Systematic review and meta-analysis of cognitive impairment in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is commonly associated with cognitive complaints. To bring out the neuropsychological symptomatology inherent to ME/CFS, we conducted a systematic review according to PRISMA and MOOSE guidelines of the literature through the analysis of 764 studies published between 1988 and 2019 by using PubMed Central website and Clarivate analytics platform. We performed a meta-analysis to delineate an idea of the neuropsychological profile inherent in ME/CFS. The clinical picture typically affects visuo-spatial immediate memory (g = - 0.55, p = 0.007), reading speed (g = - 0.82, p = 0.0001) and graphics gesture (g = - 0.59, p = 0.0001). Analysis also revealed difficulties in several processes inherent in episodic verbal memory (storage, retrieval, recognition) and visual memory (recovery) and a low efficiency in attentional abilities. Executive functions seemed to be little or not affected and instrumental functions appeared constantly preserved. With regard to the complexity and heterogeneity of the cognitive phenotype, it turns out that determining a sound clinical picture of ME/CFS cognitive profile must go through a neuropsychological examination allowing a complete evaluation integrating the notion of agreement between the choice and the number of tests and the complexity intrinsic to the pathology

‘Just Because You Teach, Doesn’t Mean It’s Over’:Bunheads and the Pedagogy of Live Performance

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Predictive value of brain 18F-FDG PET/CT in macrophagic myofasciitis?

International audienceRationale: Although several functional studies have demonstrated that positron emission tomography/computed tomography with 18 F-fluorodeoxyglucose (18 F-FDG PET/CT) appears to be efficient to identify a cerebral substrate in patients with known macrophagic myofasciitis (MMF), the predictive value of this imaging technique for MMF remains unclear. Patient concerns: We presented data and images of a 46-year-old woman. Diagnoses: The patient was referred to our center for suspected MMF due to diffuse arthromyalgias and cognitive disorder (involving an impairment of visual selective attention and a weakness in executive functions revealed by neuropsychological assessment) which occurred few years after last vaccine injections. Interventions: After a first negative deltoid muscle biopsy, a brain 18 F-FDG PET/CT was performed and revealed the known spatial pattern of a cerebral glucose hypometabolism involving occipital cortex, medial temporal areas, and cerebellum. Outcomes: Given the clinical suspicion of MMF and brain 18 F-FDG PET/CT findings, a 2nd deltoid muscle biopsy was performed and confirmed the diagnosis of MMF with typical histopathological features. Lessons: This case highlights the predictive value of brain 18 F-FDG PET/CT as a noninvasive imaging tool for MMF diagnosis, even when muscle biopsy result comes back negative. Abbreviations: 18 F-FDG = 18 F-fluorodeoxyglucose, MMF = macrophagic myofasciitis, PET/CT = positron emission tomography/ computed tomography

FDG-PET/CT Brain Findings in a Patient With Macrophagic Myofasciitis

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Comparison between ¹⁸F-FDG PET brain images of 100 MMF patients and 44 healthy subjects included in the training set.

<p>Brain areas with significant decreased uptake of ¹⁸F-FDG served as mask to train the support vector machine classifier. Results were collected at a P-value < 0.005 at the voxel level, for clusters k ≥ 200 voxels with adjustment for age.</p

Population characteristics for the training and testing groups.

<p>Population characteristics for the training and testing groups.</p

Statistical parametric mapping (SPM) and support vector machine (SVM) procedures.

<p>MMF, Macrophagic myofasciitis; L, left; R, right.</p