MEpedia - User contributions [en]

Magnetic Resonance Spectroscopy (MRS)

2021-05-27T17:24:35Z

Nikolaspham:added studies

Also known as nuclear magnetic resonance (NMR), magnetic resonance spectroscopy is a diagnostic imaging technique based on the detection of metabolites in tissues. MRS observes the local magnetic fields around atomic nuclei. MRS incorporates a similar model as an MRI. Similar to [[Positron emission tomography|PET]], MRS can measure the specific concentration of specific biochemicals. Usage of MRS in [[ME/CFS]] patients in relatively new and has advantages and disadvantages over other scanning technologies.<ref name=":0">{{Cite journal|last=VanElzakker|first=Michael B.|last2=Brumfield|first2=Sydney A.|last3=Lara Mejia|first3=Paula S.|date=2019|title=Neuroinflammation and Cytokines in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Critical Review of Research Methods|url=https://www.frontiersin.org/articles/10.3389/fneur.2018.01033/full|journal=Frontiers in Neurology|language=English|volume=9|doi=10.3389/fneur.2018.01033|issn=1664-2295|pmc=PMC6335565|pmid=30687207}}</ref>

== MRS and [[PET]] ==
MRS can be used to complement PET for studying neuroinflammation. PET scans are generally more accurate at analyzing specific metabolites. MRS usually reports metabolites as a ratio of one metabolite vs. another, while PET reports an absolute concentration. However, PET scans are invasive as radioligands are injected while MRS is not invasive. <ref name=":0" />MRS is able to produce high-resolution, high contrast images of soft tissue. On the other hand, PET is able to measure the distribution of radiotracers and biochemicals with high sensitivity. Although not many labs have dual MRS-PET scanners, incorporating both techniques into one is able to combine the strengths from MRS and PET.<ref>{{Cite journal|last=Catana|first=Ciprian|last2=Procissi|first2=Daniel|last3=Wu|first3=Yibao|last4=Judenhofer|first4=Martin S.|last5=Qi|first5=Jinyi|last6=Pichler|first6=Bernd J.|last7=Jacobs|first7=Russell E.|last8=Cherry|first8=Simon R.|date=2008-03-11|title=Simultaneous in vivo positron emission tomography and magnetic resonance imaging|url=https://www.pnas.org/content/105/10/3705|journal=Proceedings of the National Academy of Sciences|language=en|volume=105|issue=10|pages=3705–3710|doi=10.1073/pnas.0711622105|issn=0027-8424|pmc=PMC2268792|pmid=18319342}}</ref>

== MRS Studies in ME/CFS ==
MRS's ability to detect metabolites is useful for studying inflammation, metabolism, and overall brain health. Therefore, MRS and MRS-PET has been utilized in ME/CFS patients to analyze neuroinflammation,
* Natelson et al. 2017<ref>{{Cite journal|last=Natelson|first=Benjamin H.|last2=Vu|first2=Diana|last3=Coplan|first3=Jeremy D.|last4=Mao|first4=Xiangling|last5=Blate|first5=Michelle|last6=Kang|first6=Guoxin|last7=Soto|first7=Eli|last8=Kapusuz|first8=Tolga|last9=Shungu|first9=Dikoma C.|date=2017-01-02|title=Elevations of ventricular lactate levels occur in both chronic fatigue syndrome and fibromyalgia|url=https://doi.org/10.1080/21641846.2017.1280114|journal=Fatigue: Biomedicine, Health & Behavior|volume=5|issue=1|pages=15–20|doi=10.1080/21641846.2017.1280114|issn=2164-1846|pmc=PMC5754037|pmid=29308330}}</ref>
** Found a significant difference between ME/CFS patients and control group when comparing [[lactate]] in the ventricles region

* Van der Schaaf et al. 2017<ref>{{Cite journal|last=van der Schaaf|first=Marieke E.|last2=De Lange|first2=Floris P.|last3=Schmits|first3=Iris C.|last4=Geurts|first4=Dirk E.M.|last5=Roelofs|first5=Karin|last6=van der Meer|first6=Jos W.M.|last7=Toni|first7=Ivan|last8=Knoop|first8=Hans|date=2017-02|title=Prefrontal Structure Varies as a Function of Pain Symptoms in Chronic Fatigue Syndrome|url=https://linkinghub.elsevier.com/retrieve/pii/S0006322316327378|journal=Biological Psychiatry|language=en|volume=81|issue=4|pages=358–365|doi=10.1016/j.biopsych.2016.07.016}}</ref>
** Found no significant differences in metabolites between ME/CFS patients and controls

* Shungu et al. 2012<ref>{{Cite journal|last=Shungu|first=Dikoma C.|last2=Weiduschat|first2=Nora|last3=Murrough|first3=James W.|last4=Mao|first4=Xiangling|last5=Pillemer|first5=Sarah|last6=Dyke|first6=Jonathan P.|last7=Medow|first7=Marvin S.|last8=Natelson|first8=Benjamin H.|last9=Stewart|first9=Julian M.|date=2012-09|title=Increased ventricular lactate in chronic fatigue syndrome. III. Relationships to cortical glutathione and clinical symptoms implicate oxidative stress in disorder pathophysiology: VENTRICULAR LACTATE, OXIDATIVE STRESS AND CEREBRAL BLOOD FLOW IN CFS|url=http://doi.wiley.com/10.1002/nbm.2772|journal=NMR in Biomedicine|language=en|volume=25|issue=9|pages=1073–1087|doi=10.1002/nbm.2772}}</ref>
** Found significant differences in lactate and glutathione in the occipital cortex and ventricles

* Murrough et al. 2010<ref>{{Cite journal|last=Murrough|first=James W.|last2=Mao|first2=Xiangling|last3=Collins|first3=Katherine A.|last4=Kelly|first4=Chris|last5=Andrade|first5=Gizely|last6=Nestadt|first6=Paul|last7=Levine|first7=Susan M.|last8=Mathew|first8=Sanjay J.|last9=Shungu|first9=Dikoma C.|date=2010-03-16|title=Increased ventricular lactate in chronic fatigue syndrome measured by 1H MRS imaging at 3.0 T. II: comparison with major depressive disorder|url=http://doi.wiley.com/10.1002/nbm.1512|journal=NMR in Biomedicine|language=en|volume=23|issue=6|pages=643–650|doi=10.1002/nbm.1512}}</ref>
** Found a significant difference in lactate between ME/CFS patients and control group in the anterior cingulate cortex, occipital cortex, and ventricles

* Puri et al. 2009<ref>{{Cite journal|last=Puri|first=B.K.|last2=Agour|first2=M.|last3=Gunatilake|first3=K.D.R.|last4=Fernando|first4=K.A.C.|last5=Gurusinghe|first5=A.I.|last6=Treasaden|first6=I.H.|date=2009-11|title=An in vivo proton neurospectroscopy study of cerebral oxidative stress in myalgic encephalomyelitis (chronic fatigue syndrome)|url=https://linkinghub.elsevier.com/retrieve/pii/S0952327809001720|journal=Prostaglandins, Leukotrienes and Essential Fatty Acids|language=en|volume=81|issue=5-6|pages=303–305|doi=10.1016/j.plefa.2009.10.002}}</ref>

* Mathew et al. 2008<ref>{{Cite journal|last=Mathew|first=Sanjay J.|last2=Mao|first2=Xiangling|last3=Keegan|first3=Kathryn A.|last4=Levine|first4=Susan M.|last5=Smith|first5=Eric L. P.|last6=Heier|first6=Linda A.|last7=Otcheretko|first7=Viktor|last8=Coplan|first8=Jeremy D.|last9=Shungu|first9=Dikoma C.|date=2009-04|title=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|url=http://doi.wiley.com/10.1002/nbm.1315|journal=NMR in Biomedicine|language=en|volume=22|issue=3|pages=251–258|doi=10.1002/nbm.1315}}</ref>
** Found a significant difference in lactate between ME/CFS patients and control group in corpus callosum and ventricles

* Puri et al. 2002<ref>{{Cite journal|last=Puri|first=B. K.|last2=Counsell|first2=S. J.|last3=Zaman|first3=R.|last4=Main|first4=J.|last5=Collins|first5=A. G.|last6=Hajnal|first6=J. V.|last7=Davey|first7=N. J.|date=2002-09|title=Relative increase in choline in the occipital cortex in chronic fatigue syndrome: Occipital cortex in chronic fatigue syndrome|url=http://doi.wiley.com/10.1034/j.1600-0447.2002.01300.x|journal=Acta Psychiatrica Scandinavica|language=en|volume=106|issue=3|pages=224–226|doi=10.1034/j.1600-0447.2002.01300.x}}</ref>
** Found a significant differences in choline between ME/CFS patients and control group in occipital cortex and left motor cortex

* Brooks et al. 2000<ref>{{Cite journal|last=Brooks|first=J C|last2=Roberts|first2=N|last3=Whitehouse|first3=G|last4=Majeed|first4=T|date=2000-11|title=Proton magnetic resonance spectroscopy and morphometry of the hippocampus in chronic fatigue syndrome.|url=http://www.birpublications.org/doi/10.1259/bjr.73.875.11144799|journal=The British Journal of Radiology|language=en|volume=73|issue=875|pages=1206–1208|doi=10.1259/bjr.73.875.11144799|issn=0007-1285}}</ref>

* Tomoda et al.<ref>{{Cite journal|last=Tomoda|first=Akemi|last2=Miike|first2=Teruhisa|last3=Yamada|first3=Eiji|last4=Honda|first4=Hajime|last5=Moroi|first5=Toshihiro|last6=Ogawa|first6=Masakatsu|last7=Ohtani|first7=Yoshinobu|last8=Morishita|first8=Shoji|date=2000-01|title=Chronic fatigue syndrome in childhood|url=https://linkinghub.elsevier.com/retrieve/pii/S0387760499001114|journal=Brain and Development|language=en|volume=22|issue=1|pages=60–64|doi=10.1016/S0387-7604(99)00111-4}}</ref>
** Found a significant difference in choline between ME/CFS patients and control group in frontal white matter

== References ==

<references />

Magnetic Resonance Spectroscopy (MRS)

2021-05-27T16:59:48Z

Nikolaspham:

Also known as nuclear magnetic resonance (NMR), magnetic resonance spectroscopy is a diagnostic imaging technique based on the detection of metabolites in tissues. MRS observes the local magnetic fields around atomic nuclei. MRS incorporates a similar model as an MRI. Similar to [[Positron emission tomography|PET]], MRS can measure the specific concentration of specific biochemicals. Usage of MRS in [[ME/CFS]] patients in relatively new and has advantages and disadvantages over other scanning technologies.<ref name=":0">{{Cite journal|last=VanElzakker|first=Michael B.|last2=Brumfield|first2=Sydney A.|last3=Lara Mejia|first3=Paula S.|date=2019|title=Neuroinflammation and Cytokines in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Critical Review of Research Methods|url=https://www.frontiersin.org/articles/10.3389/fneur.2018.01033/full|journal=Frontiers in Neurology|language=English|volume=9|doi=10.3389/fneur.2018.01033|issn=1664-2295|pmc=PMC6335565|pmid=30687207}}</ref>

== MRS and [[PET]] ==
MRS can be used to complement PET for studying neuroinflammation. PET scans are generally more accurate at analyzing specific metabolites. MRS usually reports metabolites as a ratio of one metabolite vs. another, while PET reports an absolute concentration. However, PET scans are invasive as radioligands are injected while MRS is not invasive. <ref name=":0" />MRS is able to produce high-resolution, high contrast images of soft tissue. On the other hand, PET is able to measure the distribution of radiotracers and biochemicals with high sensitivity. Although not many labs have dual MRS-PET scanners, incorporating both techniques into one is able to combine the strengths from MRS and PET.<ref>{{Cite journal|last=Catana|first=Ciprian|last2=Procissi|first2=Daniel|last3=Wu|first3=Yibao|last4=Judenhofer|first4=Martin S.|last5=Qi|first5=Jinyi|last6=Pichler|first6=Bernd J.|last7=Jacobs|first7=Russell E.|last8=Cherry|first8=Simon R.|date=2008-03-11|title=Simultaneous in vivo positron emission tomography and magnetic resonance imaging|url=https://www.pnas.org/content/105/10/3705|journal=Proceedings of the National Academy of Sciences|language=en|volume=105|issue=10|pages=3705–3710|doi=10.1073/pnas.0711622105|issn=0027-8424|pmc=PMC2268792|pmid=18319342}}</ref>

== MRS Studies in ME/CFS ==
MRS's ability to detect metabolites is useful for studying inflammation, metabolism, and overall brain health. Therefore, MRS and MRS-PET has been utilized in ME/CFS patients to analyze neuroinflammation,
* Natelson et al. 2017<ref>{{Cite journal|last=Natelson|first=Benjamin H.|last2=Vu|first2=Diana|last3=Coplan|first3=Jeremy D.|last4=Mao|first4=Xiangling|last5=Blate|first5=Michelle|last6=Kang|first6=Guoxin|last7=Soto|first7=Eli|last8=Kapusuz|first8=Tolga|last9=Shungu|first9=Dikoma C.|date=2017-01-02|title=Elevations of ventricular lactate levels occur in both chronic fatigue syndrome and fibromyalgia|url=https://doi.org/10.1080/21641846.2017.1280114|journal=Fatigue: Biomedicine, Health & Behavior|volume=5|issue=1|pages=15–20|doi=10.1080/21641846.2017.1280114|issn=2164-1846|pmc=PMC5754037|pmid=29308330}}</ref>
** Found a significant increase between ME/CFS patients and control group when comparing [[lactate]] in the ventricles region

* Van der Schaaf et al. 2017<ref>{{Cite journal|last=van der Schaaf|first=Marieke E.|last2=De Lange|first2=Floris P.|last3=Schmits|first3=Iris C.|last4=Geurts|first4=Dirk E.M.|last5=Roelofs|first5=Karin|last6=van der Meer|first6=Jos W.M.|last7=Toni|first7=Ivan|last8=Knoop|first8=Hans|date=2017-02|title=Prefrontal Structure Varies as a Function of Pain Symptoms in Chronic Fatigue Syndrome|url=https://linkinghub.elsevier.com/retrieve/pii/S0006322316327378|journal=Biological Psychiatry|language=en|volume=81|issue=4|pages=358–365|doi=10.1016/j.biopsych.2016.07.016}}</ref>
** Found no significant differences in metabolites between ME/CFS patients and controls

* Shungu et al. 2012<ref>{{Cite journal|last=Shungu|first=Dikoma C.|last2=Weiduschat|first2=Nora|last3=Murrough|first3=James W.|last4=Mao|first4=Xiangling|last5=Pillemer|first5=Sarah|last6=Dyke|first6=Jonathan P.|last7=Medow|first7=Marvin S.|last8=Natelson|first8=Benjamin H.|last9=Stewart|first9=Julian M.|date=2012-09|title=Increased ventricular lactate in chronic fatigue syndrome. III. Relationships to cortical glutathione and clinical symptoms implicate oxidative stress in disorder pathophysiology: VENTRICULAR LACTATE, OXIDATIVE STRESS AND CEREBRAL BLOOD FLOW IN CFS|url=http://doi.wiley.com/10.1002/nbm.2772|journal=NMR in Biomedicine|language=en|volume=25|issue=9|pages=1073–1087|doi=10.1002/nbm.2772}}</ref>
** Found significant differences in lactate and glutathione in occipital cortex and ventriclesentricles

* Murrough et al. 2010<ref>{{Cite journal|last=Murrough|first=James W.|last2=Mao|first2=Xiangling|last3=Collins|first3=Katherine A.|last4=Kelly|first4=Chris|last5=Andrade|first5=Gizely|last6=Nestadt|first6=Paul|last7=Levine|first7=Susan M.|last8=Mathew|first8=Sanjay J.|last9=Shungu|first9=Dikoma C.|date=2010-03-16|title=Increased ventricular lactate in chronic fatigue syndrome measured by 1H MRS imaging at 3.0 T. II: comparison with major depressive disorder|url=http://doi.wiley.com/10.1002/nbm.1512|journal=NMR in Biomedicine|language=en|volume=23|issue=6|pages=643–650|doi=10.1002/nbm.1512}}</ref>
** Found significant differences in GABA and Lactate between ME/CFS patients and control group in the anterior cingulate cortex, occipital cortex, and ventricles

* Puri et al. 2009<ref>{{Cite journal|last=Puri|first=B.K.|last2=Agour|first2=M.|last3=Gunatilake|first3=K.D.R.|last4=Fernando|first4=K.A.C.|last5=Gurusinghe|first5=A.I.|last6=Treasaden|first6=I.H.|date=2009-11|title=An in vivo proton neurospectroscopy study of cerebral oxidative stress in myalgic encephalomyelitis (chronic fatigue syndrome)|url=https://linkinghub.elsevier.com/retrieve/pii/S0952327809001720|journal=Prostaglandins, Leukotrienes and Essential Fatty Acids|language=en|volume=81|issue=5-6|pages=303–305|doi=10.1016/j.plefa.2009.10.002}}</ref>
** Found a significant differences in creatine and choline between ME/CFS patients and control group in glutathione in occipital cortex and left motor cortex

* Mathew et al. 2008<ref>{{Cite journal|last=Mathew|first=Sanjay J.|last2=Mao|first2=Xiangling|last3=Keegan|first3=Kathryn A.|last4=Levine|first4=Susan M.|last5=Smith|first5=Eric L. P.|last6=Heier|first6=Linda A.|last7=Otcheretko|first7=Viktor|last8=Coplan|first8=Jeremy D.|last9=Shungu|first9=Dikoma C.|date=2009-04|title=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|url=http://doi.wiley.com/10.1002/nbm.1315|journal=NMR in Biomedicine|language=en|volume=22|issue=3|pages=251–258|doi=10.1002/nbm.1315}}</ref>

* Puri et al. 2002<ref>{{Cite journal|last=Puri|first=B. K.|last2=Counsell|first2=S. J.|last3=Zaman|first3=R.|last4=Main|first4=J.|last5=Collins|first5=A. G.|last6=Hajnal|first6=J. V.|last7=Davey|first7=N. J.|date=2002-09|title=Relative increase in choline in the occipital cortex in chronic fatigue syndrome: Occipital cortex in chronic fatigue syndrome|url=http://doi.wiley.com/10.1034/j.1600-0447.2002.01300.x|journal=Acta Psychiatrica Scandinavica|language=en|volume=106|issue=3|pages=224–226|doi=10.1034/j.1600-0447.2002.01300.x}}</ref>

