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Could brain scans and artificial intelligence help diagnose ME/CFS?

Researchers at the Thompson Institute of the University of the Sunshine Coast in Australia are looking to use brain imaging to investigate the dynamics between blood supply, neuronal activity and energy needs in people living with ME/CFS.

Project lead Dr Zack Shan and his team are recruiting 300 participants with ME/CFS or fibromyalgia, and others who are sedentary but in good health, for a cross-sectional study to try to determine the neurobiological origins of ME/CFS.

MRI meets AI

The study is one of the first to combine magnetic resonance imaging (MRI) and machine learning. Machine learning is a type of artificial intelligence (AI) that allows software applications to become more accurate at predicting outcomes without being explicitly programmed to do so. Machine learning algorithms use historical data to predict new output values.

In an interview in Sunshine Coast News, Dr. Shan said:

“Machine learning allows us to analyse and gain insights from the vast amount of information brain imaging provides about how specific areas of the brain differ between people with and without fatigue conditions… Through this we aim to develop a neuro-marker – a biological indicator that can be used to diagnose ME/CFS and fibromyalgia.”

An entire book has been written on the potential benefits of machine learning, highlighting that biology and the science of life is immensely diverse and complex, and almost beyond the scope of the human mind to fully grasp. It concludes that computers and AI will lead the way in the field of biosciences over the coming decades.

What this means for ME/CFS science is that AI can now be allied to more traditional methods like genetic screening, biochemistry or brain imaging methods to make sense of vast amounts of complex data.

In Dr Shan’s brain study, AI could mean the ability to marry data from MRI scans with blood flow modelling software both to visualise and to predict brain blood flow irregularities, if present, and their potential impact on brain function, specifically the impact of reduced blood flow to certain critical areas of the brain.

Could inflammation cause altered brain blood flow?

In June, ME Research UK posted a short report on another Australian study at Griffith University in Queensland, which linked some symptoms of ME/CFS – such as fatigue, pain and sleep disturbance – with structural changes in a part of the brain called the hippocampus, detected via MRI.

Researchers in Japan have used more advanced, precise and expensive positron emission tomography (PET) to demonstrate widespread neuroinflammation in the brain of patients with ME/CFS, which was associated with the severity of their neuropsychological symptoms.

PET is a scan that can help reveal the metabolic or biochemical function of tissues and organs, using a radioactive tracer to show both normal and abnormal metabolic activity. It can detect abnormal metabolism of a tracer in a disease before that disease shows up on other imaging tests such as computerised tomography or MRI.

Most roads lead to the brain

The emerging picture is that chronic and unexplained fatigue, cognitive impairment and chronic widespread pain may all emanate from disruption to energy and bio-cellular processes in the brain and central nervous system. As such, the obvious thing to do is to explore both cellular biochemistry and blood flow in the brains of people suffering from ME/CFS.

For example, the Griffith University researchers point to inflammation and structural changes in the hippocampus, a complex structure deep in the temporal lobe of the brain, which is involved in cognition, memory and regulation of the hypothalamus (which controls autonomic nervous function).

We often hear of ‘autonomic dysfunction’ in ME/CFS and other conditions like long COVID, including abnormal control of blood pressure, postural tachycardia syndrome, post-exertional malaise, heart rate variability and so on – all possibly related to disruption of autonomic brain function.

Prof. Jarrad Younger, who leads the Neuroinflammation, Pain and Fatigue Laboratory at the University of Birmingham, Alabama, has published many relevant papers on neuro-inflammation, as well as YouTube videos describing how his team has identified inflammatory markers and metabolites like lactate suggesting that brain cells are under stress (not getting enough blood supply or not functioning normally due to possible infection).

ME Research UK is currently funding Prof. Younger for one of his latest projects exploring immune responses in the brain.

MRI as a diagnostic tool

Dr Shan aims to follow up on this earlier research by investigating brain inflammation further. He hopes the novel methods they are using at the Thompson Institute in Australia will result in one of the first studies to model regional brain blood flow regulation in response to tasks in ME/CFS patients, and will also be one of the first studies to measure neurotransmitter (chemical messenger in the brain) changes in response to cognitive tasks in ME/CFS patients.

Dr Shan hopes this study will provide a neurobiology model for ME/CFS, and pave the way for doctors to use MRI and PET brain scanning devices to detect and diagnose ME/CFS, and potentially also to develop novel treatments.

Finally, Dr Shan will compare the results in both ME/CFS and fibromyalgia patients to look for differences and similarities when compared against healthy sedentary controls.

ME Research UK continues to maintain strong links with researchers in Australia and around the world working on uncovering the biological causes and consequences of ME/CFS, and has invested more than £2.5 million in global ME research.

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