Tue, 29 May 2001

Monozygotic Twins Discordant for Chronic Fatigue Syndrome: Regional
Cerebral Blood Flow SPECT

Radiology 2001 Jun;219(3):766-73

David H. Lewis, MD, Helen S. Mayberg, MD, Mary E. Fischer, MS,
Jack Goldberg, PhD, Suzanne Ashton, BS, Michael M. Graham, MD, PhD and
Dedra Buchwald, MD

From the Departments of Radiology (D.H.L., M.M.G.) and
Medicine (D.B., S.A.), University of Washington, Seattle; the Department
of Epidemiology and Biostatistics, University of Illinois, Chicago (J.G.,
M.E.F.); and the Department of Psychiatry and the Rotman Research
Institute, University of Toronto, Ontario, Canada (H.S.M.).

Received June 29, 2000; revision requested August 10; final revision
received November 30; accepted December 4.

D.B. supported by National Institutes of Health grant U19 AI38429.
Address correspondence to D.B., Harborview Medical Center, 325 Ninth Ave,
Box 359780, Seattle, WA 98104.

NLM Citation: PMID: 11376266

Abstract:

PURPOSE: To evaluate the relationship between regional cerebral blood
flow (rCBF) and chronic fatigue syndrome (CFS) in monozygotic twins
discordant for CFS.

MATERIALS AND METHODS: The authors conducted a co-twin control study of
22 monozygotic twins in which one twin met criteria for CFS and the other
was healthy. Twins underwent a structured psychiatric interview and
resting technetium 99m–hexamethyl-propyleneamine oxime single photon
emission computed tomography of the brain. They also rated their mental
status before the procedure. Scans were interpreted independently by two
physicians blinded to illness status and then at a blinded consensus
reading. Imaging fusion software with automated three-dimensional
matching of rCBF images was used to coregister and quantify results.
Outcomes were the number and distribution of abnormalities at both reader
consensus and automated quantification. Mean rCBF levels were compared by
using random effects regression models to account for the effects of twin
matching and potential confounding factors.

RESULTS: The twins with and those without CFS were similar in mean number
of visually detected abnormalities and in mean differences quantified by
using image registration software. These results were unaltered with
adjustments for fitness level, depression, and mood before imaging.

CONCLUSION: The study results did not provide evidence of a distinctive
pattern of resting rCBF abnormalities associated with CFS. The described
method highlights the importance of selecting well-matched control
subjects.


Index terms: Brain, abnormalities, 13.899 • Brain, perfusion • Brain,
SPECT, 13.12162 • Nervous system, abnormalities, 13.899 • Twins