* Brooks et al. 2000<ref>{{Cite journal|last=Brooks|first=J C|last2=Roberts|first2=N|last3=Whitehouse|first3=G|last4=Majeed|first4=T|date=2000-11|title=Proton magnetic resonance spectroscopy and morphometry of the hippocampus in chronic fatigue syndrome.|url=http://www.birpublications.org/doi/10.1259/bjr.73.875.11144799|journal=The British Journal of Radiology|language=en|volume=73|issue=875|pages=1206–1208|doi=10.1259/bjr.73.875.11144799|issn=0007-1285}}</ref>

* Tomoda et al.<ref>{{Cite journal|last=Tomoda|first=Akemi|last2=Miike|first2=Teruhisa|last3=Yamada|first3=Eiji|last4=Honda|first4=Hajime|last5=Moroi|first5=Toshihiro|last6=Ogawa|first6=Masakatsu|last7=Ohtani|first7=Yoshinobu|last8=Morishita|first8=Shoji|date=2000-01|title=Chronic fatigue syndrome in childhood|url=https://linkinghub.elsevier.com/retrieve/pii/S0387760499001114|journal=Brain and Development|language=en|volume=22|issue=1|pages=60–64|doi=10.1016/S0387-7604(99)00111-4}}</ref>

== References ==

<references />

Magnetic Resonance Spectroscopy (MRS)

2021-05-27T16:58:51Z

Nikolaspham:

Also known as nuclear magnetic resonance (NMR), magnetic resonance spectroscopy is a diagnostic imaging technique based on the detection of metabolites in tissues. MRS observes the local magnetic fields around atomic nuclei. MRS incorporates a similar model as an MRI. Similar to [[Positron emission tomography|PET]], MRS can measure the specific concentration of specific biochemicals. Usage of MRS in [[ME/CFS]] patients in relatively new and has advantages and disadvantages over other scanning technologies.<ref name=":0">{{Cite journal|last=VanElzakker|first=Michael B.|last2=Brumfield|first2=Sydney A.|last3=Lara Mejia|first3=Paula S.|date=2019|title=Neuroinflammation and Cytokines in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Critical Review of Research Methods|url=https://www.frontiersin.org/articles/10.3389/fneur.2018.01033/full|journal=Frontiers in Neurology|language=English|volume=9|doi=10.3389/fneur.2018.01033|issn=1664-2295|pmc=PMC6335565|pmid=30687207}}</ref>

== MRS and [[PET]] ==
MRS can be used to complement PET for studying neuroinflammation. PET scans are generally more accurate at analyzing specific metabolites. MRS usually reports metabolites as a ratio of one metabolite vs. another, while PET reports an absolute concentration. However, PET scans are invasive as radioligands are injected while MRS is not invasive. <ref name=":0" />MRS is able to produce high-resolution, high contrast images of soft tissue. On the other hand, PET is able to measure the distribution of radiotracers and biochemicals with high sensitivity. Although not many labs have dual MRS-PET scanners, incorporating both techniques into one is able to combine the strengths from MRS and PET.<ref>{{Cite journal|last=Catana|first=Ciprian|last2=Procissi|first2=Daniel|last3=Wu|first3=Yibao|last4=Judenhofer|first4=Martin S.|last5=Qi|first5=Jinyi|last6=Pichler|first6=Bernd J.|last7=Jacobs|first7=Russell E.|last8=Cherry|first8=Simon R.|date=2008-03-11|title=Simultaneous in vivo positron emission tomography and magnetic resonance imaging|url=https://www.pnas.org/content/105/10/3705|journal=Proceedings of the National Academy of Sciences|language=en|volume=105|issue=10|pages=3705–3710|doi=10.1073/pnas.0711622105|issn=0027-8424|pmc=PMC2268792|pmid=18319342}}</ref>

== MRS Studies in ME/CFS ==
MRS's ability to detect metabolites is useful for studying inflammation, metabolism, and overall brain health. Therefore, MRS and MRS-PET has been utilized in ME/CFS patients to analyze neuroinflammation,
* Natelson et al. 2017<ref>{{Cite journal|last=Natelson|first=Benjamin H.|last2=Vu|first2=Diana|last3=Coplan|first3=Jeremy D.|last4=Mao|first4=Xiangling|last5=Blate|first5=Michelle|last6=Kang|first6=Guoxin|last7=Soto|first7=Eli|last8=Kapusuz|first8=Tolga|last9=Shungu|first9=Dikoma C.|date=2017-01-02|title=Elevations of ventricular lactate levels occur in both chronic fatigue syndrome and fibromyalgia|url=https://doi.org/10.1080/21641846.2017.1280114|journal=Fatigue: Biomedicine, Health & Behavior|volume=5|issue=1|pages=15–20|doi=10.1080/21641846.2017.1280114|issn=2164-1846|pmc=PMC5754037|pmid=29308330}}</ref>
** Found a significant increase between ME/CFS patients and control group when comparing [[lactate]] in the ventricles region

* Van der Schaaf et al. 2017<ref>{{Cite journal|last=van der Schaaf|first=Marieke E.|last2=De Lange|first2=Floris P.|last3=Schmits|first3=Iris C.|last4=Geurts|first4=Dirk E.M.|last5=Roelofs|first5=Karin|last6=van der Meer|first6=Jos W.M.|last7=Toni|first7=Ivan|last8=Knoop|first8=Hans|date=2017-02|title=Prefrontal Structure Varies as a Function of Pain Symptoms in Chronic Fatigue Syndrome|url=https://linkinghub.elsevier.com/retrieve/pii/S0006322316327378|journal=Biological Psychiatry|language=en|volume=81|issue=4|pages=358–365|doi=10.1016/j.biopsych.2016.07.016}}</ref>
** Found no significant differences in metabolites between ME/CFS patients and controls

* Shungu et al. 2012<ref>{{Cite journal|last=Shungu|first=Dikoma C.|last2=Weiduschat|first2=Nora|last3=Murrough|first3=James W.|last4=Mao|first4=Xiangling|last5=Pillemer|first5=Sarah|last6=Dyke|first6=Jonathan P.|last7=Medow|first7=Marvin S.|last8=Natelson|first8=Benjamin H.|last9=Stewart|first9=Julian M.|date=2012-09|title=Increased ventricular lactate in chronic fatigue syndrome. III. Relationships to cortical glutathione and clinical symptoms implicate oxidative stress in disorder pathophysiology: VENTRICULAR LACTATE, OXIDATIVE STRESS AND CEREBRAL BLOOD FLOW IN CFS|url=http://doi.wiley.com/10.1002/nbm.2772|journal=NMR in Biomedicine|language=en|volume=25|issue=9|pages=1073–1087|doi=10.1002/nbm.2772}}</ref>
** Found significant differences in lactate and glutathione in occipital cortex and ventriclesentricles

* Murrough et al. 2010<ref>{{Cite journal|last=Murrough|first=James W.|last2=Mao|first2=Xiangling|last3=Collins|first3=Katherine A.|last4=Kelly|first4=Chris|last5=Andrade|first5=Gizely|last6=Nestadt|first6=Paul|last7=Levine|first7=Susan M.|last8=Mathew|first8=Sanjay J.|last9=Shungu|first9=Dikoma C.|date=2010-03-16|title=Increased ventricular lactate in chronic fatigue syndrome measured by 1H MRS imaging at 3.0 T. II: comparison with major depressive disorder|url=http://doi.wiley.com/10.1002/nbm.1512|journal=NMR in Biomedicine|language=en|volume=23|issue=6|pages=643–650|doi=10.1002/nbm.1512}}</ref>
** Found significant differences in GABA and Lactate between ME/CFS patients and control group in the anterior cingulate cortex, occipital cortex, and ventricles

* Puri et al. 2009<ref>{{Cite journal|last=Puri|first=B.K.|last2=Agour|first2=M.|last3=Gunatilake|first3=K.D.R.|last4=Fernando|first4=K.A.C.|last5=Gurusinghe|first5=A.I.|last6=Treasaden|first6=I.H.|date=2009-11|title=An in vivo proton neurospectroscopy study of cerebral oxidative stress in myalgic encephalomyelitis (chronic fatigue syndrome)|url=https://linkinghub.elsevier.com/retrieve/pii/S0952327809001720|journal=Prostaglandins, Leukotrienes and Essential Fatty Acids|language=en|volume=81|issue=5-6|pages=303–305|doi=10.1016/j.plefa.2009.10.002}}</ref>
** Found a significant differences in creatine and choline between ME/CFS patients and control group in glutathione in occipital cortex and left motor cortex

* Mathew et al. 2008<ref>{{Cite journal|last=Mathew|first=Sanjay J.|last2=Mao|first2=Xiangling|last3=Keegan|first3=Kathryn A.|last4=Levine|first4=Susan M.|last5=Smith|first5=Eric L. P.|last6=Heier|first6=Linda A.|last7=Otcheretko|first7=Viktor|last8=Coplan|first8=Jeremy D.|last9=Shungu|first9=Dikoma C.|date=2009-04|title=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|url=http://doi.wiley.com/10.1002/nbm.1315|journal=NMR in Biomedicine|language=en|volume=22|issue=3|pages=251–258|doi=10.1002/nbm.1315}}</ref>

* Puri et al. 2002<ref>{{Cite journal|last=Puri|first=B. K.|last2=Counsell|first2=S. J.|last3=Zaman|first3=R.|last4=Main|first4=J.|last5=Collins|first5=A. G.|last6=Hajnal|first6=J. V.|last7=Davey|first7=N. J.|date=2002-09|title=Relative increase in choline in the occipital cortex in chronic fatigue syndrome: Occipital cortex in chronic fatigue syndrome|url=http://doi.wiley.com/10.1034/j.1600-0447.2002.01300.x|journal=Acta Psychiatrica Scandinavica|language=en|volume=106|issue=3|pages=224–226|doi=10.1034/j.1600-0447.2002.01300.x}}</ref>

* Brooks et al. 2000<ref>{{Cite journal|last=Brooks|first=J C|last2=Roberts|first2=N|last3=Whitehouse|first3=G|last4=Majeed|first4=T|date=2000-11|title=Proton magnetic resonance spectroscopy and morphometry of the hippocampus in chronic fatigue syndrome.|url=http://www.birpublications.org/doi/10.1259/bjr.73.875.11144799|journal=The British Journal of Radiology|language=en|volume=73|issue=875|pages=1206–1208|doi=10.1259/bjr.73.875.11144799|issn=0007-1285}}</ref>

* Tomoda et al.<ref>{{Cite journal|last=Tomoda|first=Akemi|last2=Miike|first2=Teruhisa|last3=Yamada|first3=Eiji|last4=Honda|first4=Hajime|last5=Moroi|first5=Toshihiro|last6=Ogawa|first6=Masakatsu|last7=Ohtani|first7=Yoshinobu|last8=Morishita|first8=Shoji|date=2000-01|title=Chronic fatigue syndrome in childhood|url=https://linkinghub.elsevier.com/retrieve/pii/S0387760499001114|journal=Brain and Development|language=en|volume=22|issue=1|pages=60–64|doi=10.1016/S0387-7604(99)00111-4}}</ref>

Magnetic resonance imaging

2021-05-27T16:19:51Z

Nikolaspham:/* See also */

{{Stub}}

'''Magnetic Resonance Imaging''' (MRI) uses magnetic fields and radio waves to produce images of thin slices of tissues. MRI scans can be used to image many different parts of the body, including the [[brain]], joints, major organs and even the whole body.<ref>{{Cite news|url=https://www.msdmanuals.com/en-gb/professional/special-subjects/principles-of-radiologic-imaging/magnetic-resonance-imaging|title=Magnetic Resonance Imaging - Special Subjects - MSD Manual Professional Edition|work=MSD Manual Professional Edition|access-date=2018-10-12|language=en-GB}}</ref>

MRI scans can be used for many different purposes, e.g. to show:
* abnormalities of the brain and [[spinal cord]]
* abnormalities in various parts of the body such as breast, prostate, and liver
* joint injuries or abnormalities, for example a knee injury
* [[Cardiovascular system|heart]] structure and function
* areas of activity within the brain, using a [[Functional magnetic resonance imaging|functional MRI]]
* blood flow through blood vessels and arteries<ref>{{Cite web|url=https://www.fda.gov/Radiation-EmittingProducts/RadiationEmittingProductsandProcedures/MedicalImaging/MRI/ucm482763.htm|title=MRI (Magnetic Resonance Imaging) - Uses|last=Health Center for Devices and Radiological|first=|date=|website=www.fda.gov|language=en|archive-url=|archive-date=|url-status=|access-date=2018-10-12}}</ref>

==ME/CFS MRI evidence==
*Possible white matter abnormalities of unknown etiology are found on MRIs of some ME/CFS patients. These are identified by T2 hyperintensities, which might indicate lesions or Virchow-Robin spaces.<ref name=":0" /><ref name=":1" />
[[File:White Matter Fig 2.jpg|alt=brain scans showing brain changes|thumb|464x464px|Progressive brain changes in patients with Chronic Fatigue Syndrome. Shan et al. (2016).<ref>{{Cite journal|last=Shan|first=Zack Y.|last2=Kwiatek|first2=Richard|last3=Burnet|first3=Richard|last4=Del Fante|first4=Peter|last5=Staines|first5=Donald R.|last6=Marshall-Gradisnik|first6=Sonya M.|last7=Barnden|first7=Leighton R.|date=2016-04-28|title=Progressive brain changes in patients with chronic fatigue syndrome: A longitudinal MRI study|url=https://onlinelibrary.wiley.com/doi/full/10.1002/jmri.25283|journal=Journal of Magnetic Resonance Imaging|language=en|volume=44|issue=5|pages=1301–1311|doi=10.1002/jmri.25283|issn=1053-1807|pmc=5111735|pmid=27123773}}</ref>]]

==Cost and availability==

== Notable studies ==
* 1993, A controlled study of brain magnetic resonance imaging in patients with the chronic fatigue syndrome<ref name=":0">{{Cite journal|last=Natelson|first=B. H.|last2=Cohen|first2=J. M.|last3=Brassloff|first3=I.|last4=Lee|first4=H. J.|date=1993-12-15|title=A controlled study of brain magnetic resonance imaging in patients with the chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/8138812|journal=Journal of the Neurological Sciences|volume=120|issue=2|pages=213–217|doi=10.1016/0022-510x(93)90276-5|issn=0022-510X|pmid=8138812}}</ref>
* 1999, Brain MRI abnormalities exist in a subset of patients with chronic fatigue syndrome<ref name=":1">{{Cite journal|last=Lange|first=G.|last2=DeLuca|first2=J.|last3=Maldjian|first3=J. A.|last4=Lee|first4=H.|last5=Tiersky|first5=L. A.|last6=Natelson|first6=B. H.|date=1999-12-01|title=Brain MRI abnormalities exist in a subset of patients with chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/10567042|journal=Journal of the Neurological Sciences|volume=171|issue=1|pages=3–7|doi=10.1016/s0022-510x(99)00243-9|issn=0022-510X|pmid=10567042}}</ref>
*2016, Progressive Brain Changes in Patients With Chronic Fatigue Syndrome: A Longitudinal MRI Study<ref>{{Cite journal|last=Shan|first=Zack Y.|author-link=Zack Shan|last2=Kwiatek|first2=Richard|author-link2=Richard Kwiatek|last3=Burnet|first3=Richard|author-link3=Richard Burnet|last4=Fante|first4=Peter Del|author-link4=Peter Del Fante|last5=Staines|first5=Donald R.|author-link5=Donald Staines|last6=Marshall‐Gradisnik|first6=Sonya M.|author-link6=Sonya Marshall-Gradisnik|last7=Barnden|first7=Leighton R.|date=2016|title=Progressive brain changes in patients with chronic fatigue syndrome: A longitudinal MRI study|url=https://onlinelibrary.wiley.com/doi/abs/10.1002/jmri.25283|journal=Journal of Magnetic Resonance Imaging|language=en|volume=44|issue=5|pages=1301–1311|doi=10.1002/jmri.25283|issn=1522-2586|pmc=5111735|pmid=27123773|quote=|via=}}</ref>
*2016, Autonomic correlations with MRI are abnormal in the brainstem vasomotor centre in Chronic Fatigue Syndrome<ref>{{Cite journal|last=Barnden|first=Leighton R.|author-link=Leighton Barnden|last2=Kwiatek|first2=Richard|author-link2=Richard Kwiatek|last3=Crouch|first3=Benjamin|author-link3=Benjamin Crouch|last4=Burnet|first4=Richard|author-link4=Richard Burnet|last5=Del Fante|first5=Peter|author-link5=Peter Del Fante|date=2016-01-01|title=Autonomic correlations with MRI are abnormal in the brainstem vasomotor centre in Chronic Fatigue Syndrome|url=http://www.sciencedirect.com/science/article/pii/S2213158216300584|journal=NeuroImage: Clinical|volume=11|issue=|pages=530–537|doi=10.1016/j.nicl.2016.03.017|issn=2213-1582|quote=|via=}}</ref>
*2017, Medial prefrontal cortex deficits correlate with unrefreshing sleep in patients with chronic fatigue syndrome<ref>{{Cite journal|last=Shan|first=Zack Y.|author-link=Zack Shan|last2=Kwiatek|first2=Richard|author-link2=Richard Kwiatek|last3=Burnet|first3=Richard|author-link3=Richard Kwiatek|last4=Fante|first4=Peter Del|author-link4=Peter Fante|last5=Staines|first5=Donald R.|author-link5=Donald Staines|last6=Marshall‐Gradisnik|first6=Sonya M.|author-link6=Sonya Marshall-Gradisnik|last7=Barnden|first7=Leighton R.|date=2017|title=Medial prefrontal cortex deficits correlate with unrefreshing sleep in patients with chronic fatigue syndrome|url=https://onlinelibrary.wiley.com/doi/abs/10.1002/nbm.3757|journal=NMR in Biomedicine|language=en|volume=30|issue=10|pages=e3757|doi=10.1002/nbm.3757|issn=1099-1492|quote=|via=}}</ref>
*2018, Decreased Connectivity and Increased Blood Oxygenation Level Dependent Complexity in the Default Mode Network in Individuals with Chronic Fatigue Syndrome<ref>{{Cite journal|last=Shan|first=Zack Y.|author-link=Zack Shan|last2=Finegan|first2=Kevin|author-link2=Kevin Finnegan|last3=Bhuta|first3=Sandeep|author-link3=Sandeep Bhuta|last4=Ireland|first4=Timothy|author-link4=Timothy Ireland|last5=Staines|first5=Donald R.|author-link5=Donald Staines|last6=Marshall-Gradisnik|first6=Sonya M.|author-link6=Sonya Marshall-Gradisnik|last7=Barnden|first7=Leighton R.|date=Feb 2018|title=Decreased Connectivity and Increased Blood Oxygenation Level Dependent Complexity in the Default Mode Network in Individuals with Chronic Fatigue Syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/29152994|journal=Brain Connectivity|volume=8|issue=1|pages=33–39|doi=10.1089/brain.2017.0549|issn=2158-0022|pmid=29152994|quote=|via=}}</ref>
*2018, Brain function characteristics of chronic fatigue syndrome: A task fMRI study<ref>{{Cite journal|last=Shan|first=Zack Y.|author-link=Zack Shan|last2=Finegan|first2=Kevin|author-link2=Kevin Finnegan|last3=Bhuta|first3=Sandeep|author-link3=Sandeep Bhuta|last4=Ireland|first4=Timothy|author-link4=Timothy Ireland|last5=Staines|first5=Donald R.|author-link5=Donald Staines|last6=Marshall-Gradisnik|first6=Sonya M.|author-link6=Sonya Marshall-Gradisnik|last7=Barnden|first7=Leighton R.|date=2018-01-01|title=Brain function characteristics of chronic fatigue syndrome: A task fMRI study|url=http://www.sciencedirect.com/science/article/pii/S2213158218301347|journal=NeuroImage: Clinical|volume=19|issue=|pages=279–286|doi=10.1016/j.nicl.2018.04.025|issn=2213-1582|quote=|via=|author-link7=Leighton Barnden}}</ref>

