Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study

Journal of Nuclear Medicine

Akira Ishii¹  Hirohiko Kuratsune¹  Yasuhito Nakatomi¹  Sanae Fukuda¹  Kei Mizuno¹  Yosky Kataoka¹  Joji Kawabe¹  Kayo Onoe¹  Kouzi Yamaguti¹  Masaaki Inaba¹  Yasuyoshi Watanabe¹  Susumu Shiomi¹  Yasuhiro Wada¹  Shusaku Tazawa¹  Kazuhiro Takahashi¹  Masaaki Tanaka¹ 

关键词: neuroinflammation;    chronic fatigue syndrome (CFS);    myalgic encephalomyelitis (ME);    ¹¹C-(R)-PK11195;    positron emission tomography (PET);   

DOI  :  10.2967/jnumed.113.131045

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a disease characterized by chronic, profound, disabling, and unexplained fatigue. Although it is hypothesized that brain inflammation is involved in the pathophysiology of CFS/ME, there is no direct evidence of neuroinflammation in patients with CFS/ME. Activation of microglia or astrocytes is related to neuroinflammation. 11C-(R)-(2-chlorophenyl)-N-methyl-N-(1-methylpropyl)-3-isoquinoline-carboxamide (11C-(R)-PK11195) is a ligand of PET for a translocator protein that is expressed by activated microglia or astrocytes. We used 11C-(R)-PK11195 and PET to investigate the existence of neuroinflammation in CFS/ME patients. Methods: Nine CFS/ME patients and 10 healthy controls underwent 11C-(R)-PK11195 PET and completed questionnaires about fatigue, fatigue sensation, cognitive impairments, pain, and depression. To measure the density of translocator protein, nondisplaceable binding potential (BPND) values were determined using linear graphical analysis with the cerebellum as a reference region. Results: The BPND values of 11C-(R)-PK11195 in the cingulate cortex, hippocampus, amygdala, thalamus, midbrain, and pons were 45%–199% higher in CFS/ME patients than in healthy controls. In CFS/ME patients, the BPND values of 11C-(R)-PK11195 in the amygdala, thalamus, and midbrain positively correlated with cognitive impairment score, the BPND values in the cingulate cortex and thalamus positively correlated with pain score, and the BPND value in the hippocampus positively correlated with depression score. Conclusion: Neuroinflammation is present in widespread brain areas in CFS/ME patients and was associated with the severity of neuropsychologic symptoms. Evaluation of neuroinflammation in CFS/ME patients may be essential for understanding the core pathophysiology and for developing objective diagnostic criteria and effective medical treatments.

【 授权许可】

Unknown