Godlewska et al. (2026)
- Authors: Beata Godlewska, William Clarke, Sylvana Vilca-Melendez, Aaron Hess, Philip J. Cowen
- Institutes: Department of Psychiatry, University of Oxford, Oxford, United Kingdom, Wellcome Centre for Integrative Neuroimaging (WIN), University of Oxford, Oxford, United Kingdom
- Publisher: Biological Psychiatry
- Link: DOI
Summary
This study provides evidence of a biological ‘bottleneck’ in the energy production of the ME/CFS brain. By showing that the brain shifts into inefficient anaerobic metabolism during even simple visual tasks, the research helps validate patient experiences of ‘brain fog’ and cognitive exhaustion as physiological rather than psychological symptoms. These findings highlight lactate production as a potential biomarker for monitoring disease severity or testing new treatments.
What was researched?
This research investigated whether the brains of ME/CFS patients exhibit signs of mitochondrial dysfunction by measuring lactate levels during neural activity using ultra-high-field 7T functional magnetic resonance spectroscopy.
Why was it researched?
The study aimed to test the hypothesis that ME/CFS involves an inability to meet increased energy demands through aerobic metabolism, leading to a premature shift to anaerobic pathways and lactic acid buildup.
How was it researched?
Researchers compared 20 ME/CFS patients with 20 healthy controls while they viewed a flashing checkerboard to stimulate the visual cortex. The 7-Tesla scanner allowed for the precise measurement of real-time metabolic changes in the brain at rest and during stimulation.
What has been found?
While baseline lactate levels were similar between groups, ME/CFS patients showed a significantly higher increase in lactate (22.2%) during stimulation compared to healthy controls (10.6%). Other metabolites, such as N-acetylaspartate (NAA), remained stable, indicating the change was specific to energy metabolism rather than general tissue loss.
Discussion
The results suggest that mitochondrial dysfunction in ME/CFS is a dynamic issue that becomes most apparent under load. The use of high-field 7T technology was crucial for detecting these subtle metabolic changes that standard clinical scanners might miss.
Conclusion & Future Work
The study concludes that brain stimulation triggers an abnormal metabolic response in ME/CFS patients, supporting the theory of systemic mitochondrial impairment. Future studies are needed to determine if these brain lactate levels correlate with the severity of post-exertional malaise.