==Learn more==
*[https://www.msdmanuals.com/en-gb/professional/special-subjects/principles-of-radiologic-imaging/magnetic-resonance-imaging Magnetic Resonance Imaging] - Merck Manual
*[https://medlineplus.gov/mriscans.html MRI scans] - MedlinePlus
*[https://www.radiologyinfo.org/en/info.cfm?pg=headmr Head MRI] - Radiology info

==See also==
*[[Brain]]
*[[MRI]]
*[[fMRI]]
*[[SPECT]]
*[[Magnetic Resonance Spectroscopy (MRS)]]

==References==
{{Reflist}}

[[Category:Medical tests]]
[[Category:Neurology]]

Magnetic Resonance Spectroscopy (MRS)

2021-05-26T04:52:25Z

Nikolaspham:created page

Positron emission tomography

2021-05-26T04:36:51Z

Nikolaspham:/* Guedje et al 2021. */

'''Positron emission tomography''', commonly referred to as '''PET''', is a method of biomedical imaging. It uses nuclear functional imaging techniques to observe [[metabolic]] processes in the body. In clinical settings, it is predominantly used in oncology for tumor metastasis imaging, neurology, and cardiology.<ref>{{Cite web|url=https://www.sciencedirect.com/science/article/pii/S0001299800800355|title=ScienceDirect|website=www.sciencedirect.com|access-date=2019-02-27}}</ref>

== How it works ==
PET uses radioactive tracers (also called radiotracer or radioligand), which are chemical compounds that are biologically active, meaning that the compound functions/reacts/ has a biological purpose in the body. These compounds have been altered such that their structure includes a positron-emitting radioisotope (a radioactive atom). This means that the radiotracer’s movement and activity throughout the body can be detected with a PET machine. Many biological compounds have been made into a radiotracer, which allows for observation of how that compound acts throughout a region of the body.{{Citation needed|date=Mar 2021}}

=== FDG ===
For example, fludeoxyglucose (FDG), an analogue of [[glucose]], is a commonly used measure of [[metabolism]]; detection of FDG correlates with regional glucose uptake. Glucose metabolism is an important measure because cancer cells increase their metabolism to support their increased rates of proliferation and distribution throughout the body. Increased metabolic activity is usually accomplished through increased glucose-uptake. Because cancerous tumors have higher levels of metabolic activity, tumors can usually be detected with FDG-PET. In fact, around 90% of clinical PET imaging uses FDG to monitor cancer metastasis.<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pubmed/20473153|title=Glucose metabolism in cancer cells. - PubMed - NCBI|last=C|first=Annibaldi A and Widmann|website=www.ncbi.nlm.nih.gov|language=en|access-date=2019-02-27}}</ref>

== The procedure ==
A small amount of radiotracer is introduced into the subject’s body via injection, and the subject then enters the PET machine. As the radiotracer breaks down, it emits gamma rays which are picked up by the machine, and then translated into a 3-dimensional image of radiotracer concentration throughout the body. The resulting image can be thought of as a heat map, showing areas of high concentration as more brightly lit.{{Citation needed|date=Mar 2021}}

== Clinical reasons for getting a PET scan: ==
* Generally, to evaluate the function of organs such as the [[heart]] and [[brain]]
** I.e., measuring perfusion of the heart muscle
* To diagnose neurological conditions such as [[Alzheimer's disease|Alzheimer’s]], [[Huntington's disease|Huntington’s]], [[Parkinson's disease|Parkinson’s]], [[epilepsy]], and stroke
* To detect the spread of cancer
* To evaluate cancer treatment efficacy
* To locate the specific site for surgery prior to the surgical procedure
* To evaluate the brain after [[trauma]]<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== Risks ==
The risks for the amount of radiotracer injected into the body is small enough that there is usually no need to take precautions against radioactive exposure. If you are pregnant or breastfeeding, you should notify the doctor/researcher to protect against injury to the fetus or contaminating breastmilk.<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== PET research in ME ==
PET research in ME has focused on measures of [[neuroinflammation]]. This has been done using a TSPO-binding radioligand to measure [[Microglia|microglial]] activation. [[translocator protein|TSPO]] (translocator protein) is a protein that is produced when [[microglia]], the resident macrophages of the brain, become activated. Microglial activation is a commonly used measure of neuroinflammation. Further research using high-quality PET/TSPO methodology is needed to better understand the pathophysiology of neuroinflammation in ME.<ref name="Mejia2019">{{Cite journal|last=Lara Mejia|first=Paula S.|last2=Brumfield|first2=Sydney A.|last3=VanElzakker|first3=Michael B.|date=2019|title=Neuroinflammation and Cytokines in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Critical Review of Research Methods|url=https://www.frontiersin.org/articles/10.3389/fneur.2018.01033/full#B8|journal=Frontiers in Neurology|language=English|volume=9|doi=10.3389/fneur.2018.01033|issn=1664-2295}}</ref>

=== Nakatomi et al. 2014 ===
Nakatomi et al. (2014) was the first case-control study using PET to measure neuroinflammation through TSPO expression in ME. They used [[PK11195]], a first generation TSPO-binding radioligand. They found increased PK11195 in cingulate cortex, [[hippocampus]], [[amygdala]], thalamus, midbrain, and pons. PK11195 concentrations in certain regions were found to have positive correlations with cognitive impairment scores (related to brain fog), [[pain]] scores, and [[depression]] scores. The study concludes that neuroinflammation seems to be present in ME patients and is associated with neuropsychological symptoms.<ref name="Nakatomi2014" />
[[File:PK11195.gif|thumb|312x312px|center|Statistical parametric maps showing areas of significant contrast of PK11195 in brains of ME/CFS patients versus healthy controls.<ref name="Nakatomi2014">{{Cite journal|last=Nakatomi|first=Yasuhito|author-link=Yasuhito Nakatomi|author-link2=Kei Mizuno|author-link3=Akira Ishii|author-link4=Yasuhiro Wada|author-link5=Masaaki Tanaka|author-link6=Shusaku Tazawa|author-link7=Kayo Onoe|author-link8=Sanae Fukuda|author-link9=Joji Kawabe|date=Jun 1, 2014|others=Kazuhiro Takahashi; Yosky Kataoka; Susuma Shiomi; Kouzi Yamaguti, Masaaki Inaba; Hirohiko Kuratsune; Yasuyoshi Watanabe|title=Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study|url=http://jnm.snmjournals.org/content/55/6/945.full|journal=The Journal of Nuclear Medicine|volume=555|issue=6|pages=945-950|quote=|via=SNM Journals}}</ref>''This image was originally published in JNM. Nakatomi, Yasuhito, et al. [http://www.jnm.snmjournals.org/content/55/6/945.full Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study]. J Nucl Med. Mar 24, 2014; 55(6):945-950. © SNMMI (non-commercial reuse only)'']]

== PET research in [[long COVID]] ==

Because of the recency of the COVID pandemic, there is a limited amount of PET research in long COVID. Similar to ME, the PET research in long COVID is focused on neurological and brain analysis.

=== Sollini et al. 2021 ===
Sollini et al. (2021) compared 13 adult long COVID patients to a group of 26 melanoma patients with a negative PET/CT. COVID patients were matched for sex/age. In 4/13 long COVID patients, CT images showed lung abnormalities presenting mild [18F]FDG uptake. Long COVID patients also had brain hypometabolism in the right parahippocampal gyrus and [[thalamus]] (uncorrected p ≤ 0.001). This study concluded that [18F}FDG PET/CT can be a tool to analyze the multi-organ nature of long COVID.<ref name=":1">{{Cite journal|last=Sollini|first=Martina|last2=Morbelli|first2=Silvia|last3=Ciccarelli|first3=Michele|last4=Cecconi|first4=Maurizio|last5=Aghemo|first5=Alessio|last6=Morelli|first6=Paola|last7=Chiola|first7=Silvia|last8=Gelardi|first8=Fabrizia|last9=Chiti|first9=Arturo|date=2021-03-07|title=Long COVID hallmarks on [18F]FDG-PET/CT: a case-control study|url=http://link.springer.com/10.1007/s00259-021-05294-3|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05294-3|issn=1619-7070|pmc=PMC7937050|pmid=33677642}}</ref>

[[File:259 2021 5294 Fig4 HTML.jpg|thumb|'''Fig. 4 '''Brain [18F]FDG PET analysis from Sollini et al. (2021) . Regions of hypometabolism compared to controls in the 13 long COVID patients ('''a''') and subgroups of patients showing persistence of anosmia ('''b'''), fatigue ('''c'''), or mild-to-moderate vessel [18F]FDG uptake ('''d'''). Regions of significant difference are colour-graded in terms of ''Z'' values. Talairach coordinates and further details are available in Table 3 of the supplementary materials <ref name=":1" />
|274x274px|center]]

=== Guedj et al 2021. ===

Guedj et al. (2021) completed PET scans d for 35 long COVID patients which utilized a whole-brain voxel-based analysis. They compared these patients to a local database of 44 health subjects which were controlled by age and sex. Long COVID patients exhibited bilateral hypometabolism compared to health patients. Study supports that PET scans may be valuable for long COVID patients in order to perform a whole-brain voxel-based analysis. Additionally, prevalence of hypometabolism was statistically greater for COVID patients compared to healthy patients.<ref name=":0">{{Cite journal|last=Guedj|first=E.|last2=Campion|first2=J. Y.|last3=Dudouet|first3=P.|last4=Kaphan|first4=E.|last5=Bregeon|first5=F.|last6=Tissot-Dupont|first6=H.|last7=Guis|first7=S.|last8=Barthelemy|first8=F.|last9=Habert|first9=P.|date=2021-01-26|title=18F-FDG brain PET hypometabolism in patients with long COVID|url=http://link.springer.com/10.1007/s00259-021-05215-4|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05215-4|issn=1619-7070|pmc=PMC7837643|pmid=33501506}}</ref>

[[File:F43e970f9ee9daada40543d7915b4787.png|thumb|'''Fig. 1 '''from Guedje et al. (2021)
Brain 18F-FDG PET hypometabolism in patients with long COVID. In comparison to healthy subjects, the patients exhibit hypometabolism in the bilateral rectal/orbital gyrus, including the olfactory gyrus; the right temporal lobe, including the amygdala and the hippocampus, extending to the right thalamus; the bilateral pons/medulla brainstem; the bilateral cerebellum (''p''-voxel < 0.001 uncorrected, ''p''-cluster < 0.05 FWE-corrected; SPM8 3D rendering)<ref name=":0" />
|center]]

== Learn more: ==
* [https://www.nimh.nih.gov/research-priorities/therapeutics/cns-radiotracer-table.shtml List of PET radiotracers used in research]

==See also ==
*[[Brain]]
*[[Autopsy]]

== References ==
{{Reflist}}

[[Category:Medical tests]]
[[Category:Neurology]]

Positron emission tomography

2021-05-26T04:36:28Z

Nikolaspham:image format

'''Positron emission tomography''', commonly referred to as '''PET''', is a method of biomedical imaging. It uses nuclear functional imaging techniques to observe [[metabolic]] processes in the body. In clinical settings, it is predominantly used in oncology for tumor metastasis imaging, neurology, and cardiology.<ref>{{Cite web|url=https://www.sciencedirect.com/science/article/pii/S0001299800800355|title=ScienceDirect|website=www.sciencedirect.com|access-date=2019-02-27}}</ref>

== How it works ==
PET uses radioactive tracers (also called radiotracer or radioligand), which are chemical compounds that are biologically active, meaning that the compound functions/reacts/ has a biological purpose in the body. These compounds have been altered such that their structure includes a positron-emitting radioisotope (a radioactive atom). This means that the radiotracer’s movement and activity throughout the body can be detected with a PET machine. Many biological compounds have been made into a radiotracer, which allows for observation of how that compound acts throughout a region of the body.{{Citation needed|date=Mar 2021}}

=== FDG ===
For example, fludeoxyglucose (FDG), an analogue of [[glucose]], is a commonly used measure of [[metabolism]]; detection of FDG correlates with regional glucose uptake. Glucose metabolism is an important measure because cancer cells increase their metabolism to support their increased rates of proliferation and distribution throughout the body. Increased metabolic activity is usually accomplished through increased glucose-uptake. Because cancerous tumors have higher levels of metabolic activity, tumors can usually be detected with FDG-PET. In fact, around 90% of clinical PET imaging uses FDG to monitor cancer metastasis.<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pubmed/20473153|title=Glucose metabolism in cancer cells. - PubMed - NCBI|last=C|first=Annibaldi A and Widmann|website=www.ncbi.nlm.nih.gov|language=en|access-date=2019-02-27}}</ref>

== The procedure ==
A small amount of radiotracer is introduced into the subject’s body via injection, and the subject then enters the PET machine. As the radiotracer breaks down, it emits gamma rays which are picked up by the machine, and then translated into a 3-dimensional image of radiotracer concentration throughout the body. The resulting image can be thought of as a heat map, showing areas of high concentration as more brightly lit.{{Citation needed|date=Mar 2021}}

== Clinical reasons for getting a PET scan: ==
* Generally, to evaluate the function of organs such as the [[heart]] and [[brain]]
** I.e., measuring perfusion of the heart muscle
* To diagnose neurological conditions such as [[Alzheimer's disease|Alzheimer’s]], [[Huntington's disease|Huntington’s]], [[Parkinson's disease|Parkinson’s]], [[epilepsy]], and stroke
* To detect the spread of cancer
* To evaluate cancer treatment efficacy
* To locate the specific site for surgery prior to the surgical procedure
* To evaluate the brain after [[trauma]]<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== Risks ==
The risks for the amount of radiotracer injected into the body is small enough that there is usually no need to take precautions against radioactive exposure. If you are pregnant or breastfeeding, you should notify the doctor/researcher to protect against injury to the fetus or contaminating breastmilk.<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== PET research in ME ==
PET research in ME has focused on measures of [[neuroinflammation]]. This has been done using a TSPO-binding radioligand to measure [[Microglia|microglial]] activation. [[translocator protein|TSPO]] (translocator protein) is a protein that is produced when [[microglia]], the resident macrophages of the brain, become activated. Microglial activation is a commonly used measure of neuroinflammation. Further research using high-quality PET/TSPO methodology is needed to better understand the pathophysiology of neuroinflammation in ME.<ref name="Mejia2019">{{Cite journal|last=Lara Mejia|first=Paula S.|last2=Brumfield|first2=Sydney A.|last3=VanElzakker|first3=Michael B.|date=2019|title=Neuroinflammation and Cytokines in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Critical Review of Research Methods|url=https://www.frontiersin.org/articles/10.3389/fneur.2018.01033/full#B8|journal=Frontiers in Neurology|language=English|volume=9|doi=10.3389/fneur.2018.01033|issn=1664-2295}}</ref>

=== Nakatomi et al. 2014 ===
Nakatomi et al. (2014) was the first case-control study using PET to measure neuroinflammation through TSPO expression in ME. They used [[PK11195]], a first generation TSPO-binding radioligand. They found increased PK11195 in cingulate cortex, [[hippocampus]], [[amygdala]], thalamus, midbrain, and pons. PK11195 concentrations in certain regions were found to have positive correlations with cognitive impairment scores (related to brain fog), [[pain]] scores, and [[depression]] scores. The study concludes that neuroinflammation seems to be present in ME patients and is associated with neuropsychological symptoms.<ref name="Nakatomi2014" />
[[File:PK11195.gif|thumb|312x312px|center|Statistical parametric maps showing areas of significant contrast of PK11195 in brains of ME/CFS patients versus healthy controls.<ref name="Nakatomi2014">{{Cite journal|last=Nakatomi|first=Yasuhito|author-link=Yasuhito Nakatomi|author-link2=Kei Mizuno|author-link3=Akira Ishii|author-link4=Yasuhiro Wada|author-link5=Masaaki Tanaka|author-link6=Shusaku Tazawa|author-link7=Kayo Onoe|author-link8=Sanae Fukuda|author-link9=Joji Kawabe|date=Jun 1, 2014|others=Kazuhiro Takahashi; Yosky Kataoka; Susuma Shiomi; Kouzi Yamaguti, Masaaki Inaba; Hirohiko Kuratsune; Yasuyoshi Watanabe|title=Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study|url=http://jnm.snmjournals.org/content/55/6/945.full|journal=The Journal of Nuclear Medicine|volume=555|issue=6|pages=945-950|quote=|via=SNM Journals}}</ref>''This image was originally published in JNM. Nakatomi, Yasuhito, et al. [http://www.jnm.snmjournals.org/content/55/6/945.full Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study]. J Nucl Med. Mar 24, 2014; 55(6):945-950. © SNMMI (non-commercial reuse only)'']]

== PET research in [[long COVID]] ==

Because of the recency of the COVID pandemic, there is a limited amount of PET research in long COVID. Similar to ME, the PET research in long COVID is focused on neurological and brain analysis.

