Brainstem volume changes in ME/CFS and long COVID patients

Principal investigator

Dr Leighton Barnden
Griffith University, Gold Coast, Queensland, Australia

Key findings

  • ME/CFS and long COVID patients had larger than normal volumes of several areas of the brainstem
  • These volume changes correlated with clinical measures of pain and breathing difficulty

About the study

Many of the symptoms experienced by people with ME/CFS suggest abnormalities in the brain and nervous system, and research has demonstrated changes to the structure of the brain in ME/CFS patients, as well as impairments in the connectivity between different regions of the brain.

Dr Leighton Barnden and his team at Griffith University in Queensland, Australia have been particularly active in this area, and are expert in the use of magnetic resonance imaging (MRI) to explore the brain in detail.

Jiasheng Su, Leighton Barnden and Kiran Thapaliya

Their findings to date suggest that nerve signalling in the brainstem is impaired in ME/CFS. In particular, they have reported correlations between abnormal MRI findings and autonomic measures within the reticular activation system (RAS) of the brainstem. The RAS is a network of small interconnected nuclei which are involved in controlling the sleep–wake cycle and brain arousal levels, which affect attention, sensory perception, cognitive performance and memory, all of which are deficient in ME/CFS.

ME Research UK (with the financial support of The Fred and Joan Davies Bequest) awarded funding to Dr Barnden to explore the brainstem further using a stronger 7-Tesla MRI scanner, which should provide better sensitivity and resolution.

The first results of this study have now been published in the journal Frontiers in Neuroscience.

Kiran Thapaliya and colleagues used their new 7-tesla MRI scanner to assess different regions of the brainstem in 10 people with ME/CFS, 8 people with long COVID and 10 healthy control subjects.

Compared with the healthy controls, ME/CFS patients had a larger whole brainstem volume, as well as a larger volume of a particular area called the ‘pons’.

Long COVID patients had a larger brainstem volume than controls, as well as a larger ‘pons’ and larger ‘superior cerebellar peduncle’.

Interestingly, there were no differences in these measurements between ME/CFS and long COVID patients.

The researchers also assessed the presence and severity of symptoms in each of the participants, as well as their quality of life. And they found that whole and regional brainstem volumes in ME/CFS and long COVID patients were significantly associated with clinical measures of pain and breathing difficulty.

Although this was a pilot study with a relatively small number of participants, the researchers say their findings do suggest that ME/CFS and long COVID have similar brainstem abnormalities, and that these may contribute to their neurological symptoms.

The team is scanning more subjects and have a number of other analyses to conduct, so we look forward to seeing more results from them in due course.


Thapaliya K, Marshall-Gradisnik S, Barth M, Eaton-Fitch N, Barnden L
Frontiers in Neuroscience, 2023 March 2; 17:1125208


ME Research UK with the financial support of The Fred and Joan Davies Bequest.

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