objectives: To evaluate cerebral glucose metabolism, assessed by 18-fluorodeoxyglucose positron emission tomography (FDG-PET), in patients with chronic fatigue syndrome (CFS), using an observer independent analytical approach; and to characterise any observed alterations by correlating them with neuropsychological deficits. Methods: 26 patients (13 female, 13 male) were examined. They all fulfilled the CDC diagnostic criteria for CFS. Their ages ranged from 26 to 61 years (mean (SD) age, 43 (9.3) years). They underwent extensive psychometric testing including the hospital anxiety and depression scale (HADS) and the short form 36 item health questionnaire (SF-36). Brain FDG-PET was done in all the subjects. After stereotactic normalisation, single subject comparisons with an age and sex matched normal database (n = 18) and a group comparison between the patients and normal controls were undertaken, along with additional correlation analyses between brain metabolism and psychometric test scores. Results: 12 of the 26 patients showed no significant decrease in FDG uptake compared with the controls. Of the remaining 14, 12 showed hypometabolism bilaterally in the cingulate gyrus and the adjacent mesial cortical areas. Five of these 12 patients also had decreased metabolism in the orbitofrontal cortex. The two remaining patients had hypometabolism in the cuneus/praecuneus. Correlation analyses showed significant correlations between some test scores (anxiety, depression, health related quality of life) but not fatigue and regional reductions in glucose metabolism. Conclusions: Although abnormalities in FDG-PET were only detectable in approximately half the CFS patients examined, and no specific pattern for CFS could be identified, PET may provide valuable information in helping to separate CFS patients into subpopulations with and without apparent alterations in the central nervous system. |
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Methods: 26 patients (13 female, 13 male) were examined. They all fulfilled the CDC diagnostic criteria for CFS. Their ages ranged from 26 to 61 years (mean (SD) age, 43 (9.3) years). They underwent extensive psychometric testing including the hospital anxiety and depression scale (HADS) and the short form 36 item health questionnaire (SF-36). Brain FDG-PET was done in all the subjects. After stereotactic normalisation, single subject comparisons with an age and sex matched normal database (n = 18) and a group comparison between the patients and normal controls were undertaken, along with additional correlation analyses between brain metabolism and psychometric test scores. Results: 12 of the 26 patients showed no significant decrease in FDG uptake compared with the controls. Of the remaining 14, 12 showed hypometabolism bilaterally in the cingulate gyrus and the adjacent mesial cortical areas. Five of these 12 patients also had decreased metabolism in the orbitofrontal cortex. The two remaining patients had hypometabolism in the cuneus/praecuneus. Correlation analyses showed significant correlations between some test scores (anxiety, depression, health related quality of life) but not fatigue and regional reductions in glucose metabolism. Conclusions: Although abnormalities in FDG-PET were only detectable in approximately half the CFS patients examined, and no specific pattern for CFS could be identified, PET may provide valuable information in helping to separate CFS patients into subpopulations with and without apparent alterations in the central nervous system.</description><identifier>ISSN: 0022-3050</identifier><identifier>EISSN: 1468-330X</identifier><identifier>DOI: 10.1136/jnnp.74.7.922</identifier><identifier>PMID: 12810781</identifier><identifier>CODEN: JNNPAU</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>18-fluorodeoxyglucose positron emission tomography ; Adult ; Anxiety ; Biological and medical sciences ; Brain - metabolism ; CDC ; Centers for Disease Control ; CFS ; Chronic fatigue syndrome ; Disease ; Fatigue Syndrome, Chronic - physiopathology ; FDG PET ; Female ; Fluorodeoxyglucose F18 ; full width half maximum ; FWHM ; Glucose ; Glucose - metabolism ; HADS ; health related quality of life ; hospital anxiety and depression scale ; Hospitals ; HRQOL ; Humans ; Male ; Measurement ; Medical sciences ; Mental depression ; Metabolism ; Middle Aged ; Nervous system (semeiology, syndromes) ; Nervous system as a whole ; Neurology ; Neuropsychology ; observer independent analysis ; PET ; PET imaging ; Physiological aspects ; positron emission tomography ; Quality of life ; Quantitative psychology ; Questionnaires ; Radiopharmaceuticals ; SCID ; SF-36 ; short form 36 item questionnaire ; single photon emission computed tomography ; SPECT ; structured clinical interview for DSM-IV ; Tomography ; Tomography, Emission-Computed</subject><ispartof>Journal of neurology, neurosurgery and psychiatry, 2003-07, Vol.74 (7), p.922-928</ispartof><rights>Copyright 2003 Journal of Neurology Neurosurgery and Psychiatry</rights><rights>2003 INIST-CNRS</rights><rights>COPYRIGHT 2003 BMJ Publishing Group Ltd.