=== Sollini et al. 2021 ===
Sollini et al. (2021) compared 13 adult long COVID patients to a group of 26 melanoma patients with a negative PET/CT. COVID patients were matched for sex/age. In 4/13 long COVID patients, CT images showed lung abnormalities presenting mild [18F]FDG uptake. Long COVID patients also had brain hypometabolism in the right parahippocampal gyrus and [[thalamus]] (uncorrected p ≤ 0.001). This study concluded that [18F}FDG PET/CT can be a tool to analyze the multi-organ nature of long COVID.<ref name=":1">{{Cite journal|last=Sollini|first=Martina|last2=Morbelli|first2=Silvia|last3=Ciccarelli|first3=Michele|last4=Cecconi|first4=Maurizio|last5=Aghemo|first5=Alessio|last6=Morelli|first6=Paola|last7=Chiola|first7=Silvia|last8=Gelardi|first8=Fabrizia|last9=Chiti|first9=Arturo|date=2021-03-07|title=Long COVID hallmarks on [18F]FDG-PET/CT: a case-control study|url=http://link.springer.com/10.1007/s00259-021-05294-3|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05294-3|issn=1619-7070|pmc=PMC7937050|pmid=33677642}}</ref>

[[File:259 2021 5294 Fig4 HTML.jpg|thumb|'''Fig. 4 '''Brain [18F]FDG PET analysis from Sollini et al. (2021) . Regions of hypometabolism compared to controls in the 13 long COVID patients ('''a''') and subgroups of patients showing persistence of anosmia ('''b'''), fatigue ('''c'''), or mild-to-moderate vessel [18F]FDG uptake ('''d'''). Regions of significant difference are colour-graded in terms of ''Z'' values. Talairach coordinates and further details are available in Table 3 of the supplementary materials <ref name=":1" />
|274x274px|center]]

=== Guedje et al 2021. ===

Guedj et al. (2021) completed PET scans d for 35 long COVID patients which utilized a whole-brain voxel-based analysis. They compared these patients to a local database of 44 health subjects which were controlled by age and sex. Long COVID patients exhibited bilateral hypometabolism compared to health patients. Study supports that PET scans may be valuable for long COVID patients in order to perform a whole-brain voxel-based analysis. Additionally, prevalence of hypometabolism was statistically greater for COVID patients compared to healthy patients.<ref name=":0">{{Cite journal|last=Guedj|first=E.|last2=Campion|first2=J. Y.|last3=Dudouet|first3=P.|last4=Kaphan|first4=E.|last5=Bregeon|first5=F.|last6=Tissot-Dupont|first6=H.|last7=Guis|first7=S.|last8=Barthelemy|first8=F.|last9=Habert|first9=P.|date=2021-01-26|title=18F-FDG brain PET hypometabolism in patients with long COVID|url=http://link.springer.com/10.1007/s00259-021-05215-4|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05215-4|issn=1619-7070|pmc=PMC7837643|pmid=33501506}}</ref>

[[File:F43e970f9ee9daada40543d7915b4787.png|thumb|'''Fig. 1 '''from Guedje et al. (2021)
Brain 18F-FDG PET hypometabolism in patients with long COVID. In comparison to healthy subjects, the patients exhibit hypometabolism in the bilateral rectal/orbital gyrus, including the olfactory gyrus; the right temporal lobe, including the amygdala and the hippocampus, extending to the right thalamus; the bilateral pons/medulla brainstem; the bilateral cerebellum (''p''-voxel < 0.001 uncorrected, ''p''-cluster < 0.05 FWE-corrected; SPM8 3D rendering)<ref name=":0" />
|center]]

== Learn more: ==
* [https://www.nimh.nih.gov/research-priorities/therapeutics/cns-radiotracer-table.shtml List of PET radiotracers used in research]

==See also ==
*[[Brain]]
*[[Autopsy]]

== References ==
{{Reflist}}

[[Category:Medical tests]]
[[Category:Neurology]]

Positron emission tomography

2021-05-26T04:31:58Z

Nikolaspham:/* PET research in long COVID */

'''Positron emission tomography''', commonly referred to as '''PET''', is a method of biomedical imaging. It uses nuclear functional imaging techniques to observe [[metabolic]] processes in the body. In clinical settings, it is predominantly used in oncology for tumor metastasis imaging, neurology, and cardiology.<ref>{{Cite web|url=https://www.sciencedirect.com/science/article/pii/S0001299800800355|title=ScienceDirect|website=www.sciencedirect.com|access-date=2019-02-27}}</ref>

== How it works ==
PET uses radioactive tracers (also called radiotracer or radioligand), which are chemical compounds that are biologically active, meaning that the compound functions/reacts/ has a biological purpose in the body. These compounds have been altered such that their structure includes a positron-emitting radioisotope (a radioactive atom). This means that the radiotracer’s movement and activity throughout the body can be detected with a PET machine. Many biological compounds have been made into a radiotracer, which allows for observation of how that compound acts throughout a region of the body.{{Citation needed|date=Mar 2021}}

=== FDG ===
For example, fludeoxyglucose (FDG), an analogue of [[glucose]], is a commonly used measure of [[metabolism]]; detection of FDG correlates with regional glucose uptake. Glucose metabolism is an important measure because cancer cells increase their metabolism to support their increased rates of proliferation and distribution throughout the body. Increased metabolic activity is usually accomplished through increased glucose-uptake. Because cancerous tumors have higher levels of metabolic activity, tumors can usually be detected with FDG-PET. In fact, around 90% of clinical PET imaging uses FDG to monitor cancer metastasis.<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pubmed/20473153|title=Glucose metabolism in cancer cells. - PubMed - NCBI|last=C|first=Annibaldi A and Widmann|website=www.ncbi.nlm.nih.gov|language=en|access-date=2019-02-27}}</ref>

== The procedure ==
A small amount of radiotracer is introduced into the subject’s body via injection, and the subject then enters the PET machine. As the radiotracer breaks down, it emits gamma rays which are picked up by the machine, and then translated into a 3-dimensional image of radiotracer concentration throughout the body. The resulting image can be thought of as a heat map, showing areas of high concentration as more brightly lit.{{Citation needed|date=Mar 2021}}

== Clinical reasons for getting a PET scan: ==
* Generally, to evaluate the function of organs such as the [[heart]] and [[brain]]
** I.e., measuring perfusion of the heart muscle
* To diagnose neurological conditions such as [[Alzheimer's disease|Alzheimer’s]], [[Huntington's disease|Huntington’s]], [[Parkinson's disease|Parkinson’s]], [[epilepsy]], and stroke
* To detect the spread of cancer
* To evaluate cancer treatment efficacy
* To locate the specific site for surgery prior to the surgical procedure
* To evaluate the brain after [[trauma]]<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== Risks ==
The risks for the amount of radiotracer injected into the body is small enough that there is usually no need to take precautions against radioactive exposure. If you are pregnant or breastfeeding, you should notify the doctor/researcher to protect against injury to the fetus or contaminating breastmilk.<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== PET research in ME ==
PET research in ME has focused on measures of [[neuroinflammation]]. This has been done using a TSPO-binding radioligand to measure [[Microglia|microglial]] activation. [[translocator protein|TSPO]] (translocator protein) is a protein that is produced when [[microglia]], the resident macrophages of the brain, become activated. Microglial activation is a commonly used measure of neuroinflammation. Further research using high-quality PET/TSPO methodology is needed to better understand the pathophysiology of neuroinflammation in ME.<ref name="Mejia2019">{{Cite journal|last=Lara Mejia|first=Paula S.|last2=Brumfield|first2=Sydney A.|last3=VanElzakker|first3=Michael B.|date=2019|title=Neuroinflammation and Cytokines in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Critical Review of Research Methods|url=https://www.frontiersin.org/articles/10.3389/fneur.2018.01033/full#B8|journal=Frontiers in Neurology|language=English|volume=9|doi=10.3389/fneur.2018.01033|issn=1664-2295}}</ref>

=== Nakatomi et al. 2014 ===
Nakatomi et al. (2014) was the first case-control study using PET to measure neuroinflammation through TSPO expression in ME. They used [[PK11195]], a first generation TSPO-binding radioligand. They found increased PK11195 in cingulate cortex, [[hippocampus]], [[amygdala]], thalamus, midbrain, and pons. PK11195 concentrations in certain regions were found to have positive correlations with cognitive impairment scores (related to brain fog), [[pain]] scores, and [[depression]] scores. The study concludes that neuroinflammation seems to be present in ME patients and is associated with neuropsychological symptoms.<ref name="Nakatomi2014" />
[[File:PK11195.gif|thumb|312x312px|center|Statistical parametric maps showing areas of significant contrast of PK11195 in brains of ME/CFS patients versus healthy controls.<ref name="Nakatomi2014">{{Cite journal|last=Nakatomi|first=Yasuhito|author-link=Yasuhito Nakatomi|author-link2=Kei Mizuno|author-link3=Akira Ishii|author-link4=Yasuhiro Wada|author-link5=Masaaki Tanaka|author-link6=Shusaku Tazawa|author-link7=Kayo Onoe|author-link8=Sanae Fukuda|author-link9=Joji Kawabe|date=Jun 1, 2014|others=Kazuhiro Takahashi; Yosky Kataoka; Susuma Shiomi; Kouzi Yamaguti, Masaaki Inaba; Hirohiko Kuratsune; Yasuyoshi Watanabe|title=Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study|url=http://jnm.snmjournals.org/content/55/6/945.full|journal=The Journal of Nuclear Medicine|volume=555|issue=6|pages=945-950|quote=|via=SNM Journals}}</ref>''This image was originally published in JNM. Nakatomi, Yasuhito, et al. [http://www.jnm.snmjournals.org/content/55/6/945.full Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study]. J Nucl Med. Mar 24, 2014; 55(6):945-950. © SNMMI (non-commercial reuse only)'']]

== PET research in [[long COVID]] ==

Because of the recency of the COVID pandemic, there is a limited amount of PET research in long COVID. Similar to ME, the PET research in long COVID is focused on neurological and brain analysis.

=== Sollini et al. 2021 ===
Sollini et al. (2021) compared 13 adult long COVID patients to a group of 26 melanoma patients with a negative PET/CT. COVID patients were matched for sex/age. In 4/13 long COVID patients, CT images showed lung abnormalities presenting mild [18F]FDG uptake. Long COVID patients also had brain hypometabolism in the right parahippocampal gyrus and [[thalamus]] (uncorrected p ≤ 0.001). This study concluded that [18F}FDG PET/CT can be a tool to analyze the multi-organ nature of long COVID.<ref name=":1">{{Cite journal|last=Sollini|first=Martina|last2=Morbelli|first2=Silvia|last3=Ciccarelli|first3=Michele|last4=Cecconi|first4=Maurizio|last5=Aghemo|first5=Alessio|last6=Morelli|first6=Paola|last7=Chiola|first7=Silvia|last8=Gelardi|first8=Fabrizia|last9=Chiti|first9=Arturo|date=2021-03-07|title=Long COVID hallmarks on [18F]FDG-PET/CT: a case-control study|url=http://link.springer.com/10.1007/s00259-021-05294-3|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05294-3|issn=1619-7070|pmc=PMC7937050|pmid=33677642}}</ref>

=== Guedje et al 2021. ===

Guedj et al. (2021) completed PET scans d for 35 long COVID patients which utilized a whole-brain voxel-based analysis. They compared these patients to a local database of 44 health subjects which were controlled by age and sex. Long COVID patients exhibited bilateral hypometabolism compared to health patients. Study supports that PET scans may be valuable for long COVID patients in order to perform a whole-brain voxel-based analysis. Additionally, prevalence of hypometabolism was statistically greater for COVID patients compared to healthy patients.<ref name=":0">{{Cite journal|last=Guedj|first=E.|last2=Campion|first2=J. Y.|last3=Dudouet|first3=P.|last4=Kaphan|first4=E.|last5=Bregeon|first5=F.|last6=Tissot-Dupont|first6=H.|last7=Guis|first7=S.|last8=Barthelemy|first8=F.|last9=Habert|first9=P.|date=2021-01-26|title=18F-FDG brain PET hypometabolism in patients with long COVID|url=http://link.springer.com/10.1007/s00259-021-05215-4|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05215-4|issn=1619-7070|pmc=PMC7837643|pmid=33501506}}</ref>

[[File:259 2021 5294 Fig4 HTML.jpg|thumb|'''Fig. 4 '''Brain [18F]FDG PET analysis from Sollini et al. (2021) . Regions of hypometabolism compared to controls in the 13 long COVID patients ('''a''') and subgroups of patients showing persistence of anosmia ('''b'''), fatigue ('''c'''), or mild-to-moderate vessel [18F]FDG uptake ('''d'''). Regions of significant difference are colour-graded in terms of ''Z'' values. Talairach coordinates and further details are available in Table 3 of the supplementary materials <ref name=":1" />
|274x274px]]

[[File:F43e970f9ee9daada40543d7915b4787.png|thumb|'''Fig. 1 '''from Guedje et al. (2021)
Brain 18F-FDG PET hypometabolism in patients with long COVID. In comparison to healthy subjects, the patients exhibit hypometabolism in the bilateral rectal/orbital gyrus, including the olfactory gyrus; the right temporal lobe, including the amygdala and the hippocampus, extending to the right thalamus; the bilateral pons/medulla brainstem; the bilateral cerebellum (''p''-voxel < 0.001 uncorrected, ''p''-cluster < 0.05 FWE-corrected; SPM8 3D rendering)<ref name=":0" />
]]

== Learn more: ==
* [https://www.nimh.nih.gov/research-priorities/therapeutics/cns-radiotracer-table.shtml List of PET radiotracers used in research]

==See also ==
*[[Brain]]
*[[Autopsy]]

== References ==
{{Reflist}}

[[Category:Medical tests]]
[[Category:Neurology]]

Positron emission tomography

2021-05-26T04:29:46Z

Nikolaspham:/* PET research in long COVID */

'''Positron emission tomography''', commonly referred to as '''PET''', is a method of biomedical imaging. It uses nuclear functional imaging techniques to observe [[metabolic]] processes in the body. In clinical settings, it is predominantly used in oncology for tumor metastasis imaging, neurology, and cardiology.<ref>{{Cite web|url=https://www.sciencedirect.com/science/article/pii/S0001299800800355|title=ScienceDirect|website=www.sciencedirect.com|access-date=2019-02-27}}</ref>

== How it works ==
PET uses radioactive tracers (also called radiotracer or radioligand), which are chemical compounds that are biologically active, meaning that the compound functions/reacts/ has a biological purpose in the body. These compounds have been altered such that their structure includes a positron-emitting radioisotope (a radioactive atom). This means that the radiotracer’s movement and activity throughout the body can be detected with a PET machine. Many biological compounds have been made into a radiotracer, which allows for observation of how that compound acts throughout a region of the body.{{Citation needed|date=Mar 2021}}

=== FDG ===
For example, fludeoxyglucose (FDG), an analogue of [[glucose]], is a commonly used measure of [[metabolism]]; detection of FDG correlates with regional glucose uptake. Glucose metabolism is an important measure because cancer cells increase their metabolism to support their increased rates of proliferation and distribution throughout the body. Increased metabolic activity is usually accomplished through increased glucose-uptake. Because cancerous tumors have higher levels of metabolic activity, tumors can usually be detected with FDG-PET. In fact, around 90% of clinical PET imaging uses FDG to monitor cancer metastasis.<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pubmed/20473153|title=Glucose metabolism in cancer cells. - PubMed - NCBI|last=C|first=Annibaldi A and Widmann|website=www.ncbi.nlm.nih.gov|language=en|access-date=2019-02-27}}</ref>

== The procedure ==
A small amount of radiotracer is introduced into the subject’s body via injection, and the subject then enters the PET machine. As the radiotracer breaks down, it emits gamma rays which are picked up by the machine, and then translated into a 3-dimensional image of radiotracer concentration throughout the body. The resulting image can be thought of as a heat map, showing areas of high concentration as more brightly lit.{{Citation needed|date=Mar 2021}}

== Clinical reasons for getting a PET scan: ==
* Generally, to evaluate the function of organs such as the [[heart]] and [[brain]]
** I.e., measuring perfusion of the heart muscle
* To diagnose neurological conditions such as [[Alzheimer's disease|Alzheimer’s]], [[Huntington's disease|Huntington’s]], [[Parkinson's disease|Parkinson’s]], [[epilepsy]], and stroke
* To detect the spread of cancer
* To evaluate cancer treatment efficacy
* To locate the specific site for surgery prior to the surgical procedure
* To evaluate the brain after [[trauma]]<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== Risks ==
The risks for the amount of radiotracer injected into the body is small enough that there is usually no need to take precautions against radioactive exposure. If you are pregnant or breastfeeding, you should notify the doctor/researcher to protect against injury to the fetus or contaminating breastmilk.<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== PET research in ME ==
PET research in ME has focused on measures of [[neuroinflammation]]. This has been done using a TSPO-binding radioligand to measure [[Microglia|microglial]] activation. [[translocator protein|TSPO]] (translocator protein) is a protein that is produced when [[microglia]], the resident macrophages of the brain, become activated. Microglial activation is a commonly used measure of neuroinflammation. Further research using high-quality PET/TSPO methodology is needed to better understand the pathophysiology of neuroinflammation in ME.<ref name="Mejia2019">{{Cite journal|last=Lara Mejia|first=Paula S.|last2=Brumfield|first2=Sydney A.|last3=VanElzakker|first3=Michael B.|date=2019|title=Neuroinflammation and Cytokines in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Critical Review of Research Methods|url=https://www.frontiersin.org/articles/10.3389/fneur.2018.01033/full#B8|journal=Frontiers in Neurology|language=English|volume=9|doi=10.3389/fneur.2018.01033|issn=1664-2295}}</ref>

=== Nakatomi et al. 2014 ===
Nakatomi et al. (2014) was the first case-control study using PET to measure neuroinflammation through TSPO expression in ME. They used [[PK11195]], a first generation TSPO-binding radioligand. They found increased PK11195 in cingulate cortex, [[hippocampus]], [[amygdala]], thalamus, midbrain, and pons. PK11195 concentrations in certain regions were found to have positive correlations with cognitive impairment scores (related to brain fog), [[pain]] scores, and [[depression]] scores. The study concludes that neuroinflammation seems to be present in ME patients and is associated with neuropsychological symptoms.<ref name="Nakatomi2014" />
[[File:PK11195.gif|thumb|300x300px|center|Statistical parametric maps showing areas of significant contrast of PK11195 in brains of ME/CFS patients versus healthy controls.<ref name="Nakatomi2014">{{Cite journal|last=Nakatomi|first=Yasuhito|author-link=Yasuhito Nakatomi|author-link2=Kei Mizuno|author-link3=Akira Ishii|author-link4=Yasuhiro Wada|author-link5=Masaaki Tanaka|author-link6=Shusaku Tazawa|author-link7=Kayo Onoe|author-link8=Sanae Fukuda|author-link9=Joji Kawabe|date=Jun 1, 2014|others=Kazuhiro Takahashi; Yosky Kataoka; Susuma Shiomi; Kouzi Yamaguti, Masaaki Inaba; Hirohiko Kuratsune; Yasuyoshi Watanabe|title=Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study|url=http://jnm.snmjournals.org/content/55/6/945.full|journal=The Journal of Nuclear Medicine|volume=555|issue=6|pages=945-950|quote=|via=SNM Journals}}</ref>''This image was originally published in JNM. Nakatomi, Yasuhito, et al. [http://www.jnm.snmjournals.org/content/55/6/945.full Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study]. J Nucl Med. Mar 24, 2014; 55(6):945-950. © SNMMI (non-commercial reuse only)'']]

== PET research in [[long COVID]] ==

Because of the recency of the COVID pandemic, there is a limited amount of PET research in long COVID. Similar to ME, the PET research in long COVID is focused on neurological and brain analysis.

