Ventricular cerebrospinal fluid lactate is increased in chronic 

fatigue syndrome compared with generalized anxiety disorder: an in 

vivo 3.0 T (1)H MRS imaging study.

Journal: NMR Biomed. 2008 Oct 21. [Epub ahead of print]

Authors: Mathew SJ, Mao X, Keegan KA, Levine SM, Smith EL, Heier LA, 

Otcheretko V, Coplan JD, Shungu DC.

Affiliation: Department of Psychiatry, Mount Sinai School of 

Medicine, New York, NY, USA.

NLM Citation: PMID: 18942064

Chronic fatigue syndrome (CFS) is a controversial diagnosis because 

of the lack of biomarkers for the illness and its symptom overlap 

with neuropsychiatric, infectious, and rheumatological disorders.

We compared lateral ventricular volumes derived from tissue-segmented 

T(1)-weighted volumetric MRI data and cerebrospinal fluid (CSF) 

lactate concentrations measured by proton MRS imaging ((1)H MRSI) in 

16 subjects with CFS (modified US Centers for Disease Control and 

Prevention criteria) with those in 14 patients with generalized 

anxiety disorder (GAD) and in 15 healthy volunteers, matched 

group-wise for age, sex, body mass index, handedness, and IQ.

Mean lateral ventricular lactate concentrations measured by (1)H MRSI 

in CFS were increased by 297% compared with those in GAD (P < 0.001) 

and by 348% compared with those in healthy volunteers (P < 0.001), 

even after controlling for ventricular volume, which did not differ 

significantly between the groups. Regression analysis revealed that 

diagnosis accounted for 43% of the variance in ventricular lactate.

CFS is associated with significantly raised concentrations of 

ventricular lactate, potentially consistent with recent evidence of 

decreased cortical blood flow, secondary mitochondrial dysfunction, 

and/or oxidative stress abnormalities in the disorder.

Copyright (c) 2008 John Wiley & Sons, Ltd.