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Brain Responses in CFS and TMD to Autonomic Challenges: An Exploratory fMRI Study

Lookup NU author(s): Dr Quoc Vuong, James AllisonORCiD, Dr Andreas FinkelmeyerORCiD, Emerita Professor Julia Newton, Professor Justin DurhamORCiD



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Sage Publications, 2019.

For re-use rights please refer to the publisher's terms and conditions.


INTRODUCTION: Dysfunction of the autonomic nervous system (ANS) is seen in chronic fatigue syndrome (CFS) and temporomandibular disorders (TMD). Both conditions have poorly understood pathophysiology. Several brain structures which play a role in pain and fatigue, such as the insular cortex and basal ganglia, are also implicated in autonomic function. OBJECTIVES: ANS dysfunction may point to common neuro-physiological mechanisms underlying the predominant symptoms for both CFS and TMD. No studies to date have investigated the combination of both conditions. Thus our aim was to test whether CFS patients with or without TMD show differences in brain responses to autonomic challenges. METHODS: In this exploratory functional imaging study, CFS patients who screened positive for TMD (n=26), patients who screened negative for TMD (n=16) and age-matched control participants (n=10) performed the Valsalva manoeuvre whilst in a 3T MRI scanner. This manoeuvre is known to activate the ANS. RESULTS: For all three groups, whole-brain F-test showed increased brain activation during the manoeuvre in superior and inferior frontal gyri, left and right putamen and thalamus, and insular cortex. Furthermore, group contrasts with small-volume correction showed that CFS patients who screened positive for TMD showed greater activity in the left insular cortex compared to patients who screened negative, and in the left caudate nucleus compared to controls. CONCLUSION: Our results suggest that increased activity in cortical and subcortical regions observed during autonomic challenges may be modulated by fatigue and pain. ANS dysfunction may be a contributing factor to these findings and further work is required to tease apart the complex relationship between CFS, TMD and autonomic functions.

Publication metadata

Author(s): Vuong QC, Allison JR, Finkelmeyer A, Newton J, Durham J

Publication type: Article

Publication status: Published

Journal: JDR Clinical & Translational Research

Year: 2019

Volume: 5

Issue: 3

Pages: 224-232

Online publication date: 28/08/2019

Acceptance date: 05/08/2019

Date deposited: 19/08/2019

ISSN (print): 2380-0844

ISSN (electronic): 2380-0852

Publisher: Sage Publications


DOI: 10.1177/2380084419872135


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