=== Sollini et al. 2021 ===
Sollini et al. (2021) compared 13 adult long COVID patients to a group of 26 melanoma patients with a negative PET/CT. COVID patients were matched for sex/age. In 4/13 long COVID patients, CT images showed lung abnormalities presenting mild [18F]FDG uptake. Long COVID patients also had brain hypometabolism in the right parahippocampal gyrus and [[thalamus]] (uncorrected p ≤ 0.001). This study concluded that [18F}FDG PET/CT can be a tool to analyze the multi-organ nature of long COVID.<ref name=":1">{{Cite journal|last=Sollini|first=Martina|last2=Morbelli|first2=Silvia|last3=Ciccarelli|first3=Michele|last4=Cecconi|first4=Maurizio|last5=Aghemo|first5=Alessio|last6=Morelli|first6=Paola|last7=Chiola|first7=Silvia|last8=Gelardi|first8=Fabrizia|last9=Chiti|first9=Arturo|date=2021-03-07|title=Long COVID hallmarks on [18F]FDG-PET/CT: a case-control study|url=http://link.springer.com/10.1007/s00259-021-05294-3|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05294-3|issn=1619-7070|pmc=PMC7937050|pmid=33677642}}</ref>

=== Guedje et al 2021. ===

Guedj et al. (2021) completed PET scans d for 35 long COVID patients which utilized a whole-brain voxel-based analysis. They compared these patients to a local database of 44 health subjects which were controlled by age and sex. Long COVID patients exhibited bilateral hypometabolism compared to health patients. Study supports that PET scans may be valuable for long COVID patients in order to perform a whole-brain voxel-based analysis. Additionally, prevalence of hypometabolism was statistically greater for COVID patients compared to healthy patients.<ref name=":0">{{Cite journal|last=Guedj|first=E.|last2=Campion|first2=J. Y.|last3=Dudouet|first3=P.|last4=Kaphan|first4=E.|last5=Bregeon|first5=F.|last6=Tissot-Dupont|first6=H.|last7=Guis|first7=S.|last8=Barthelemy|first8=F.|last9=Habert|first9=P.|date=2021-01-26|title=18F-FDG brain PET hypometabolism in patients with long COVID|url=http://link.springer.com/10.1007/s00259-021-05215-4|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05215-4|issn=1619-7070|pmc=PMC7837643|pmid=33501506}}</ref>

[[File:F43e970f9ee9daada40543d7915b4787.png|thumb|'''Fig. 1 '''from Guedje et al. (2021)
Brain 18F-FDG PET hypometabolism in patients with long COVID. In comparison to healthy subjects, the patients exhibit hypometabolism in the bilateral rectal/orbital gyrus, including the olfactory gyrus; the right temporal lobe, including the amygdala and the hippocampus, extending to the right thalamus; the bilateral pons/medulla brainstem; the bilateral cerebellum (''p''-voxel < 0.001 uncorrected, ''p''-cluster < 0.05 FWE-corrected; SPM8 3D rendering)<ref name=":0" />
]]

[[File:259 2021 5294 Fig4 HTML.jpg|thumb|'''Fig. 4 '''Brain [18F]FDG PET analysis from Sollini et al. (2021) . Regions of hypometabolism compared to controls in the 13 long COVID patients ('''a''') and subgroups of patients showing persistence of anosmia ('''b'''), fatigue ('''c'''), or mild-to-moderate vessel [18F]FDG uptake ('''d'''). Regions of significant difference are colour-graded in terms of ''Z'' values. Talairach coordinates and further details are available in Table 3 of the supplementary materials <ref name=":1" />
|274x274px]]

== Learn more: ==
* [https://www.nimh.nih.gov/research-priorities/therapeutics/cns-radiotracer-table.shtml List of PET radiotracers used in research]

==See also ==
*[[Brain]]
*[[Autopsy]]

== References ==
{{Reflist}}

[[Category:Medical tests]]
[[Category:Neurology]]

Positron emission tomography

2021-05-26T04:28:45Z

Nikolaspham:/* PET research in long COVID */

'''Positron emission tomography''', commonly referred to as '''PET''', is a method of biomedical imaging. It uses nuclear functional imaging techniques to observe [[metabolic]] processes in the body. In clinical settings, it is predominantly used in oncology for tumor metastasis imaging, neurology, and cardiology.<ref>{{Cite web|url=https://www.sciencedirect.com/science/article/pii/S0001299800800355|title=ScienceDirect|website=www.sciencedirect.com|access-date=2019-02-27}}</ref>

== How it works ==
PET uses radioactive tracers (also called radiotracer or radioligand), which are chemical compounds that are biologically active, meaning that the compound functions/reacts/ has a biological purpose in the body. These compounds have been altered such that their structure includes a positron-emitting radioisotope (a radioactive atom). This means that the radiotracer’s movement and activity throughout the body can be detected with a PET machine. Many biological compounds have been made into a radiotracer, which allows for observation of how that compound acts throughout a region of the body.{{Citation needed|date=Mar 2021}}

=== FDG ===
For example, fludeoxyglucose (FDG), an analogue of [[glucose]], is a commonly used measure of [[metabolism]]; detection of FDG correlates with regional glucose uptake. Glucose metabolism is an important measure because cancer cells increase their metabolism to support their increased rates of proliferation and distribution throughout the body. Increased metabolic activity is usually accomplished through increased glucose-uptake. Because cancerous tumors have higher levels of metabolic activity, tumors can usually be detected with FDG-PET. In fact, around 90% of clinical PET imaging uses FDG to monitor cancer metastasis.<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pubmed/20473153|title=Glucose metabolism in cancer cells. - PubMed - NCBI|last=C|first=Annibaldi A and Widmann|website=www.ncbi.nlm.nih.gov|language=en|access-date=2019-02-27}}</ref>

== The procedure ==
A small amount of radiotracer is introduced into the subject’s body via injection, and the subject then enters the PET machine. As the radiotracer breaks down, it emits gamma rays which are picked up by the machine, and then translated into a 3-dimensional image of radiotracer concentration throughout the body. The resulting image can be thought of as a heat map, showing areas of high concentration as more brightly lit.{{Citation needed|date=Mar 2021}}

== Clinical reasons for getting a PET scan: ==
* Generally, to evaluate the function of organs such as the [[heart]] and [[brain]]
** I.e., measuring perfusion of the heart muscle
* To diagnose neurological conditions such as [[Alzheimer's disease|Alzheimer’s]], [[Huntington's disease|Huntington’s]], [[Parkinson's disease|Parkinson’s]], [[epilepsy]], and stroke
* To detect the spread of cancer
* To evaluate cancer treatment efficacy
* To locate the specific site for surgery prior to the surgical procedure
* To evaluate the brain after [[trauma]]<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== Risks ==
The risks for the amount of radiotracer injected into the body is small enough that there is usually no need to take precautions against radioactive exposure. If you are pregnant or breastfeeding, you should notify the doctor/researcher to protect against injury to the fetus or contaminating breastmilk.<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== PET research in ME ==
PET research in ME has focused on measures of [[neuroinflammation]]. This has been done using a TSPO-binding radioligand to measure [[Microglia|microglial]] activation. [[translocator protein|TSPO]] (translocator protein) is a protein that is produced when [[microglia]], the resident macrophages of the brain, become activated. Microglial activation is a commonly used measure of neuroinflammation. Further research using high-quality PET/TSPO methodology is needed to better understand the pathophysiology of neuroinflammation in ME.<ref name="Mejia2019">{{Cite journal|last=Lara Mejia|first=Paula S.|last2=Brumfield|first2=Sydney A.|last3=VanElzakker|first3=Michael B.|date=2019|title=Neuroinflammation and Cytokines in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Critical Review of Research Methods|url=https://www.frontiersin.org/articles/10.3389/fneur.2018.01033/full#B8|journal=Frontiers in Neurology|language=English|volume=9|doi=10.3389/fneur.2018.01033|issn=1664-2295}}</ref>

=== Nakatomi et al. 2014 ===
Nakatomi et al. (2014) was the first case-control study using PET to measure neuroinflammation through TSPO expression in ME. They used [[PK11195]], a first generation TSPO-binding radioligand. They found increased PK11195 in cingulate cortex, [[hippocampus]], [[amygdala]], thalamus, midbrain, and pons. PK11195 concentrations in certain regions were found to have positive correlations with cognitive impairment scores (related to brain fog), [[pain]] scores, and [[depression]] scores. The study concludes that neuroinflammation seems to be present in ME patients and is associated with neuropsychological symptoms.<ref name="Nakatomi2014" />
[[File:PK11195.gif|thumb|300x300px|center|Statistical parametric maps showing areas of significant contrast of PK11195 in brains of ME/CFS patients versus healthy controls.<ref name="Nakatomi2014">{{Cite journal|last=Nakatomi|first=Yasuhito|author-link=Yasuhito Nakatomi|author-link2=Kei Mizuno|author-link3=Akira Ishii|author-link4=Yasuhiro Wada|author-link5=Masaaki Tanaka|author-link6=Shusaku Tazawa|author-link7=Kayo Onoe|author-link8=Sanae Fukuda|author-link9=Joji Kawabe|date=Jun 1, 2014|others=Kazuhiro Takahashi; Yosky Kataoka; Susuma Shiomi; Kouzi Yamaguti, Masaaki Inaba; Hirohiko Kuratsune; Yasuyoshi Watanabe|title=Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study|url=http://jnm.snmjournals.org/content/55/6/945.full|journal=The Journal of Nuclear Medicine|volume=555|issue=6|pages=945-950|quote=|via=SNM Journals}}</ref>''This image was originally published in JNM. Nakatomi, Yasuhito, et al. [http://www.jnm.snmjournals.org/content/55/6/945.full Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study]. J Nucl Med. Mar 24, 2014; 55(6):945-950. © SNMMI (non-commercial reuse only)'']]

== PET research in [[long COVID]] ==

Because of the recency of the COVID pandemic, there is a limited amount of PET research in long COVID. Similar to ME, the PET research in long COVID is focused on neurological and brain analysis.

=== Sollini et al. 2021 ===
Sollini et al. (2021) compared 13 adult long COVID patients to a group of 26 melanoma patients with a negative PET/CT. COVID patients were matched for sex/age. In 4/13 long COVID patients, CT images showed lung abnormalities presenting mild [18F]FDG uptake. Long COVID patients also had brain hypometabolism in the right parahippocampal gyrus and [[thalamus]] (uncorrected p ≤ 0.001). This study concluded that [18F}FDG PET/CT can be a tool to analyze the multi-organ nature of long COVID.<ref name=":1">{{Cite journal|last=Sollini|first=Martina|last2=Morbelli|first2=Silvia|last3=Ciccarelli|first3=Michele|last4=Cecconi|first4=Maurizio|last5=Aghemo|first5=Alessio|last6=Morelli|first6=Paola|last7=Chiola|first7=Silvia|last8=Gelardi|first8=Fabrizia|last9=Chiti|first9=Arturo|date=2021-03-07|title=Long COVID hallmarks on [18F]FDG-PET/CT: a case-control study|url=http://link.springer.com/10.1007/s00259-021-05294-3|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05294-3|issn=1619-7070|pmc=PMC7937050|pmid=33677642}}</ref>

[[File:259 2021 5294 Fig4 HTML.jpg|thumb|'''Fig. 4 '''Brain [18F]FDG PET analysis from Sollini et al. (2021) . Regions of hypometabolism compared to controls in the 13 long COVID patients ('''a''') and subgroups of patients showing persistence of anosmia ('''b'''), fatigue ('''c'''), or mild-to-moderate vessel [18F]FDG uptake ('''d'''). Regions of significant difference are colour-graded in terms of ''Z'' values. Talairach coordinates and further details are available in Table 3 of the supplementary materials <ref name=":1" />
]]

=== Guedje et al 2021. ===

Guedj et al. (2021) completed PET scans d for 35 long COVID patients which utilized a whole-brain voxel-based analysis. They compared these patients to a local database of 44 health subjects which were controlled by age and sex. Long COVID patients exhibited bilateral hypometabolism compared to health patients. Study supports that PET scans may be valuable for long COVID patients in order to perform a whole-brain voxel-based analysis. Additionally, prevalence of hypometabolism was statistically greater for COVID patients compared to healthy patients.<ref name=":0">{{Cite journal|last=Guedj|first=E.|last2=Campion|first2=J. Y.|last3=Dudouet|first3=P.|last4=Kaphan|first4=E.|last5=Bregeon|first5=F.|last6=Tissot-Dupont|first6=H.|last7=Guis|first7=S.|last8=Barthelemy|first8=F.|last9=Habert|first9=P.|date=2021-01-26|title=18F-FDG brain PET hypometabolism in patients with long COVID|url=http://link.springer.com/10.1007/s00259-021-05215-4|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05215-4|issn=1619-7070|pmc=PMC7837643|pmid=33501506}}</ref>

[[File:F43e970f9ee9daada40543d7915b4787.png|thumb|'''Fig. 1 '''from Guedje et al. (2021)
Brain 18F-FDG PET hypometabolism in patients with long COVID. In comparison to healthy subjects, the patients exhibit hypometabolism in the bilateral rectal/orbital gyrus, including the olfactory gyrus; the right temporal lobe, including the amygdala and the hippocampus, extending to the right thalamus; the bilateral pons/medulla brainstem; the bilateral cerebellum (''p''-voxel < 0.001 uncorrected, ''p''-cluster < 0.05 FWE-corrected; SPM8 3D rendering)<ref name=":0" />
]]

== Learn more: ==
* [https://www.nimh.nih.gov/research-priorities/therapeutics/cns-radiotracer-table.shtml List of PET radiotracers used in research]

==See also ==
*[[Brain]]
*[[Autopsy]]

== References ==
{{Reflist}}

[[Category:Medical tests]]
[[Category:Neurology]]

Positron emission tomography

2021-05-26T04:25:51Z

Nikolaspham:/* PET research in long COVID */

'''Positron emission tomography''', commonly referred to as '''PET''', is a method of biomedical imaging. It uses nuclear functional imaging techniques to observe [[metabolic]] processes in the body. In clinical settings, it is predominantly used in oncology for tumor metastasis imaging, neurology, and cardiology.<ref>{{Cite web|url=https://www.sciencedirect.com/science/article/pii/S0001299800800355|title=ScienceDirect|website=www.sciencedirect.com|access-date=2019-02-27}}</ref>

== How it works ==
PET uses radioactive tracers (also called radiotracer or radioligand), which are chemical compounds that are biologically active, meaning that the compound functions/reacts/ has a biological purpose in the body. These compounds have been altered such that their structure includes a positron-emitting radioisotope (a radioactive atom). This means that the radiotracer’s movement and activity throughout the body can be detected with a PET machine. Many biological compounds have been made into a radiotracer, which allows for observation of how that compound acts throughout a region of the body.{{Citation needed|date=Mar 2021}}

=== FDG ===
For example, fludeoxyglucose (FDG), an analogue of [[glucose]], is a commonly used measure of [[metabolism]]; detection of FDG correlates with regional glucose uptake. Glucose metabolism is an important measure because cancer cells increase their metabolism to support their increased rates of proliferation and distribution throughout the body. Increased metabolic activity is usually accomplished through increased glucose-uptake. Because cancerous tumors have higher levels of metabolic activity, tumors can usually be detected with FDG-PET. In fact, around 90% of clinical PET imaging uses FDG to monitor cancer metastasis.<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pubmed/20473153|title=Glucose metabolism in cancer cells. - PubMed - NCBI|last=C|first=Annibaldi A and Widmann|website=www.ncbi.nlm.nih.gov|language=en|access-date=2019-02-27}}</ref>

== The procedure ==
A small amount of radiotracer is introduced into the subject’s body via injection, and the subject then enters the PET machine. As the radiotracer breaks down, it emits gamma rays which are picked up by the machine, and then translated into a 3-dimensional image of radiotracer concentration throughout the body. The resulting image can be thought of as a heat map, showing areas of high concentration as more brightly lit.{{Citation needed|date=Mar 2021}}

