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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Veröffentlicht in:Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 2003-07, Vol.74 (7), p.922-928
Hauptverfasser: Siessmeier, T, Nix, W A, Hardt, J, Schreckenberger, M, Egle, U T, Bartenstein, P
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container_end_page 928
container_issue 7
container_start_page 922
container_title Journal of neurology, neurosurgery and psychiatry
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creator Siessmeier, T
Nix, W A
Hardt, J
Schreckenberger, M
Egle, U T
Bartenstein, P
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&amp;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. 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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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