Increased Ventricular Lactate In Chronic Fatigue Syndrome

[ramakentesh]

http://www.ncbi.nlm.nih.gov/pubmed/22281935

getting interesting and very cerebral:

Increased ventricular lactate in chronic fatigue syndrome. III. Relationships to cortical glutathione and clinical symptoms implicate oxidative stress in disorder pathophysiology.

Shungu DC, Weiduschat N, Murrough JW, Mao X, Pillemer S, Dyke JP, Medow MS, Natelson BH, Stewart JM, Mathew SJ.

Abstract

Chronic fatigue syndrome (CFS) is a complex illness, which is often misdiagnosed as a psychiatric illness. In two previous reports, using (1) H MRSI, we found significantly higher levels of ventricular cerebrospinal fluid (CSF) lactate in patients with CFS relative to those with generalized anxiety disorder and healthy volunteers (HV), but not relative to those with major depressive disorder (MDD). In this third independent cross-sectional neuroimaging study, we investigated a pathophysiological model which postulated that elevations of CSF lactate in patients with CFS might be caused by increased oxidative stress, cerebral hypoperfusion and/or secondary mitochondrial dysfunction. Fifteen patients with CFS, 15 with MDD and 13 HVs were studied using the following modalities: (i) (1) H MRSI to measure CSF lactate; (ii) single-voxel (1) H MRS to measure levels of cortical glutathione (GSH) as a marker of antioxidant capacity; (iii) arterial spin labeling (ASL) MRI to measure regional cerebral blood flow (rCBF); and (iv) (31) P MRSI to measure brain high-energy phosphates as objective indices of mitochondrial dysfunction. We found elevated ventricular lactate and decreased GSH in patients with CFS and MDD relative to HVs. GSH did not differ significantly between the two patient groups. In addition, we found lower rCBF in the left anterior cingulate cortex and the right lingual gyrus in patients with CFS relative to HVs, but rCBF did not differ between those with CFS and MDD. We found no differences between the three groups in terms of any high-energy phosphate metabolites. In exploratory correlation analyses, we found that levels of ventricular lactate and cortical GSH were inversely correlated, and significantly associated with several key indices of physical health and disability. Collectively, the results of this third independent study support a pathophysiological model of CFS in which increased oxidative stress may play a key role in CFS etiopathophysiology.

[Katybug]

What has started to strike me about some of these studies is the low numbers of participants. If you took 15 of us (people on this forum dx'ed with POTS), I don't think it would turn out accurate results because of the vast variations we all have in our disease presentation. I know that CFS patients are similar to us in that way. How can they feel confident that using 15/15/13 is really giving scientifically accurate information?

[issie]

What does this indicate - mitro dysfunction due to oxidative stress?

[Trach]

Here is a link on oxidative stress

http://www.drweil.com/drw/u/QAA400537/Stumped-by-Oxidative-Stress.html

[issie]

Nice article. simple to understand.

[HopeSprings]

Isn't Dr. Stewart using vitamin C in some patients - wonder if it relates to this.