TY - JOUR
T1 - Intracranial compliance is associated with symptoms of orthostatic intolerance in chronic fatigue syndrome
AU - Finkelmeyer, Andreas
AU - He, Jiabao
AU - Maclachlan, Laura
AU - Blamire, Andrew M.
AU - Newton, Julia
N1 - Funding: This research was funded through a grant by the UK Medical Research Council (https://www.mrc.ac.uk/) awarded to JLN (MR/J002712/1). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
PY - 2018
Y1 - 2018
N2 - Symptoms of orthostatic intolerance (OI) are common in Chronic Fatigue Syndrome (CFS) and similar disorders. These symptoms may relate to individual differences in intracranial compliance and cerebral blood perfusion. The present study used phase-contrast, quantitative flow magnetic resonance imaging (MRI) to determine intracranial compliance based on
arterial inflow, venous outflow and cerebrospinal fluid flow along the spinal canal into and out of the cranial cavity. Flow-sensitive Alternating Inversion Recovery (FAIR) Arterial Spin
Labelling was used to measure cerebral blood perfusion at rest. Forty patients with CFS and 10 age and gender matched controls were scanned. Severity of symptoms of OI was
determined from self-report using the Autonomic Symptom Profile. CFS patients reported significantly higher levels of OI (p < .001). Within the patient group, higher severity of OI
symptoms were associated with lower intracranial compliance (r = -.346, p = .033) and higher resting perfusion (r = .337, p = .038). In both groups intracranial compliance was negatively
correlated with cerebral perfusion. There were no significant differences between the
groups in intracranial compliance or perfusion. In patients with CFS, low intracranial compliance
and high resting cerebral perfusion appear to be associated with an increased severity
of symptoms of OI. This may signify alterations in the ability of the cerebral vasculature to
cope with changes to systemic blood pressure due to orthostatic stress, but this may not be
specific to CFS.
AB - Symptoms of orthostatic intolerance (OI) are common in Chronic Fatigue Syndrome (CFS) and similar disorders. These symptoms may relate to individual differences in intracranial compliance and cerebral blood perfusion. The present study used phase-contrast, quantitative flow magnetic resonance imaging (MRI) to determine intracranial compliance based on
arterial inflow, venous outflow and cerebrospinal fluid flow along the spinal canal into and out of the cranial cavity. Flow-sensitive Alternating Inversion Recovery (FAIR) Arterial Spin
Labelling was used to measure cerebral blood perfusion at rest. Forty patients with CFS and 10 age and gender matched controls were scanned. Severity of symptoms of OI was
determined from self-report using the Autonomic Symptom Profile. CFS patients reported significantly higher levels of OI (p < .001). Within the patient group, higher severity of OI
symptoms were associated with lower intracranial compliance (r = -.346, p = .033) and higher resting perfusion (r = .337, p = .038). In both groups intracranial compliance was negatively
correlated with cerebral perfusion. There were no significant differences between the
groups in intracranial compliance or perfusion. In patients with CFS, low intracranial compliance
and high resting cerebral perfusion appear to be associated with an increased severity
of symptoms of OI. This may signify alterations in the ability of the cerebral vasculature to
cope with changes to systemic blood pressure due to orthostatic stress, but this may not be
specific to CFS.
U2 - 10.1371/journal.pone.0200068
DO - 10.1371/journal.pone.0200068
M3 - Article
SN - 1932-6203
VL - 13
JO - PloS ONE
JF - PloS ONE
IS - 7
M1 - 0200068
ER -