Myalgic Encephalomyelitis or Chronic Fatigue Syndrome (ME/CFS) subjects suffer from a variety of cognitive complaints indicating that the central nervous system plays a role in its pathophysiology. Recently, the ratio T1w/T2w has been used to study changes in tissue myelin and/or iron levels in neurodegenerative diseases such as multiple sclerosis and schizophrenia. In this study, we applied the T1w/T2w method to detect changes in tissue microstructure in ME/CFS patients relative to healthy controls. We mapped the T1w/T2w signal intensity values in the whole brain for forty-five ME/CFS patients who met Fukuda criteria and twenty-seven healthy controls and applied both region- and voxel-based quantification. We also performed interaction-with-group regressions with clinical measures to test for T1w/T2w relationships that are abnormal in ME/CFS at the population level. Region-based analysis showed significantly elevated T1w/T2w values (increased myelin and/or iron) in ME/CFS in both white matter (WM) and subcortical grey matter. The voxel-based group comparison with sub-millimetre resolution voxels detected very significant clusters with increased T1w/T2w in ME/CFS, mostly in subcortical grey matter, but also in brainstem and projection WM tracts. No areas with decreased T1w/T2w were found in either analysis. ME/CFS T1w/T2w regressions with heart-rate variability, cognitive performance, respiration rate and physical well-being were abnormal in both gray and white matter foci. Our study demonstrates that the T1w/T2w approach is very sensitive and shows increases in myelin and/or iron in WM and basal ganglia in ME/CFS.

肌痛性脑脊髓炎或慢性疲劳综合症（ME/CFS）受试者患有多种认知疾病，表明中枢神经系统在其病理生理学中发挥着作用。最近，T1w/T2w 比率已被用于研究神经退行性疾病（如多发性硬化症和精神分裂症）中组织髓磷脂和/或铁水平的变化。在本研究中，我们应用 T1w/T2w 方法来检测 ME/CFS 患者相对于健康对照的组织微观结构变化。我们绘制了 45 名符合福田标准的 ME/CFS 患者和 27 名健康对照者全脑的 T1w/T2w 信号强度值，并应用了基于区域和体素的量化。我们还通过临床测量进行了群体交互回归，以测试人群水平上 ME/CFS 中异常的 T1w/T2w 关系。基于区域的分析显示，ME/CFS 中白质 (WM) 和皮质下灰质的 T1w/T2w 值显着升高（髓磷脂和/或铁增加）。基于体素的组与亚毫米分辨率体素的比较检测到 ME/CFS 中 T1w/T2w 增加的非常显着的簇，主要在皮质下灰质中，但也在脑干和投射 WM 束中。任一分析均未发现 T1w/T2w 降低的区域。灰质和白质病灶的 ME/CFS T1w/T2w 回归与心率变异性、认知表现、呼吸频率和身体健康均异常。我们的研究表明，T1w/T2w 方法非常敏感，并且显示 WM 中的髓磷脂和/或铁以及 ME/CFS 中的基底神经节增加。