MRI scanner

Neurological biomarkers in paediatric ME/CFS

Principal Investigators

Dr Sarah Knight and colleagues


Murdoch Children’s Research Institute, The Royal Children’s Hospital, University of Melbourne, Melbourne, Australia


ME Research UK

Background and aim

There are few, if any, good estimates of the numbers of children affected by ME/CFS. Assuming rough prevalence figures of 60 to 70 cases per 100,000, however, it is likely that around 9,000 people under the age of 16 in the UK have this diagnosis. As the report to the Chief Medical Officer in 2002 (read more) made clear, this illness “represents a substantial problem in the young” and “potentially threatens physical, emotional, and intellectual development of children and young people, and can disrupt education and social and family life, at a particularly vulnerable time of life”. For these reasons, scientific investigations of ME/CFS in young people are urgently needed, and may well result in important findings. ME Research UK-funded researchers at the University of Dundee, for example, have found biomedical anomalies in children with ME/CFS — increased oxidative stress and increased white blood cell apoptosis — similar to those seen in adults with the illness, and have shown that the quality of life of these children is profoundly reduced compared with their healthy counterparts (read more).

There is now very good evidence of difficulties with memory, concentration/attention, and information processing in adults with ME/CFS (read a review). The memory problems include difficulties with visual & verbal memory, short-term and long-term recall, and mental clouding (“brain fog”). These have significant effects on daily functioning at home or work, as most patients know. Much less is known about these neurocognitive difficulties in youngsters, particularly the role of mental exertion in worsening these symptoms. In fact, advanced structural and functional neuroimaging techniques have only rarely been applied to understanding the impact of ME/CFS on the function of the developing brain. For this reason, ME Research UK has awarded funding to Dr Sarah Knight and colleagues of the Murdoch Children’s Research Institute in Melbourne to examine how the brain and its underlying functioning responds to mental exertion in adolescents with ME/CFS, using a variety of neuroimaging techniques.

fMRI example
Researcher examining functional magnetic resonance images (NIMH – US Department of Health and Human Services)

Dr Knight and colleagues lead a growing paediatric ME/CFS clinical research program – the only program of its kind in Australia, and one of the very few in the world – which is dedicated to improving the lives of these children and adolescents. For this study, 25 adolescents diagnosed using the Canadian Clinical Criteria adapted for paediatricians and 25 matched healthy controls will have baseline functional neuroimaging, followed by 90 minutes of structured effortful thinking and learning activities similar to school work or home work, after which another brain scan will take place. The aim is to combine sophisticated brain imaging techniques with cognitive assessments to examine underlying brain function in these adolescent patients who are suffering from ME/CFS at a critical time in their development and are at risk of significant long-term consequences affecting their academic and social activities.

Further reading
Memory and attention problems in ME/CFS.
Biochemical and vascular aspects of pediatric chronic fatigue syndrome.
£1 million of biomedical research. A 32-page overview (pdf) of the projects ME Research UK has funded.

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