</rights><rights>Copyright: 2003 Copyright 2003 Journal of Neurology Neurosurgery and Psychiatry</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b589t-27d6d7d58e8c2764e336ddc4e287d6ccfae007d3214e5fe5a64e94d3bbe359633</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1738575/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1738575/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14873436$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12810781$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Siessmeier, T</creatorcontrib><creatorcontrib>Nix, W A</creatorcontrib><creatorcontrib>Hardt, J</creatorcontrib><creatorcontrib>Schreckenberger, M</creatorcontrib><creatorcontrib>Egle, U T</creatorcontrib><creatorcontrib>Bartenstein, P</creatorcontrib><title>Observer independent analysis of cerebral glucose metabolism in patients with chronic fatigue syndrome</title><title>Journal of neurology, neurosurgery and psychiatry</title><addtitle>J Neurol Neurosurg Psychiatry</addtitle><description>Objectives: To evaluate cerebral glucose metabolism, assessed by 18-fluorodeoxyglucose positron emission tomography (FDG-PET), in patients with chronic fatigue syndrome (CFS), using an observer independent analytical approach; and to characterise any observed alterations by correlating them with neuropsychological deficits. Methods: 26 patients (13 female, 13 male) were examined. They all fulfilled the CDC diagnostic criteria for CFS. Their ages ranged from 26 to 61 years (mean (SD) age, 43 (9.3) years). They underwent extensive psychometric testing including the hospital anxiety and depression scale (HADS) and the short form 36 item health questionnaire (SF-36). Brain FDG-PET was done in all the subjects. After stereotactic normalisation, single subject comparisons with an age and sex matched normal database (n = 18) and a group comparison between the patients and normal controls were undertaken, along with additional correlation analyses between brain metabolism and psychometric test scores. Results: 12 of the 26 patients showed no significant decrease in FDG uptake compared with the controls. Of the remaining 14, 12 showed hypometabolism bilaterally in the cingulate gyrus and the adjacent mesial cortical areas. Five of these 12 patients also had decreased metabolism in the orbitofrontal cortex. The two remaining patients had hypometabolism in the cuneus/praecuneus. Correlation analyses showed significant correlations between some test scores (anxiety, depression, health related quality of life) but not fatigue and regional reductions in glucose metabolism. Conclusions: Although abnormalities in FDG-PET were only detectable in approximately half the CFS patients examined, and no specific pattern for CFS could be identified, PET may provide valuable information in helping to separate CFS patients into subpopulations with and without apparent alterations in the central nervous system.</description><subject>18-fluorodeoxyglucose positron emission tomography</subject><subject>Adult</subject><subject>Anxiety</subject><subject>Biological and medical sciences</subject><subject>Brain - metabolism</subject><subject>CDC</subject><subject>Centers for Disease Control</subject><subject>CFS</subject><subject>Chronic fatigue syndrome</subject><subject>Disease</subject><subject>Fatigue Syndrome, Chronic - physiopathology</subject><subject>FDG PET</subject><subject>Female</subject><subject>Fluorodeoxyglucose F18</subject><subject>full width half maximum</subject><subject>FWHM</subject><subject>Glucose</subject><subject>Glucose - metabolism</subject><subject>HADS</subject><subject>health related quality of life</subject><subject>hospital anxiety and depression scale</subject><subject>Hospitals</subject><subject>HRQOL</subject><subject>Humans</subject><subject>Male</subject><subject>Measurement</subject><subject>Medical sciences</subject><subject>Mental depression</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Nervous system as a whole</subject><subject>Neurology</subject><subject>Neuropsychology</subject><subject>observer independent analysis</subject><subject>PET</subject><subject>PET imaging</subject><subject>Physiological aspects</subject><subject>positron emission tomography</subject><subject>Quality of life</subject><subject>Quantitative psychology</subject><subject>Questionnaires</subject><subject>Radiopharmaceuticals</subject><subject>SCID</subject><subject>SF-36</subject><subject>short form 36 item questionnaire</subject><subject>single photon emission computed tomography</subject><subject>SPECT</subject><subject>structured clinical interview for DSM-IV</subject><subject>Tomography</subject><subject>Tomography, 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T</creator><creator>Nix, W A</creator><creator>Hardt, J</creator><creator>Schreckenberger, M</creator><creator>Egle, U T</creator><creator>Bartenstein, P</creator><general>BMJ Publishing Group Ltd</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><general>BMJ 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cerebral glucose metabolism in patients with chronic fatigue syndrome</title><author>Siessmeier, T ; Nix, W A ; Hardt, J ; Schreckenberger, M ; Egle, U T ; Bartenstein, P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b589t-27d6d7d58e8c2764e336ddc4e287d6ccfae007d3214e5fe5a64e94d3bbe359633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>18-fluorodeoxyglucose positron emission