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Neuroendocrine, Vascular and Metabolism in ME/CFS, POTS and Long COVID

Study AIM

The study will explore the structural, neuro-vascular, and biochemical differences in the brains of individuals with ME/CFS, Long COVID, and POTS to elucidate the underlying pathology and identify potential targets for effective treatment strategies.

INVESTIGATORS
  • Xiaoyun Wang, PhD
  • Elena Christopoulos
  • Natalie Thomas, PhD
  • David Fineberg, MBBS, FRACGP, DCH
  • Paul Gooley, PhD
  • Leigh Johnston, PhD
  • Rebecca Glarin, BApSc, PGDip(MRI)
  • Rob Williams
  • Bradford Moffat, PhD
  • Christopher Rowe, BMBS, FRACP, MD, FAANMS
  • Christopher Armstrong, PhD
Updates and Potential
  • Developed a collaboration with Austin Hospital and the Melbourne Brain Centre to conduct extensive MRI and PET studies.
  • Will be conducted on ME/CFS, LC and POTS patients along with healthy controls.
  • MRI analysis of blood flow before and after exertion.
  • MRS analysis of metabolite in brain changing before and after exertion.
  • PET scan to assess neuroinflammation and to assess blood flow upon standing.
  • Recruitment to begin mid-2024.
STUDY HYPOTHESIS AND DESCRIPTION

We’re exploring the connections between ME/CFS, Long COVID (LC), and POTS, as they often share similar symptoms and frequently occur together, making it challenging for patients to manage their symptoms and maintain a good quality of life.

Recent research suggests that inflammation in the brain might play a role in ME/CFS and LC, with potential pathways involving sustained activation of certain brain cells and inflammation in specific brain areas. This inflammation could affect the balance of a substance called glutamate in the brain, which might contribute to problems with hormone regulation seen in ME/CFS and LC. Additionally, reduced blood flow to the brain could be a common factor in all three conditions.

Our study aims to look at differences in brain structure, blood flow, and biochemistry between these groups to better understand the underlying causes of ME/CFS, LC, and POTS, and to develop treatments that work effectively. By examining various factors like astrocyte activity (a type of brain cell), changes in metabolism, how the brain responds to exercise, and markers of inflammation in the brain, we hope to identify important mechanisms driving symptoms and find potential targets for therapy.

OBJECTIVES

  1. Investigate astrocyte activity and glucose hypometabolic patterns to elucidate brain neuroinflammation mechanisms in ME/CFS and LC.
  2. Analyse metabolite variations, particularly glutamate and GABA levels, in the hypothalamus among ME/CFS and LC patients compared to controls.
  3. Explore correlations with central nervous system neuroinflammation, blood hormone levels, and symptom manifestation.
  4. Assess changes in cerebral blood flow during exercise in ME/CFS and POTS patients, both globally and regionally in the brain. Evaluate the impact of cerebral blood flow alterations on symptomatology and post-exertional malaise severity in ME/CFS, LC and POTS populations.
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