Distinct white matter alteration patterns in post-infectious and gradual onset chronic fatigue syndrome revealed by diffusion MRI

Abstract While post-infectious (PI-ME/CFS) and gradual onset (GO-ME/CFS) myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) manifest similar symptoms, it has long been suspected that different disease processes underlie them. However, the lack of biological evidence has left this question u...

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Main Authors: Qiang Yu, Richard A. Kwiatek, Peter Del Fante, Anya Bonner, Vince D. Calhoun, Grant A. Bateman, Takashi Yamamura, Zack Y. Shan
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-09379-z
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author Qiang Yu
Richard A. Kwiatek
Peter Del Fante
Anya Bonner
Vince D. Calhoun
Grant A. Bateman
Takashi Yamamura
Zack Y. Shan
author_facet Qiang Yu
Richard A. Kwiatek
Peter Del Fante
Anya Bonner
Vince D. Calhoun
Grant A. Bateman
Takashi Yamamura
Zack Y. Shan
author_sort Qiang Yu
collection DOAJ
description Abstract While post-infectious (PI-ME/CFS) and gradual onset (GO-ME/CFS) myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) manifest similar symptoms, it has long been suspected that different disease processes underlie them. However, the lack of biological evidence has left this question unanswered. In this study, how white matter microstructural changes in PI-ME/CFS and GO-ME/CFS patients were investigated. PI-ME/CFS and GO-ME/CFS patients were recruited based on consensus diagnoses made by two experienced clinicians and compared their diffusion MRI features with those of rigorously matched healthy controls (HCs) with sedentary lifestyles. PI-ME/CFS participants showed significantly higher axial diffusivity (AD) in several association and projection fibres compared to HCs. Higher AD in PI-ME/CFS was significantly related to worse physical health. In contrast, GO-ME/CFS participants exhibited significantly decreased AD in the corpus callosum. Lower AD in GO-ME/CFS was significantly associated with worse mental health in commissural and projection fibres. No significant group differences were found for fractional anisotropy, mean diffusivity, or radial diffusivity. Distinct patterns of AD alterations in PI-ME/CFS and GO-ME/CFS provide neurophysiological evidence of different disease processes and highlight the heterogeneities of ME/CFS.
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spelling doaj-art-47479edcb0d344df9deb76edf1dc146c2025-08-20T03:45:55ZengNature PortfolioScientific Reports2045-23222025-07-0115111310.1038/s41598-025-09379-zDistinct white matter alteration patterns in post-infectious and gradual onset chronic fatigue syndrome revealed by diffusion MRIQiang Yu0Richard A. Kwiatek1Peter Del Fante2Anya Bonner3Vince D. Calhoun4Grant A. Bateman5Takashi Yamamura6Zack Y. Shan7Thompson Institute, University of the Sunshine CoastThompson Institute, University of the Sunshine CoastThompson Institute, University of the Sunshine CoastThompson Institute, University of the Sunshine CoastTri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory UniversityDepartment of Medical Imaging, John Hunter HospitalDepartment of Immunology, National Institute of Neuroscience, National Center of Neurology and PsychiatryThompson Institute, University of the Sunshine CoastAbstract While post-infectious (PI-ME/CFS) and gradual onset (GO-ME/CFS) myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) manifest similar symptoms, it has long been suspected that different disease processes underlie them. However, the lack of biological evidence has left this question unanswered. In this study, how white matter microstructural changes in PI-ME/CFS and GO-ME/CFS patients were investigated. PI-ME/CFS and GO-ME/CFS patients were recruited based on consensus diagnoses made by two experienced clinicians and compared their diffusion MRI features with those of rigorously matched healthy controls (HCs) with sedentary lifestyles. PI-ME/CFS participants showed significantly higher axial diffusivity (AD) in several association and projection fibres compared to HCs. Higher AD in PI-ME/CFS was significantly related to worse physical health. In contrast, GO-ME/CFS participants exhibited significantly decreased AD in the corpus callosum. Lower AD in GO-ME/CFS was significantly associated with worse mental health in commissural and projection fibres. No significant group differences were found for fractional anisotropy, mean diffusivity, or radial diffusivity. Distinct patterns of AD alterations in PI-ME/CFS and GO-ME/CFS provide neurophysiological evidence of different disease processes and highlight the heterogeneities of ME/CFS.https://doi.org/10.1038/s41598-025-09379-zMyalgic encephalomyelitis/Chronic fatigue syndromePost-infectiousGradual onsetDiffusion tensor imagingAxial diffusivityWhite matter microstructure
spellingShingle Qiang Yu
Richard A. Kwiatek
Peter Del Fante
Anya Bonner
Vince D. Calhoun
Grant A. Bateman
Takashi Yamamura
Zack Y. Shan
Distinct white matter alteration patterns in post-infectious and gradual onset chronic fatigue syndrome revealed by diffusion MRI
Scientific Reports
Myalgic encephalomyelitis/Chronic fatigue syndrome
Post-infectious
Gradual onset
Diffusion tensor imaging
Axial diffusivity
White matter microstructure
title Distinct white matter alteration patterns in post-infectious and gradual onset chronic fatigue syndrome revealed by diffusion MRI
title_full Distinct white matter alteration patterns in post-infectious and gradual onset chronic fatigue syndrome revealed by diffusion MRI
title_fullStr Distinct white matter alteration patterns in post-infectious and gradual onset chronic fatigue syndrome revealed by diffusion MRI
title_full_unstemmed Distinct white matter alteration patterns in post-infectious and gradual onset chronic fatigue syndrome revealed by diffusion MRI
title_short Distinct white matter alteration patterns in post-infectious and gradual onset chronic fatigue syndrome revealed by diffusion MRI
title_sort distinct white matter alteration patterns in post infectious and gradual onset chronic fatigue syndrome revealed by diffusion mri
topic Myalgic encephalomyelitis/Chronic fatigue syndrome
Post-infectious
Gradual onset
Diffusion tensor imaging
Axial diffusivity
White matter microstructure
url https://doi.org/10.1038/s41598-025-09379-z
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