tomography</topic><topic>Adult</topic><topic>Anxiety</topic><topic>Biological and medical sciences</topic><topic>Brain - metabolism</topic><topic>CDC</topic><topic>Centers for Disease Control</topic><topic>CFS</topic><topic>Chronic fatigue syndrome</topic><topic>Disease</topic><topic>Fatigue Syndrome, Chronic - physiopathology</topic><topic>FDG PET</topic><topic>Female</topic><topic>Fluorodeoxyglucose F18</topic><topic>full width half maximum</topic><topic>FWHM</topic><topic>Glucose</topic><topic>Glucose - metabolism</topic><topic>HADS</topic><topic>health related quality of life</topic><topic>hospital anxiety and depression scale</topic><topic>Hospitals</topic><topic>HRQOL</topic><topic>Humans</topic><topic>Male</topic><topic>Measurement</topic><topic>Medical sciences</topic><topic>Mental depression</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Nervous system as a whole</topic><topic>Neurology</topic><topic>Neuropsychology</topic><topic>observer independent analysis</topic><topic>PET</topic><topic>PET imaging</topic><topic>Physiological aspects</topic><topic>positron emission tomography</topic><topic>Quality of life</topic><topic>Quantitative psychology</topic><topic>Questionnaires</topic><topic>Radiopharmaceuticals</topic><topic>SCID</topic><topic>SF-36</topic><topic>short form 36 item questionnaire</topic><topic>single photon emission 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psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Siessmeier, T</au><au>Nix, W A</au><au>Hardt, J</au><au>Schreckenberger, M</au><au>Egle, U T</au><au>Bartenstein, P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Observer independent analysis of cerebral glucose metabolism in patients with chronic fatigue syndrome</atitle><jtitle>Journal of neurology, neurosurgery and psychiatry</jtitle><addtitle>J Neurol Neurosurg Psychiatry</addtitle><date>2003-07-01</date><risdate>2003</risdate><volume>74</volume><issue>7</issue><spage>922</spage><epage>928</epage><pages>922-928</pages><issn>0022-3050</issn><eissn>1468-330X</eissn><coden>JNNPAU</coden><abstract>Objectives: To evaluate cerebral glucose metabolism, assessed by 18-fluorodeoxyglucose positron emission tomography (FDG-PET), in patients with chronic fatigue syndrome (CFS), using an observer independent analytical approach; and to characterise any observed alterations by correlating them with neuropsychological deficits. Methods: 26 patients (13 female, 13 male) were examined. They all fulfilled the CDC diagnostic criteria for CFS. Their ages ranged from 26 to 61 years (mean (SD) age, 43 (9.3) years). They underwent extensive psychometric testing including the hospital anxiety and depression scale (HADS) and the short form 36 item health questionnaire (SF-36). Brain FDG-PET was done in all the subjects. After stereotactic normalisation, single subject comparisons with an age and sex matched normal database (n = 18) and a group comparison between the patients and normal controls were undertaken, along with additional correlation analyses between brain metabolism and psychometric test scores. Results: 12 of the 26 patients showed no significant decrease in FDG uptake compared with the controls. Of the remaining 14, 12 showed hypometabolism bilaterally in the cingulate gyrus and the adjacent mesial cortical areas. Five of these 12 patients also had decreased metabolism in the orbitofrontal cortex. The two remaining patients had hypometabolism in the cuneus/praecuneus. Correlation analyses showed significant correlations between some test scores (anxiety, depression, health related quality of life) but not fatigue and regional reductions in glucose metabolism. Conclusions: Although abnormalities in FDG-PET were only detectable in approximately half the CFS patients examined, and no specific pattern for CFS could be identified, PET may provide valuable information in helping to separate CFS patients into subpopulations with and without apparent alterations in the central nervous system.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>12810781</pmid><doi>10.1136/jnnp.74.7.922</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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subjects | 18-fluorodeoxyglucose positron emission tomography Adult Anxiety Biological and medical sciences Brain - metabolism CDC Centers for Disease Control CFS Chronic fatigue syndrome Disease Fatigue Syndrome, Chronic - physiopathology FDG PET Female Fluorodeoxyglucose F18 full width half maximum FWHM Glucose Glucose - metabolism HADS health related quality of life hospital anxiety and depression scale Hospitals HRQOL Humans Male Measurement Medical sciences Mental depression Metabolism Middle Aged Nervous system (semeiology, syndromes) Nervous system as a whole Neurology Neuropsychology observer independent analysis PET PET imaging Physiological aspects positron emission tomography Quality of life Quantitative psychology Questionnaires Radiopharmaceuticals SCID SF-36 short form 36 item questionnaire single photon emission computed tomography SPECT structured clinical interview for DSM-IV Tomography Tomography, Emission-Computed |
title | Observer independent analysis of cerebral glucose metabolism in patients with chronic fatigue syndrome |
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