== Clinical reasons for getting a PET scan: ==
* Generally, to evaluate the function of organs such as the [[heart]] and [[brain]]
** I.e., measuring perfusion of the heart muscle
* To diagnose neurological conditions such as [[Alzheimer's disease|Alzheimer’s]], [[Huntington's disease|Huntington’s]], [[Parkinson's disease|Parkinson’s]], [[epilepsy]], and stroke
* To detect the spread of cancer
* To evaluate cancer treatment efficacy
* To locate the specific site for surgery prior to the surgical procedure
* To evaluate the brain after [[trauma]]<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== Risks ==
The risks for the amount of radiotracer injected into the body is small enough that there is usually no need to take precautions against radioactive exposure. If you are pregnant or breastfeeding, you should notify the doctor/researcher to protect against injury to the fetus or contaminating breastmilk.<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== PET research in ME ==
PET research in ME has focused on measures of [[neuroinflammation]]. This has been done using a TSPO-binding radioligand to measure [[Microglia|microglial]] activation. [[translocator protein|TSPO]] (translocator protein) is a protein that is produced when [[microglia]], the resident macrophages of the brain, become activated. Microglial activation is a commonly used measure of neuroinflammation. Further research using high-quality PET/TSPO methodology is needed to better understand the pathophysiology of neuroinflammation in ME.<ref name="Mejia2019">{{Cite journal|last=Lara Mejia|first=Paula S.|last2=Brumfield|first2=Sydney A.|last3=VanElzakker|first3=Michael B.|date=2019|title=Neuroinflammation and Cytokines in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Critical Review of Research Methods|url=https://www.frontiersin.org/articles/10.3389/fneur.2018.01033/full#B8|journal=Frontiers in Neurology|language=English|volume=9|doi=10.3389/fneur.2018.01033|issn=1664-2295}}</ref>

=== Nakatomi et al. 2014 ===
Nakatomi et al. (2014) was the first case-control study using PET to measure neuroinflammation through TSPO expression in ME. They used [[PK11195]], a first generation TSPO-binding radioligand. They found increased PK11195 in cingulate cortex, [[hippocampus]], [[amygdala]], thalamus, midbrain, and pons. PK11195 concentrations in certain regions were found to have positive correlations with cognitive impairment scores (related to brain fog), [[pain]] scores, and [[depression]] scores. The study concludes that neuroinflammation seems to be present in ME patients and is associated with neuropsychological symptoms.<ref name="Nakatomi2014" />
[[File:PK11195.gif|thumb|300x300px|center|Statistical parametric maps showing areas of significant contrast of PK11195 in brains of ME/CFS patients versus healthy controls.<ref name="Nakatomi2014">{{Cite journal|last=Nakatomi|first=Yasuhito|author-link=Yasuhito Nakatomi|author-link2=Kei Mizuno|author-link3=Akira Ishii|author-link4=Yasuhiro Wada|author-link5=Masaaki Tanaka|author-link6=Shusaku Tazawa|author-link7=Kayo Onoe|author-link8=Sanae Fukuda|author-link9=Joji Kawabe|date=Jun 1, 2014|others=Kazuhiro Takahashi; Yosky Kataoka; Susuma Shiomi; Kouzi Yamaguti, Masaaki Inaba; Hirohiko Kuratsune; Yasuyoshi Watanabe|title=Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study|url=http://jnm.snmjournals.org/content/55/6/945.full|journal=The Journal of Nuclear Medicine|volume=555|issue=6|pages=945-950|quote=|via=SNM Journals}}</ref>''This image was originally published in JNM. Nakatomi, Yasuhito, et al. [http://www.jnm.snmjournals.org/content/55/6/945.full Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study]. J Nucl Med. Mar 24, 2014; 55(6):945-950. © SNMMI (non-commercial reuse only)'']]

== PET research in [[long COVID]] ==

Because of the recency of the COVID pandemic, there is a limited amount of PET research in long COVID. Similar to ME, the PET research in long COVID is focused on neurological and brain analysis.

=== Sollini et al. 2021 ===
Sollini et al. (2021) compared 13 adult long COVID patients to a group of 26 melanoma patients with a negative PET/CT. COVID patients were matched for sex/age. In 4/13 long COVID patients, CT images showed lung abnormalities presenting mild [18F]FDG uptake. Long COVID patients also had brain hypometabolism in the right parahippocampal gyrus and [[thalamus]] (uncorrected p ≤ 0.001). This study concluded that [18F}FDG PET/CT can be a tool to analyze the multi-organ nature of long COVID.<ref name=":1">{{Cite journal|last=Sollini|first=Martina|last2=Morbelli|first2=Silvia|last3=Ciccarelli|first3=Michele|last4=Cecconi|first4=Maurizio|last5=Aghemo|first5=Alessio|last6=Morelli|first6=Paola|last7=Chiola|first7=Silvia|last8=Gelardi|first8=Fabrizia|last9=Chiti|first9=Arturo|date=2021-03-07|title=Long COVID hallmarks on [18F]FDG-PET/CT: a case-control study|url=http://link.springer.com/10.1007/s00259-021-05294-3|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05294-3|issn=1619-7070|pmc=PMC7937050|pmid=33677642}}</ref>

[[File:259 2021 5294 Fig4 HTML.jpg|thumb|'''Fig. 4 '''Brain [18F]FDG PET analysis from Sollini et al. (2021) . Regions of hypometabolism compared to controls in the 13 long COVID patients ('''a''') and subgroups of patients showing persistence of anosmia ('''b'''), fatigue ('''c'''), or mild-to-moderate vessel [18F]FDG uptake ('''d'''). Regions of significant difference are colour-graded in terms of ''Z'' values. Talairach coordinates and further details are available in Table 3 of the supplementary materials <ref name=":1" />
]]

=== Guedje et al 2021. ===

Guedj et al. (2021) completed PET scans d for 35 long COVID patients which utilized a whole-brain voxel-based analysis. They compared these patients to a local database of 44 health subjects which were controlled by age and sex. Long COVID patients exhibited bilateral hypometabolism compared to health patients. Study supports that PET scans may be valuable for long COVID patients in order to perform a whole-brain voxel-based analysis. Additionally, prevalence of hypometabolism was statistically greater for COVID patients compared to healthy patients.<ref name=":0">{{Cite journal|last=Guedj|first=E.|last2=Campion|first2=J. Y.|last3=Dudouet|first3=P.|last4=Kaphan|first4=E.|last5=Bregeon|first5=F.|last6=Tissot-Dupont|first6=H.|last7=Guis|first7=S.|last8=Barthelemy|first8=F.|last9=Habert|first9=P.|date=2021-01-26|title=18F-FDG brain PET hypometabolism in patients with long COVID|url=http://link.springer.com/10.1007/s00259-021-05215-4|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05215-4|issn=1619-7070|pmc=PMC7837643|pmid=33501506}}</ref>

== Learn more: ==
* [https://www.nimh.nih.gov/research-priorities/therapeutics/cns-radiotracer-table.shtml List of PET radiotracers used in research]

==See also ==
*[[Brain]]
*[[Autopsy]]

== References ==
{{Reflist}}

[[Category:Medical tests]]
[[Category:Neurology]]

Positron emission tomography

2021-05-26T04:25:06Z

Nikolaspham:/* PET research in long COVID */

'''Positron emission tomography''', commonly referred to as '''PET''', is a method of biomedical imaging. It uses nuclear functional imaging techniques to observe [[metabolic]] processes in the body. In clinical settings, it is predominantly used in oncology for tumor metastasis imaging, neurology, and cardiology.<ref>{{Cite web|url=https://www.sciencedirect.com/science/article/pii/S0001299800800355|title=ScienceDirect|website=www.sciencedirect.com|access-date=2019-02-27}}</ref>

== How it works ==
PET uses radioactive tracers (also called radiotracer or radioligand), which are chemical compounds that are biologically active, meaning that the compound functions/reacts/ has a biological purpose in the body. These compounds have been altered such that their structure includes a positron-emitting radioisotope (a radioactive atom). This means that the radiotracer’s movement and activity throughout the body can be detected with a PET machine. Many biological compounds have been made into a radiotracer, which allows for observation of how that compound acts throughout a region of the body.{{Citation needed|date=Mar 2021}}

=== FDG ===
For example, fludeoxyglucose (FDG), an analogue of [[glucose]], is a commonly used measure of [[metabolism]]; detection of FDG correlates with regional glucose uptake. Glucose metabolism is an important measure because cancer cells increase their metabolism to support their increased rates of proliferation and distribution throughout the body. Increased metabolic activity is usually accomplished through increased glucose-uptake. Because cancerous tumors have higher levels of metabolic activity, tumors can usually be detected with FDG-PET. In fact, around 90% of clinical PET imaging uses FDG to monitor cancer metastasis.<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pubmed/20473153|title=Glucose metabolism in cancer cells. - PubMed - NCBI|last=C|first=Annibaldi A and Widmann|website=www.ncbi.nlm.nih.gov|language=en|access-date=2019-02-27}}</ref>

== The procedure ==
A small amount of radiotracer is introduced into the subject’s body via injection, and the subject then enters the PET machine. As the radiotracer breaks down, it emits gamma rays which are picked up by the machine, and then translated into a 3-dimensional image of radiotracer concentration throughout the body. The resulting image can be thought of as a heat map, showing areas of high concentration as more brightly lit.{{Citation needed|date=Mar 2021}}

== Clinical reasons for getting a PET scan: ==
* Generally, to evaluate the function of organs such as the [[heart]] and [[brain]]
** I.e., measuring perfusion of the heart muscle
* To diagnose neurological conditions such as [[Alzheimer's disease|Alzheimer’s]], [[Huntington's disease|Huntington’s]], [[Parkinson's disease|Parkinson’s]], [[epilepsy]], and stroke
* To detect the spread of cancer
* To evaluate cancer treatment efficacy
* To locate the specific site for surgery prior to the surgical procedure
* To evaluate the brain after [[trauma]]<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== Risks ==
The risks for the amount of radiotracer injected into the body is small enough that there is usually no need to take precautions against radioactive exposure. If you are pregnant or breastfeeding, you should notify the doctor/researcher to protect against injury to the fetus or contaminating breastmilk.<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== PET research in ME ==
PET research in ME has focused on measures of [[neuroinflammation]]. This has been done using a TSPO-binding radioligand to measure [[Microglia|microglial]] activation. [[translocator protein|TSPO]] (translocator protein) is a protein that is produced when [[microglia]], the resident macrophages of the brain, become activated. Microglial activation is a commonly used measure of neuroinflammation. Further research using high-quality PET/TSPO methodology is needed to better understand the pathophysiology of neuroinflammation in ME.<ref name="Mejia2019">{{Cite journal|last=Lara Mejia|first=Paula S.|last2=Brumfield|first2=Sydney A.|last3=VanElzakker|first3=Michael B.|date=2019|title=Neuroinflammation and Cytokines in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Critical Review of Research Methods|url=https://www.frontiersin.org/articles/10.3389/fneur.2018.01033/full#B8|journal=Frontiers in Neurology|language=English|volume=9|doi=10.3389/fneur.2018.01033|issn=1664-2295}}</ref>

=== Nakatomi et al. 2014 ===
Nakatomi et al. (2014) was the first case-control study using PET to measure neuroinflammation through TSPO expression in ME. They used [[PK11195]], a first generation TSPO-binding radioligand. They found increased PK11195 in cingulate cortex, [[hippocampus]], [[amygdala]], thalamus, midbrain, and pons. PK11195 concentrations in certain regions were found to have positive correlations with cognitive impairment scores (related to brain fog), [[pain]] scores, and [[depression]] scores. The study concludes that neuroinflammation seems to be present in ME patients and is associated with neuropsychological symptoms.<ref name="Nakatomi2014" />
[[File:PK11195.gif|thumb|300x300px|center|Statistical parametric maps showing areas of significant contrast of PK11195 in brains of ME/CFS patients versus healthy controls.<ref name="Nakatomi2014">{{Cite journal|last=Nakatomi|first=Yasuhito|author-link=Yasuhito Nakatomi|author-link2=Kei Mizuno|author-link3=Akira Ishii|author-link4=Yasuhiro Wada|author-link5=Masaaki Tanaka|author-link6=Shusaku Tazawa|author-link7=Kayo Onoe|author-link8=Sanae Fukuda|author-link9=Joji Kawabe|date=Jun 1, 2014|others=Kazuhiro Takahashi; Yosky Kataoka; Susuma Shiomi; Kouzi Yamaguti, Masaaki Inaba; Hirohiko Kuratsune; Yasuyoshi Watanabe|title=Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study|url=http://jnm.snmjournals.org/content/55/6/945.full|journal=The Journal of Nuclear Medicine|volume=555|issue=6|pages=945-950|quote=|via=SNM Journals}}</ref>''This image was originally published in JNM. Nakatomi, Yasuhito, et al. [http://www.jnm.snmjournals.org/content/55/6/945.full Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study]. J Nucl Med. Mar 24, 2014; 55(6):945-950. © SNMMI (non-commercial reuse only)'']]

== PET research in [[long COVID]] ==

Because of the recency of the COVID pandemic, there is a limited amount of PET research in long COVID. Similar to ME, the PET research in long COVID is focused on neurological and brain analysis.

=== Sollini et al. 2021 ===
Sollini et al. (2021) compared 13 adult long COVID patients to a group of 26 melanoma patients with a negative PET/CT. COVID patients were matched for sex/age. In 4/13 long COVID patients, CT images showed lung abnormalities presenting mild [18F]FDG uptake. Long COVID patients also had brain hypometabolism in the right parahippocampal gyrus and [[thalamus]] (uncorrected p ≤ 0.001). This study concluded that [18F}FDG PET/CT can be a tool to analyze the multi-organ nature of long COVID.<ref>{{Cite journal|last=Sollini|first=Martina|last2=Morbelli|first2=Silvia|last3=Ciccarelli|first3=Michele|last4=Cecconi|first4=Maurizio|last5=Aghemo|first5=Alessio|last6=Morelli|first6=Paola|last7=Chiola|first7=Silvia|last8=Gelardi|first8=Fabrizia|last9=Chiti|first9=Arturo|date=2021-03-07|title=Long COVID hallmarks on [18F]FDG-PET/CT: a case-control study|url=http://link.springer.com/10.1007/s00259-021-05294-3|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05294-3|issn=1619-7070|pmc=PMC7937050|pmid=33677642}}</ref>

[[File:259 2021 5294 Fig4 HTML.jpg|thumb|'''Fig. 4 '''Brain [18F]FDG PET analysis from Guedj et al. (2021) . Regions of hypometabolism compared to controls in the 13 long COVID patients ('''a''') and subgroups of patients showing persistence of anosmia ('''b'''), fatigue ('''c'''), or mild-to-moderate vessel [18F]FDG uptake ('''d'''). Regions of significant difference are colour-graded in terms of ''Z'' values. Talairach coordinates and further details are available in Table 3 of the supplementary materials <ref name=":0" />
]]

=== Guedje et al 2021. ===

Guedj et al. (2021) completed PET scans d for 35 long COVID patients which utilized a whole-brain voxel-based analysis. They compared these patients to a local database of 44 health subjects which were controlled by age and sex. Long COVID patients exhibited bilateral hypometabolism compared to health patients. Study supports that PET scans may be valuable for long COVID patients in order to perform a whole-brain voxel-based analysis. Additionally, prevalence of hypometabolism was statistically greater for COVID patients compared to healthy patients.<ref name=":0">{{Cite journal|last=Guedj|first=E.|last2=Campion|first2=J. Y.|last3=Dudouet|first3=P.|last4=Kaphan|first4=E.|last5=Bregeon|first5=F.|last6=Tissot-Dupont|first6=H.|last7=Guis|first7=S.|last8=Barthelemy|first8=F.|last9=Habert|first9=P.|date=2021-01-26|title=18F-FDG brain PET hypometabolism in patients with long COVID|url=http://link.springer.com/10.1007/s00259-021-05215-4|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05215-4|issn=1619-7070|pmc=PMC7837643|pmid=33501506}}</ref>

== Learn more: ==
* [https://www.nimh.nih.gov/research-priorities/therapeutics/cns-radiotracer-table.shtml List of PET radiotracers used in research]

==See also ==
*[[Brain]]
*[[Autopsy]]

== References ==
{{Reflist}}

[[Category:Medical tests]]
[[Category:Neurology]]

Positron emission tomography

2021-05-26T04:23:57Z

Nikolaspham:/* PET research in ME */

'''Positron emission tomography''', commonly referred to as '''PET''', is a method of biomedical imaging. It uses nuclear functional imaging techniques to observe [[metabolic]] processes in the body. In clinical settings, it is predominantly used in oncology for tumor metastasis imaging, neurology, and cardiology.<ref>{{Cite web|url=https://www.sciencedirect.com/science/article/pii/S0001299800800355|title=ScienceDirect|website=www.sciencedirect.com|access-date=2019-02-27}}</ref>

== How it works ==
PET uses radioactive tracers (also called radiotracer or radioligand), which are chemical compounds that are biologically active, meaning that the compound functions/reacts/ has a biological purpose in the body. These compounds have been altered such that their structure includes a positron-emitting radioisotope (a radioactive atom). This means that the radiotracer’s movement and activity throughout the body can be detected with a PET machine. Many biological compounds have been made into a radiotracer, which allows for observation of how that compound acts throughout a region of the body.{{Citation needed|date=Mar 2021}}

=== FDG ===
For example, fludeoxyglucose (FDG), an analogue of [[glucose]], is a commonly used measure of [[metabolism]]; detection of FDG correlates with regional glucose uptake. Glucose metabolism is an important measure because cancer cells increase their metabolism to support their increased rates of proliferation and distribution throughout the body. Increased metabolic activity is usually accomplished through increased glucose-uptake. Because cancerous tumors have higher levels of metabolic activity, tumors can usually be detected with FDG-PET. In fact, around 90% of clinical PET imaging uses FDG to monitor cancer metastasis.<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pubmed/20473153|title=Glucose metabolism in cancer cells. - PubMed - NCBI|last=C|first=Annibaldi A and Widmann|website=www.ncbi.nlm.nih.gov|language=en|access-date=2019-02-27}}</ref>

== The procedure ==
A small amount of radiotracer is introduced into the subject’s body via injection, and the subject then enters the PET machine. As the radiotracer breaks down, it emits gamma rays which are picked up by the machine, and then translated into a 3-dimensional image of radiotracer concentration throughout the body. The resulting image can be thought of as a heat map, showing areas of high concentration as more brightly lit.{{Citation needed|date=Mar 2021}}

