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Deep Assessment of Neuroinflammation

Using CNS Imaging and Analysis of CSF, Blood, Saliva Samples

To explore the hypothesis that low-grade neuroinflammation in the central nervous system can be part of the cardinal symptoms of ME/CFS.

  • Jonas Bergquist, MD, PhD
  • Wenzhong Xiao, PhD
  • Björn Bragée, MD
  • The analysis of cerebrospinal fluid and matching plasma samples are ongoing and manuscripts are in preparation.
  • Study protocol for MRI and PET imaging study was approved by the IRB in September 2024.
STUDY HYPOTHESIS AND DESCRIPTION

The overall aim is to explore the hypothesis that low-grade neuroinflammation in the central nervous system can be part of the cardinal symptoms of ME/CFS. Accumulating evidence suggests that ME/CFS patients can suffer from chronic neuroinflammation, the sustained activation of microglia and astrocytes, to strongly influence neurocognitive disturbances, headache, and fatigue and contribute to its progression. A major question is whether inhibition of the inflammatory response has the ability to reverse or slow down its symptoms. Furthermore, for many other brain diseases, such as neurodegenerative disorders, neuroinflammation is emerging as a cause, rather than a consequence, of the pathogenesis.

 

Neuroinflammation can possibly be monitored in cerebrospinal fluid (CSF) as a result of the inflammatory reaction itself or as secondary markers of cell degradation and impaired cell repair mechanisms. Our study will be the first to systematically measure CNS structural abnormalities in a large ME/CFS case-control study using CSF collection and in-situ measurement of intracranial pressure together with the study of microglia activation by the application of a novel diffusion-based MRI methodology. Added to this will be collected biospecimens to perform extensive state-of-the-art analyses with the ambition to identify diagnostic and prognostic biomarkers.

OBJECTIVES

Graphic showing how proinflamatory cytokines and damage to blood brain barrier

  • Characterize neuroinflammation by CSF composition analyses, monitoring inflammatory markers, as well as markers of cell damage and impaired cell repair mechanisms.
  • Characterize the prevalence and severity of CNS structural abnormalities and microglia activation using structural and diffusion-based magnetic resonance imaging (MRI).
  • Characterize CSF pressure and flow using noninvasive and invasive techniques during lumbar puncture.
  • Identify biomarkers of the disease by extensive and detailed analyses of CSF and blood using proteomics and metabolomics.
  • Conduct and analyze special magnetic resonance imaging of neuroinflammatory involvement of activated microglia in patients with ME/CFS (and later Long COVID) for an available neuroinflammatory detection tool and to be used in outcome measures in clinical trials.
Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME / CFS) Post Treatment Lyme Disease Syndrome (PTLDS), Fibromyalgia Leading Research. Delivering Hope.Open Medicine Foundation®

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