MRI measurement of Blood-Brain Barrier Permeability in ME/CFS with and without PASC

Motivation: It has been hypothesized that increases in blood-brain barrier (BBB) permeability in patients with ME/CFS lead to many of the symptoms experienced by these patients. Assessing BBB permeability across PASC ME/CFS, classic non-PASC ME/CFS, and healthy individuals could validate this hypothesis and deepen our understanding of ME/CFS pathophysiology. Goal(s): To non-invasively measure BBB permeability to water in the three groups. Approach: We applied water-extraction-with-phase-contrast-arterial-spin-tagging (WEPCAST) MRI to measure BBB permeability. Results: No significant differences in CBF or E were observed between the groups, PS was significantly higher in the classic non-PASC ME/CFS group compared to both the PASC ME/CFS and control groups. Impact: In this pilot study, we found increased BBB permeability in the non-PASC ME/CFS group compared to the PASC ME/CFS and control groups, providing preliminary imaging evidence of neuroinflammation in ME/CFS. This finding can deepen our understanding of ME/CFS pathophysiology.