== Clinical reasons for getting a PET scan: ==
* Generally, to evaluate the function of organs such as the [[heart]] and [[brain]]
** I.e., measuring perfusion of the heart muscle
* To diagnose neurological conditions such as [[Alzheimer's disease|Alzheimer’s]], [[Huntington's disease|Huntington’s]], [[Parkinson's disease|Parkinson’s]], [[epilepsy]], and stroke
* To detect the spread of cancer
* To evaluate cancer treatment efficacy
* To locate the specific site for surgery prior to the surgical procedure
* To evaluate the brain after [[trauma]]<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== Risks ==
The risks for the amount of radiotracer injected into the body is small enough that there is usually no need to take precautions against radioactive exposure. If you are pregnant or breastfeeding, you should notify the doctor/researcher to protect against injury to the fetus or contaminating breastmilk.<ref>{{Cite web|url=https://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/positron_emission_tomography_pet_92,p07654|title=How Does a PET Scan Work?|website=www.hopkinsmedicine.org|language=en|access-date=2019-02-27}}</ref>

== PET research in ME ==
PET research in ME has focused on measures of [[neuroinflammation]]. This has been done using a TSPO-binding radioligand to measure [[Microglia|microglial]] activation. [[translocator protein|TSPO]] (translocator protein) is a protein that is produced when [[microglia]], the resident macrophages of the brain, become activated. Microglial activation is a commonly used measure of neuroinflammation. Further research using high-quality PET/TSPO methodology is needed to better understand the pathophysiology of neuroinflammation in ME.<ref name="Mejia2019">{{Cite journal|last=Lara Mejia|first=Paula S.|last2=Brumfield|first2=Sydney A.|last3=VanElzakker|first3=Michael B.|date=2019|title=Neuroinflammation and Cytokines in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Critical Review of Research Methods|url=https://www.frontiersin.org/articles/10.3389/fneur.2018.01033/full#B8|journal=Frontiers in Neurology|language=English|volume=9|doi=10.3389/fneur.2018.01033|issn=1664-2295}}</ref>

=== Nakatomi et al. 2014 ===
Nakatomi et al. (2014) was the first case-control study using PET to measure neuroinflammation through TSPO expression in ME. They used [[PK11195]], a first generation TSPO-binding radioligand. They found increased PK11195 in cingulate cortex, [[hippocampus]], [[amygdala]], thalamus, midbrain, and pons. PK11195 concentrations in certain regions were found to have positive correlations with cognitive impairment scores (related to brain fog), [[pain]] scores, and [[depression]] scores. The study concludes that neuroinflammation seems to be present in ME patients and is associated with neuropsychological symptoms.<ref name="Nakatomi2014" />
[[File:PK11195.gif|thumb|300x300px|center|Statistical parametric maps showing areas of significant contrast of PK11195 in brains of ME/CFS patients versus healthy controls.<ref name="Nakatomi2014">{{Cite journal|last=Nakatomi|first=Yasuhito|author-link=Yasuhito Nakatomi|author-link2=Kei Mizuno|author-link3=Akira Ishii|author-link4=Yasuhiro Wada|author-link5=Masaaki Tanaka|author-link6=Shusaku Tazawa|author-link7=Kayo Onoe|author-link8=Sanae Fukuda|author-link9=Joji Kawabe|date=Jun 1, 2014|others=Kazuhiro Takahashi; Yosky Kataoka; Susuma Shiomi; Kouzi Yamaguti, Masaaki Inaba; Hirohiko Kuratsune; Yasuyoshi Watanabe|title=Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study|url=http://jnm.snmjournals.org/content/55/6/945.full|journal=The Journal of Nuclear Medicine|volume=555|issue=6|pages=945-950|quote=|via=SNM Journals}}</ref>''This image was originally published in JNM. Nakatomi, Yasuhito, et al. [http://www.jnm.snmjournals.org/content/55/6/945.full Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study]. J Nucl Med. Mar 24, 2014; 55(6):945-950. © SNMMI (non-commercial reuse only)'']]

== PET research in [[long COVID]] ==

Because of the recency of the COVID pandemic, there is a limited amount of PET research in long COVID. Similar to ME, the PET research in long COVID is focused on neurological and brain analysis.

=== Sollini et al. 2021 ===
Sollini et al. (2021) compared 13 adult long COVID patients to a group of 26 melanoma patients with a negative PET/CT. COVID patients were matched for sex/age. In 4/13 long COVID patients, CT images showed lung abnormalities presenting mild [18F]FDG uptake. Long COVID patients also had brain hypometabolism in the right parahippocampal gyrus and [[thalamus]] (uncorrected p ≤ 0.001). This study concluded that [18F}FDG PET/CT can be a tool to analyze the multi-organ nature of long COVID.<ref>{{Cite journal|last=Sollini|first=Martina|last2=Morbelli|first2=Silvia|last3=Ciccarelli|first3=Michele|last4=Cecconi|first4=Maurizio|last5=Aghemo|first5=Alessio|last6=Morelli|first6=Paola|last7=Chiola|first7=Silvia|last8=Gelardi|first8=Fabrizia|last9=Chiti|first9=Arturo|date=2021-03-07|title=Long COVID hallmarks on [18F]FDG-PET/CT: a case-control study|url=http://link.springer.com/10.1007/s00259-021-05294-3|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05294-3|issn=1619-7070|pmc=PMC7937050|pmid=33677642}}</ref>

[[File:259 2021 5294 Fig4 HTML.jpg|thumb|'''Fig. 4 '''
Brain [18F]FDG PET analysis. Regions of hypometabolism compared to controls in the 13 long COVID patients ('''a''') and subgroups of patients showing persistence of anosmia ('''b'''), fatigue ('''c'''), or mild-to-moderate vessel [18F]FDG uptake ('''d'''). Regions of significant difference are colour-graded in terms of ''Z'' values. Talairach coordinates and further details are available in Table 3 of the supplementary materials
]]

=== Guedje et al 2021. ===

Guedj et al. (2021) completed PET scans d for 35 long COVID patients which utilized a whole-brain voxel-based analysis. They compared these patients to a local database of 44 health subjects which were controlled by age and sex. Long COVID patients exhibited bilateral hypometabolism compared to health patients. Study supports that PET scans may be valuable for long COVID patients in order to perform a whole-brain voxel-based analysis. Additionally, prevalence of hypometabolism was statistically greater for COVID patients compared to healthy patients.<ref>{{Cite journal|last=Guedj|first=E.|last2=Campion|first2=J. Y.|last3=Dudouet|first3=P.|last4=Kaphan|first4=E.|last5=Bregeon|first5=F.|last6=Tissot-Dupont|first6=H.|last7=Guis|first7=S.|last8=Barthelemy|first8=F.|last9=Habert|first9=P.|date=2021-01-26|title=18F-FDG brain PET hypometabolism in patients with long COVID|url=http://link.springer.com/10.1007/s00259-021-05215-4|journal=European Journal of Nuclear Medicine and Molecular Imaging|language=en|doi=10.1007/s00259-021-05215-4|issn=1619-7070|pmc=PMC7837643|pmid=33501506}}</ref>

== Learn more: ==
* [https://www.nimh.nih.gov/research-priorities/therapeutics/cns-radiotracer-table.shtml List of PET radiotracers used in research]

==See also ==
*[[Brain]]
*[[Autopsy]]

== References ==
{{Reflist}}

[[Category:Medical tests]]
[[Category:Neurology]]

File:Sollini et al (2021) Figure 1.png

2021-05-26T04:13:57Z

Nikolaspham:

Brain 18F-FDG PET hypometabolism in patients with long COVID. In comparison to healthy subjects, the patients exhibit hypometabolism in the bilateral rectal/orbital gyrus, including the olfactory gyrus; the right temporal lobe, including the amygdala and the hippocampus, extending to the right thalamus; the bilateral pons/medulla brainstem; the bilateral cerebellum (p-voxel < 0.001 uncorrected, p-cluster < 0.05 FWE-corrected; SPM8 3D rendering)

Stretching

2021-05-20T18:07:51Z

Nikolaspham:added link

Boron

2021-04-12T20:13:54Z

Nikolaspham:remove citation tag

{{Cleanup/Citations needed|date=Mar 2021}}
'''Boron''', a chemical element represented by the chemical symbol B, is a metalloid found in food and the environment. Its exact role in the human body is unclear.<ref>{{Cite journal|last=Naghii|first=M. R.|last2=Samman|first2=S.|date=Oct 1993|title=The role of boron in nutrition and metabolism|url=https://www.ncbi.nlm.nih.gov/pubmed/8140253|journal=Progress in Food & Nutrition Science|volume=17|issue=4|pages=331–349|issn=0306-0632|pmid=8140253}}</ref><ref>{{Cite journal|last=Nielsen|first=Forrest H.|date=Oct 2014|title=Update on human health effects of boron|url=https://www.ncbi.nlm.nih.gov/pubmed/25063690|journal=Journal of trace elements in medicine and biology: organ of the Society for Minerals and Trace Elements (GMS)|volume=28|issue=4|pages=383–387|doi=10.1016/j.jtemb.2014.06.023|issn=1878-3252|pmid=25063690}}</ref> As a micronutrient, boron may play a role in bone development and regeneration, wound healing, the production and metabolism of steroid sex [[hormone]]s and [[vitamin D]], and the absorption and use of [[calcium]] and [[magnesium]]. In addition, boron may have anti-[[Inflammation|inflammatory]] effects that might help alleviate [[arthritis]] or improve brain function.<ref>{{Cite journal|last=Pizzorno|first=Lara|author-link=|author-link2=|author-link3=|author-link4=|author-link5=|date=Aug 2015|title=Nothing Boring About Boron|url=https://www.ncbi.nlm.nih.gov/pubmed/26770156|journal=Integrative Medicine (Encinitas, Calif.)|volume=14|issue=4|pages=35–48|issn=1546-993X|pmc=4712861|pmid=26770156|quote=|via=}}</ref>

== Nutritional supplement ==
Some believe that boron supplements are best taken orally. The recommended daily intake of 3 or 6mg with dinner five hours before bed. The supplement requires that insulin be activated for the greatest effectiveness. Boron works on the principle of ‘less is more.’<ref>{{Cite web|url=https://ods.od.nih.gov/factsheets/Boron-HealthProfessional/|title=Office of Dietary Supplements - Boron|website=ods.od.nih.gov|language=en|access-date=2021-04-12}}</ref>

A supplementation régime could go as follows: you might start by taking 9mg for a couple of days and then find on subsequent days that the boron no longer has the same effectiveness. You would then LOWER your intake to say, 6mg. per dinner meal five hours before bed.

After a week or more at a lower intake, the body will begin to excrete excess boron.(you can tell by a change in odour) Lower to 3mg. per dinner meal five hours before bed. Once Boron is no longer effective at a low dose, then your supplementation would be complete.{{Citation needed}}

A supplementation regime with boron can be repeated many times over, but not greatly increase the intake, as greatly increasing the intake will not have the intended effect.{{Citation needed}}

Boron as a supplement is cheaply available off the shelf, and should not be supplemented along with other vitamins/minerals because the time is important to observe, and other supplements may be best taken at other times.{{Citation needed}}

Other supplements may also interfere with the common benefit of taking boron, which would be better sleep.{{Citation needed}}

A side effect of boron supplementation is better UV Ray absorption, meaning not burning as quickly in the sun.{{Citation needed}}

A side effect of taking too much boron is an irritated gall bladder.{{Citation needed}}

Boron may help those with chronic fatigue by improving sleep.{{Citation needed}}

== Side Effects ==
Any mineral that may be lacking that the body may require will help with restful sleep.{{Citation needed}}

For example, supplementing with Magnesium will improve restfulness, that is, until there’s a metabolic change. With Magnesium, a sign of metabolic change would be the onset of loose stools. Loose stools will oblige the user to interrupt supplementation. Filling out the requirement for Magnesium is relatively straight forward, either through supplementation or using Epsom salts.{{Citation needed}}

Another good example would be Iron supplementation. Lacking somewhat in Iron then supplementing will contribute to restful sleep. But then once the requirement is filled out, Iron supplements will contribute to serious constipation. This is a metabolic change which should be heeded, to discontinue supplementation. Iron overload carries health risks, and would be similar in effect to very mild heavy metal intake.{{Citation needed}}

Boron and Iron compete for a relatively similar place in the metabolism. But Boron is very different in its metabolic function. The body can also substitute Boron with Iron, thus leading to Iron overload. Boron does not have a simple metabolic change where the user might discern a metabolic change, except that it simply becomes less effective. This should be heeded.{{Citation needed}}

The impulse once Boron becomes less effective would be to double and triple intake in order to reproduce the same initial surprising effects. Overloading with Boron carries very serious health risks and should be avoided. While an irritated gall bladder may seem a minor inconvenience, major health problems that come with damaging the liver or worse can easily be avoided by allowing Boron to work as an effective supplement.{{Citation needed}}

Once a course of Boron has been tried, allow for a few weeks time to try again. Boron may be best taken as a single occasion supplement for that one night a week restful sleep is really desired.{{Citation needed}}

== See also ==
[[:Category:Supplements|Supplements]] (category)

== Learn more ==
*[https://pdfs.semanticscholar.org/ec1f/4e3a7bb5c292affd19a04b5d5edff6d78089.pdf The Physiological Effects of Dietary Boron]
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712861/ Nothing boring about boron]

== References ==
{{Reflist}}

[[Category:Supplements]]
[[Category:Potential treatments]]
[[Category:Chemical elements]]

Boron

2021-04-12T20:05:30Z

Nikolaspham:typo

{{Cleanup/Citations needed|date=Mar 2021}}
'''Boron''', a chemical element represented by the chemical symbol B, is a metalloid found in food and the environment. Its exact role in the human body is unclear.<ref>{{Cite journal|last=Naghii|first=M. R.|last2=Samman|first2=S.|date=Oct 1993|title=The role of boron in nutrition and metabolism|url=https://www.ncbi.nlm.nih.gov/pubmed/8140253|journal=Progress in Food & Nutrition Science|volume=17|issue=4|pages=331–349|issn=0306-0632|pmid=8140253}}</ref><ref>{{Cite journal|last=Nielsen|first=Forrest H.|date=Oct 2014|title=Update on human health effects of boron|url=https://www.ncbi.nlm.nih.gov/pubmed/25063690|journal=Journal of trace elements in medicine and biology: organ of the Society for Minerals and Trace Elements (GMS)|volume=28|issue=4|pages=383–387|doi=10.1016/j.jtemb.2014.06.023|issn=1878-3252|pmid=25063690}}</ref> As a micronutrient, boron may play a role in bone development and regeneration, wound healing, the production and metabolism of steroid sex [[hormone]]s and [[vitamin D]], and the absorption and use of [[calcium]] and [[magnesium]]. In addition, boron may have anti-[[Inflammation|inflammatory]] effects that might help alleviate [[arthritis]] or improve brain function.<ref>{{Cite journal|last=Pizzorno|first=Lara|author-link=|author-link2=|author-link3=|author-link4=|author-link5=|date=Aug 2015|title=Nothing Boring About Boron|url=https://www.ncbi.nlm.nih.gov/pubmed/26770156|journal=Integrative Medicine (Encinitas, Calif.)|volume=14|issue=4|pages=35–48|issn=1546-993X|pmc=4712861|pmid=26770156|quote=|via=}}</ref>

== Nutritional supplement ==
Some believe that boron supplements are best taken orally. The recommended daily intake of 3 or 6mg with dinner five hours before bed. The supplement requires that insulin be activated for the greatest effectiveness. Boron works on the principle of ‘less is more.’{{Citation needed|date=12 April 2021}}<ref>{{Cite web|url=https://ods.od.nih.gov/factsheets/Boron-HealthProfessional/|title=Office of Dietary Supplements - Boron|website=ods.od.nih.gov|language=en|access-date=2021-04-12}}</ref>

A supplementation régime could go as follows: you might start by taking 9mg for a couple of days and then find on subsequent days that the boron no longer has the same effectiveness. You would then LOWER your intake to say, 6mg. per dinner meal five hours before bed.

