The Neurobiology of Post-Exertional Fatigue in Patients with ME/CFS
Research type
Research Study
Full title
Is fatigue in patients with chronic fatigue syndrome associated with the top-down activation of an interoceptive network known to be associated with sickness behaviour in response to immune activation?
IRAS ID
214809
Contact name
Mark John James Edwards
Contact email
Sponsor organisation
St George's University of London
Duration of Study in the UK
0 years, 6 months, 1 days
Research summary
The Neurobiology of Post-Exertional Fatigue in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/ CFS)
Severe tiredness after exercise is a key, debilitating feature of ME/CFS, but is poorly understood. Following any illness people experience a transient increase in blood markers of inflammation, and tiredness. We have previously discovered that this inflammation transiently activates a part of the brain called the insula, and the level of activation corresponds to the levels of reported tiredness. We have funding from the UK Medical Research Council to investigate whether ME/CFS sufferers have persistently high levels of activation of this brain region, and whether abnormal increases in activation of this region after exercise, correspond to the worsening of fatigue, and a rise of inflammatory blood markers, after exercise.
We will recruit healthy controls locally, and patients via the Sussex Community NHS Trust CFS/ME service with a confirmed diagnosis of ME/CFS. After an initial screening process over the phone, all assessments will take place at the University of Sussex. On day 1, participants will undergo assessments of fatigue/mood, brain scans and blood tests. They will then undertake 10 minutes of supervised exercise on an exercise bike which they can voluntarily terminate. On day 2, participants will repeat the blood tests, mood/fatigue assessment, brain scans, and exercise task. The brain scans will use functional MRI to identify the brain networks that are abnormally activated in patients with ME/CFS after exercise. The blood tests will identify inflammatory markers in the blood stream that rise after exercise and may correspond to levels of brain activation and reported fatigue.
This study has the potential to identify a brain network that is abnormally and persistently activated in patients with ME/CFS. A better understanding of the neurobiological cause of ME/CFS will ultimately allow us to develop better forms of treatment for this common, debilitating illness.
REC name
London - City & East Research Ethics Committee
REC reference
17/LO/1013
Date of REC Opinion
22 Jun 2017
REC opinion
Favourable Opinion