Up to 4 million Americans experience chronic fatigue syndrome (CFS), a debilitating, difficult-to-diagnose and complex disorder marked by extreme periods of fatigue that can last up to six months and are not improved by bed rest.

CFS is often thought of as a problem in adults, but it also affects children and adolescents. Between 0.2 percent and 2.3 percent of children or adolescents suffer from CFS. In children, particularly in adolescents, CFS is more likely to develop after an acute flu-like or mononucleosis-like illness.

An important area of research in CFS has been looking at ways that viruses may be involved in the cause of CFS. But CFS continues to be one of the greatest scientific and medical challenges. Besides overwhelming fatigue, CFS sufferers complain of joint and muscle pain, incapacitating headaches, food intolerance, sore throat, lymph node enlargement, gastrointestinal problems, abnormal blood pressure and hypersensitivity to light, noise and other sensations.

Because CFS can devastate a person's life for 10 to 30 years, researchers have been following 200 CFS patients for several years to identify the syndrome's underlying mechanisms. Recently, scientists at Stanford School of Medicine decided to try brain imaging to see if there were any differences between the brains of 14 healthy people and 15 CFS patients. And there were.

The Stanford researchers published their results Oct. 30. Basically, they discovered three key findings:

  • The MRI showed that overall white matter content of CFS patients' brains was reduced compared with that of healthy subjects' brains.
  • Using tensor imaging, especially suited to assessing the integrity of white matter, researchers identified a consistent abnormality in a particular part of a nerve tract in the right hemisphere of CFS patients' brains.
  • There was a fairly strong correlation between the degree of abnormality in a CFS patient's right arcuate fasciculus and the severity of the patient's condition, as assessed by performance on a standard psychometric test used to evaluate fatigue.

What researchers don't know is if the differences in the brain led to CFS or whether these were new changes that occurred since the people developed CFS. Also, if the differences led to CFS, were they always present or did some other unknown factors caused them to occur?

It must be remembered that this research only used a small sample of people with CFS who may not be representative of the many of thousands of people affected by this condition. This was a cross-sectional study that took the brain scans of 15 people with CFS and a comparison group of age- and sex-matched people without CFS.

The study objective was to research differences in the brain structure and used a special MRI technique called diffusion tensor imaging (DTI). DTI measures the diffusion of water through the brain tissues, which provides 3-D images of the size, shape and microscopic structure of tissues.

Certainly, further imaging studies of larger samples of people with this condition may reveal whether these results are consistent observations in the brain structure of people with CFS. The next step would be to try and understand how these differences are associated with the condition's development.