Understanding chronic fatigue syndrome

Using a state-of-the-art MRI scanner helps researchers understand the cognitive impairment which is often associated with chronic fatigue syndrome.

Jade Thai, Senior Research fellow and manager of CRIC Bristol, the University’s Clinical Research and Imaging Centre, conducts research into chronic fatigue syndrome (CFS). By analysing brain images generated by the centre’s high-technology MRI scanner, she can assess levels of brain activity involved when undertaking various tasks and then compare the patterns between people with and without the condition.

“The objective of my research is to get a clearer understanding of the cognitive impairment that is often associated with chronic fatigue syndrome”, said Jade. “I want to find out whether patients’ brains process information differently and whether this relates to their clinical symptoms.”

Chronic fatigue syndrome is a debilitating condition that leaves patients utterly exhausted. It affects around 250,000 in the UK (NHS Website 2013) and, to date, the reasons behind it remain unclear. There is no cure for CFS and treatment focuses on mitigating the impact of the condition, with cognitive behavioural therapy, exercise therapy and medication to control pain and sleep disorders.

Jade’s research is currently in its pilot phase. 15 people with CFS were recruited from various local CFS/myalgic encephalomyelitis (ME) action groups and charities. They were asked to undertake a variety of simple tasks while their brains were scanned by the MRI Scanner. The images were then compared to brain scans of a 15-strong group of people without CFS. The results demonstrated very different patterns of activity.

“We found that, although the patient group performed the task as well as the control group, their brain patterns were very different” said Jade. “The CFS group used significantly more of the brain than the control group, which indicates some sort of compensatory mechanism at play.”

These early findings were presented at an event hosted by The Wellcome Trust in London, in April 2013, at which CFS/ME researchers from around the UK shared research findings and identified gaps in current CFS research, with a view to defining future research priorities.

“The pilot study was funded by the University of Bristol’s Alumni Fund,” explains Jade. “The project also obtained additional funding from British Psychological Society for summer student scholarships and I am supervising two Masters students who are also attached to it. We have close links to the School of Social and Community at the University, working with Dr Esther Crawley who is the clinical lead.” The team is also working with Dr Rosemary Jones of Bristol and Avon MS Research Centre, Frenchay Hospital.

The CRIC MRI scanner, made by Siemens, generates incredibly detailed images and resulting data and it is a cutting-edge piece of equipment. “Having this facility on site is a huge advantage to our ability to make progress in this area”, commented Jade. “Although the research is in the early phases, I think that the outcomes for understanding this condition and its links to cognitive performance are positive.”

Next steps include expanding the study to look at issues around memory and attention. The study will consider the extent to which fatigue impacts upon cognitive performance, and the research will expand to patients with multiple sclerosis (MS), also known to suffer from extreme fatigue. Like CFS/ME there is little known about the impact of fatigue on cognitive performance with MS patients.

“In the long term, I hope that we can use this information to develop more effective therapies for Chronic Fatigue Syndrome, and really make a difference to the lives of sufferers.”

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