After a week or more at a lower intake, the body will begin to excrete excess boron.(you can tell by a change in odour) Lower to 3mg. per dinner meal five hours before bed. Once Boron is no longer effective at a low dose, then your supplementation would be complete.{{Citation needed}}

A supplementation regime with boron can be repeated many times over, but not greatly increase the intake, as greatly increasing the intake will not have the intended effect.{{Citation needed}}

Boron as a supplement is cheaply available off the shelf, and should not be supplemented along with other vitamins/minerals because the time is important to observe, and other supplements may be best taken at other times.{{Citation needed}}

Other supplements may also interfere with the common benefit of taking boron, which would be better sleep.{{Citation needed}}

A side effect of boron supplementation is better UV Ray absorption, meaning not burning as quickly in the sun.{{Citation needed}}

A side effect of taking too much boron is an irritated gall bladder.{{Citation needed}}

Boron may help those with chronic fatigue by improving sleep.{{Citation needed}}

== Side Effects ==
Any mineral that may be lacking that the body may require will help with restful sleep.{{Citation needed}}

For example, supplementing with Magnesium will improve restfulness, that is, until there’s a metabolic change. With Magnesium, a sign of metabolic change would be the onset of loose stools. Loose stools will oblige the user to interrupt supplementation. Filling out the requirement for Magnesium is relatively straight forward, either through supplementation or using Epsom salts.{{Citation needed}}

Another good example would be Iron supplementation. Lacking somewhat in Iron then supplementing will contribute to restful sleep. But then once the requirement is filled out, Iron supplements will contribute to serious constipation. This is a metabolic change which should be heeded, to discontinue supplementation. Iron overload carries health risks, and would be similar in effect to very mild heavy metal intake.{{Citation needed}}

Boron and Iron compete for a relatively similar place in the metabolism. But Boron is very different in its metabolic function. The body can also substitute Boron with Iron, thus leading to Iron overload. Boron does not have a simple metabolic change where the user might discern a metabolic change, except that it simply becomes less effective. This should be heeded.{{Citation needed}}

The impulse once Boron becomes less effective would be to double and triple intake in order to reproduce the same initial surprising effects. Overloading with Boron carries very serious health risks and should be avoided. While an irritated gall bladder may seem a minor inconvenience, major health problems that come with damaging the liver or worse can easily be avoided by allowing Boron to work as an effective supplement.{{Citation needed}}

Once a course of Boron has been tried, allow for a few weeks time to try again. Boron may be best taken as a single occasion supplement for that one night a week restful sleep is really desired.{{Citation needed}}

== See also ==
[[:Category:Supplements|Supplements]] (category)

== Learn more ==
*[https://pdfs.semanticscholar.org/ec1f/4e3a7bb5c292affd19a04b5d5edff6d78089.pdf The Physiological Effects of Dietary Boron]
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712861/ Nothing boring about boron]

== References ==
{{Reflist}}

[[Category:Supplements]]
[[Category:Potential treatments]]
[[Category:Chemical elements]]

Boron

2021-04-12T20:03:30Z

Nikolaspham:no citation needed

{{Cleanup/Citations needed|date=Mar 2021}}
'''Boron''', a chemical element represented by the chemical symbol B, is a metalloid found in food and the environment. Its exact role in the human body is unclear.<ref>{{Cite journal|last=Naghii|first=M. R.|last2=Samman|first2=S.|date=Oct 1993|title=The role of boron in nutrition and metabolism|url=https://www.ncbi.nlm.nih.gov/pubmed/8140253|journal=Progress in Food & Nutrition Science|volume=17|issue=4|pages=331–349|issn=0306-0632|pmid=8140253}}</ref><ref>{{Cite journal|last=Nielsen|first=Forrest H.|date=Oct 2014|title=Update on human health effects of boron|url=https://www.ncbi.nlm.nih.gov/pubmed/25063690|journal=Journal of trace elements in medicine and biology: organ of the Society for Minerals and Trace Elements (GMS)|volume=28|issue=4|pages=383–387|doi=10.1016/j.jtemb.2014.06.023|issn=1878-3252|pmid=25063690}}</ref> As a micronutrient, boron may play a role in bone development and regeneration, wound healing, the production and metabolism of steroid sex [[hormone]]s and [[vitamin D]], and the absorption and use of [[calcium]] and [[magnesium]]. In addition, boron may have anti-[[Inflammation|inflammatory]] effects that might help alleviate [[arthritis]] or improve brain function.<ref>{{Cite journal|last=Pizzorno|first=Lara|author-link=|author-link2=|author-link3=|author-link4=|author-link5=|date=Aug 2015|title=Nothing Boring About Boron|url=https://www.ncbi.nlm.nih.gov/pubmed/26770156|journal=Integrative Medicine (Encinitas, Calif.)|volume=14|issue=4|pages=35–48|issn=1546-993X|pmc=4712861|pmid=26770156|quote=|via=}}</ref>

== Nutritional supplement ==
Some believe that boron supplements are best taken orally in recommended daily intake of 3 or 6mg with dinner five hours before bed. The supplement requires that insulin be activated for the greatest effectiveness. Boron works on the principle of ‘less is more.’{{Citation needed|date=12 April 2021}}<ref>{{Cite web|url=https://ods.od.nih.gov/factsheets/Boron-HealthProfessional/|title=Office of Dietary Supplements - Boron|website=ods.od.nih.gov|language=en|access-date=2021-04-12}}</ref>

A supplementation régime could go as follows: you might start by taking 9mg for a couple of days and then find on subsequent days that the boron no longer has the same effectiveness. You would then LOWER your intake to say, 6mg. per dinner meal five hours before bed.

After a week or more at a lower intake, the body will begin to excrete excess boron.(you can tell by a change in odour) Lower to 3mg. per dinner meal five hours before bed. Once Boron is no longer effective at a low dose, then your supplementation would be complete.{{Citation needed}}

A supplementation regime with boron can be repeated many times over, but not greatly increase the intake, as greatly increasing the intake will not have the intended effect.{{Citation needed}}

Boron as a supplement is cheaply available off the shelf, and should not be supplemented along with other vitamins/minerals because the time is important to observe, and other supplements may be best taken at other times.{{Citation needed}}

Other supplements may also interfere with the common benefit of taking boron, which would be better sleep.{{Citation needed}}

A side effect of boron supplementation is better UV Ray absorption, meaning not burning as quickly in the sun.{{Citation needed}}

A side effect of taking too much boron is an irritated gall bladder.{{Citation needed}}

Boron may help those with chronic fatigue by improving sleep.{{Citation needed}}

== Side Effects ==
Any mineral that may be lacking that the body may require will help with restful sleep.{{Citation needed}}

For example, supplementing with Magnesium will improve restfulness, that is, until there’s a metabolic change. With Magnesium, a sign of metabolic change would be the onset of loose stools. Loose stools will oblige the user to interrupt supplementation. Filling out the requirement for Magnesium is relatively straight forward, either through supplementation or using Epsom salts.{{Citation needed}}

Another good example would be Iron supplementation. Lacking somewhat in Iron then supplementing will contribute to restful sleep. But then once the requirement is filled out, Iron supplements will contribute to serious constipation. This is a metabolic change which should be heeded, to discontinue supplementation. Iron overload carries health risks, and would be similar in effect to very mild heavy metal intake.{{Citation needed}}

Boron and Iron compete for a relatively similar place in the metabolism. But Boron is very different in its metabolic function. The body can also substitute Boron with Iron, thus leading to Iron overload. Boron does not have a simple metabolic change where the user might discern a metabolic change, except that it simply becomes less effective. This should be heeded.{{Citation needed}}

The impulse once Boron becomes less effective would be to double and triple intake in order to reproduce the same initial surprising effects. Overloading with Boron carries very serious health risks and should be avoided. While an irritated gall bladder may seem a minor inconvenience, major health problems that come with damaging the liver or worse can easily be avoided by allowing Boron to work as an effective supplement.{{Citation needed}}

Once a course of Boron has been tried, allow for a few weeks time to try again. Boron may be best taken as a single occasion supplement for that one night a week restful sleep is really desired.{{Citation needed}}

== See also ==
[[:Category:Supplements|Supplements]] (category)

== Learn more ==
*[https://pdfs.semanticscholar.org/ec1f/4e3a7bb5c292affd19a04b5d5edff6d78089.pdf The Physiological Effects of Dietary Boron]
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712861/ Nothing boring about boron]

== References ==
{{Reflist}}

[[Category:Supplements]]
[[Category:Potential treatments]]
[[Category:Chemical elements]]

Boron

2021-04-12T20:01:57Z

Nikolaspham:/* Nutritional supplement */

{{Cleanup/Citations needed|date=Mar 2021}}
'''Boron''', a chemical element represented by the chemical symbol B, is a metalloid found in food and the environment. Its exact role in the human body is unclear.<ref>{{Cite journal|last=Naghii|first=M. R.|last2=Samman|first2=S.|date=Oct 1993|title=The role of boron in nutrition and metabolism|url=https://www.ncbi.nlm.nih.gov/pubmed/8140253|journal=Progress in Food & Nutrition Science|volume=17|issue=4|pages=331–349|issn=0306-0632|pmid=8140253}}</ref><ref>{{Cite journal|last=Nielsen|first=Forrest H.|date=Oct 2014|title=Update on human health effects of boron|url=https://www.ncbi.nlm.nih.gov/pubmed/25063690|journal=Journal of trace elements in medicine and biology: organ of the Society for Minerals and Trace Elements (GMS)|volume=28|issue=4|pages=383–387|doi=10.1016/j.jtemb.2014.06.023|issn=1878-3252|pmid=25063690}}</ref> As a micronutrient, boron may play a role in bone development and regeneration, wound healing, the production and metabolism of steroid sex [[hormone]]s and [[vitamin D]], and the absorption and use of [[calcium]] and [[magnesium]]. In addition, boron may have anti-[[Inflammation|inflammatory]] effects that might help alleviate [[arthritis]] or improve brain function.<ref>{{Cite journal|last=Pizzorno|first=Lara|author-link=|author-link2=|author-link3=|author-link4=|author-link5=|date=Aug 2015|title=Nothing Boring About Boron|url=https://www.ncbi.nlm.nih.gov/pubmed/26770156|journal=Integrative Medicine (Encinitas, Calif.)|volume=14|issue=4|pages=35–48|issn=1546-993X|pmc=4712861|pmid=26770156|quote=|via=}}</ref>

== Nutritional supplement ==
Some believe that boron supplements are best taken orally in recommended daily intake of 3 or 6mg with dinner five hours before bed. The supplement requires that insulin be activated for the greatest effectiveness. Boron works on the principle of ‘less is more.’{{Citation needed}}<ref>{{Cite web|url=https://ods.od.nih.gov/factsheets/Boron-HealthProfessional/|title=Office of Dietary Supplements - Boron|website=ods.od.nih.gov|language=en|access-date=2021-04-12}}</ref>

A supplementation régime could go as follows: you might start by taking 9mg for a couple of days and then find on subsequent days that the boron no longer has the same effectiveness. You would then LOWER your intake to say, 6mg. per dinner meal five hours before bed.{{Citation needed}}

After a week or more at a lower intake, the body will begin to excrete excess boron.(you can tell by a change in odour) Lower to 3mg. per dinner meal five hours before bed. Once Boron is no longer effective at a low dose, then your supplementation would be complete.{{Citation needed}}

A supplementation regime with boron can be repeated many times over, but not greatly increase the intake, as greatly increasing the intake will not have the intended effect.{{Citation needed}}

Boron as a supplement is cheaply available off the shelf, and should not be supplemented along with other vitamins/minerals because the time is important to observe, and other supplements may be best taken at other times.{{Citation needed}}

Other supplements may also interfere with the common benefit of taking boron, which would be better sleep.{{Citation needed}}

A side effect of boron supplementation is better UV Ray absorption, meaning not burning as quickly in the sun.{{Citation needed}}

A side effect of taking too much boron is an irritated gall bladder.{{Citation needed}}

Boron may help those with chronic fatigue by improving sleep.{{Citation needed}}

== Side Effects ==
Any mineral that may be lacking that the body may require will help with restful sleep.{{Citation needed}}

For example, supplementing with Magnesium will improve restfulness, that is, until there’s a metabolic change. With Magnesium, a sign of metabolic change would be the onset of loose stools. Loose stools will oblige the user to interrupt supplementation. Filling out the requirement for Magnesium is relatively straight forward, either through supplementation or using Epsom salts.{{Citation needed}}

Another good example would be Iron supplementation. Lacking somewhat in Iron then supplementing will contribute to restful sleep. But then once the requirement is filled out, Iron supplements will contribute to serious constipation. This is a metabolic change which should be heeded, to discontinue supplementation. Iron overload carries health risks, and would be similar in effect to very mild heavy metal intake.{{Citation needed}}

Boron and Iron compete for a relatively similar place in the metabolism. But Boron is very different in its metabolic function. The body can also substitute Boron with Iron, thus leading to Iron overload. Boron does not have a simple metabolic change where the user might discern a metabolic change, except that it simply becomes less effective. This should be heeded.{{Citation needed}}

The impulse once Boron becomes less effective would be to double and triple intake in order to reproduce the same initial surprising effects. Overloading with Boron carries very serious health risks and should be avoided. While an irritated gall bladder may seem a minor inconvenience, major health problems that come with damaging the liver or worse can easily be avoided by allowing Boron to work as an effective supplement.{{Citation needed}}

Once a course of Boron has been tried, allow for a few weeks time to try again. Boron may be best taken as a single occasion supplement for that one night a week restful sleep is really desired.{{Citation needed}}

== See also ==
[[:Category:Supplements|Supplements]] (category)

== Learn more ==
*[https://pdfs.semanticscholar.org/ec1f/4e3a7bb5c292affd19a04b5d5edff6d78089.pdf The Physiological Effects of Dietary Boron]
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712861/ Nothing boring about boron]

== References ==
{{Reflist}}

[[Category:Supplements]]
[[Category:Potential treatments]]
[[Category:Chemical elements]]

Boron

2021-04-12T20:01:27Z

Nikolaspham:/* Nutritional supplement */

{{Cleanup/Citations needed|date=Mar 2021}}
'''Boron''', a chemical element represented by the chemical symbol B, is a metalloid found in food and the environment. Its exact role in the human body is unclear.<ref>{{Cite journal|last=Naghii|first=M. R.|last2=Samman|first2=S.|date=Oct 1993|title=The role of boron in nutrition and metabolism|url=https://www.ncbi.nlm.nih.gov/pubmed/8140253|journal=Progress in Food & Nutrition Science|volume=17|issue=4|pages=331–349|issn=0306-0632|pmid=8140253}}</ref><ref>{{Cite journal|last=Nielsen|first=Forrest H.|date=Oct 2014|title=Update on human health effects of boron|url=https://www.ncbi.nlm.nih.gov/pubmed/25063690|journal=Journal of trace elements in medicine and biology: organ of the Society for Minerals and Trace Elements (GMS)|volume=28|issue=4|pages=383–387|doi=10.1016/j.jtemb.2014.06.023|issn=1878-3252|pmid=25063690}}</ref> As a micronutrient, boron may play a role in bone development and regeneration, wound healing, the production and metabolism of steroid sex [[hormone]]s and [[vitamin D]], and the absorption and use of [[calcium]] and [[magnesium]]. In addition, boron may have anti-[[Inflammation|inflammatory]] effects that might help alleviate [[arthritis]] or improve brain function.<ref>{{Cite journal|last=Pizzorno|first=Lara|author-link=|author-link2=|author-link3=|author-link4=|author-link5=|date=Aug 2015|title=Nothing Boring About Boron|url=https://www.ncbi.nlm.nih.gov/pubmed/26770156|journal=Integrative Medicine (Encinitas, Calif.)|volume=14|issue=4|pages=35–48|issn=1546-993X|pmc=4712861|pmid=26770156|quote=|via=}}</ref>

== Nutritional supplement ==
Some believe that boron supplements are best taken orally in recommended daily intake of 3 or 6mg with dinner five hours before bed. The supplement requires that insulin be activated for the greatest effectiveness. Boron works on the principle of ‘less is more.’{{Citation needed|reason=no citation|date=12 April 2021}}<ref>{{Cite web|url=https://ods.od.nih.gov/factsheets/Boron-HealthProfessional/|title=Office of Dietary Supplements - Boron|website=ods.od.nih.gov|language=en|access-date=2021-04-12}}</ref>

A supplementation régime could go as follows: you might start by taking 9mg for a couple of days and then find on subsequent days that the boron no longer has the same effectiveness. You would then LOWER your intake to say, 6mg. per dinner meal five hours before bed.{{Citation needed}}

After a week or more at a lower intake, the body will begin to excrete excess boron.(you can tell by a change in odour) Lower to 3mg. per dinner meal five hours before bed. Once Boron is no longer effective at a low dose, then your supplementation would be complete.{{Citation needed}}

A supplementation regime with boron can be repeated many times over, but not greatly increase the intake, as greatly increasing the intake will not have the intended effect.{{Citation needed}}

Boron as a supplement is cheaply available off the shelf, and should not be supplemented along with other vitamins/minerals because the time is important to observe, and other supplements may be best taken at other times.{{Citation needed}}

Other supplements may also interfere with the common benefit of taking boron, which would be better sleep.{{Citation needed}}

A side effect of boron supplementation is better UV Ray absorption, meaning not burning as quickly in the sun.{{Citation needed}}

A side effect of taking too much boron is an irritated gall bladder.{{Citation needed}}

Boron may help those with chronic fatigue by improving sleep.{{Citation needed}}

== Side Effects ==
Any mineral that may be lacking that the body may require will help with restful sleep.{{Citation needed}}

For example, supplementing with Magnesium will improve restfulness, that is, until there’s a metabolic change. With Magnesium, a sign of metabolic change would be the onset of loose stools. Loose stools will oblige the user to interrupt supplementation. Filling out the requirement for Magnesium is relatively straight forward, either through supplementation or using Epsom salts.{{Citation needed}}

Another good example would be Iron supplementation. Lacking somewhat in Iron then supplementing will contribute to restful sleep. But then once the requirement is filled out, Iron supplements will contribute to serious constipation. This is a metabolic change which should be heeded, to discontinue supplementation. Iron overload carries health risks, and would be similar in effect to very mild heavy metal intake.{{Citation needed}}

Boron and Iron compete for a relatively similar place in the metabolism. But Boron is very different in its metabolic function. The body can also substitute Boron with Iron, thus leading to Iron overload. Boron does not have a simple metabolic change where the user might discern a metabolic change, except that it simply becomes less effective. This should be heeded.{{Citation needed}}

The impulse once Boron becomes less effective would be to double and triple intake in order to reproduce the same initial surprising effects. Overloading with Boron carries very serious health risks and should be avoided. While an irritated gall bladder may seem a minor inconvenience, major health problems that come with damaging the liver or worse can easily be avoided by allowing Boron to work as an effective supplement.{{Citation needed}}

Once a course of Boron has been tried, allow for a few weeks time to try again. Boron may be best taken as a single occasion supplement for that one night a week restful sleep is really desired.{{Citation needed}}

== See also ==
[[:Category:Supplements|Supplements]] (category)

== Learn more ==
*[https://pdfs.semanticscholar.org/ec1f/4e3a7bb5c292affd19a04b5d5edff6d78089.pdf The Physiological Effects of Dietary Boron]
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712861/ Nothing boring about boron]

== References ==
{{Reflist}}

[[Category:Supplements]]
[[Category:Potential treatments]]
[[Category:Chemical elements]]

Stretching

2021-04-12T02:37:37Z

Nikolaspham:/* References */

Stretching

2021-04-12T02:37:05Z

Nikolaspham:edit reference

Stretching

2021-04-12T02:36:28Z

Nikolaspham:/* References */

Guidelines for healthy are inappropriate for ME/CFS patients, as they can often cause post-exertional relapse. For the moderately impaired, 1-2 min of gentle stretching followed by rest is recommended as an exercise. If no symptoms of post-exertional relapse have occurred after stretching, short intervals of recumbent exercise can be utilized.<ref>{{Cite journal|last=Rowe|first=Peter C.|last2=Underhill|first2=Rosemary A.|last3=Friedman|first3=Kenneth J.|last4=Gurwitt|first4=Alan|last5=Medow|first5=Marvin S.|last6=Schwartz|first6=Malcolm S.|last7=Speight|first7=Nigel|last8=Stewart|first8=Julian M.|last9=Vallings|first9=Rosamund|date=2017|title=Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer|url=https://pubmed.ncbi.nlm.nih.gov/28674681|journal=Frontiers in Pediatrics|volume=5|pages=121|doi=10.3389/fped.2017.00121|issn=2296-2360|pmc=5474682|pmid=28674681}}</ref>

Stretching can help prevent excessive pooling of blood, which can lead to orthostatic intolerance.<ref>| last1 = Rowe | first1 = Peter | authorlink1 = Peter Rowe
<nowiki>| last2 = Rosemary |</nowiki> first2 = Underhill | authorlink2 = Rosemary Underhill
<nowiki>| last3 = Friedman |</nowiki> first3 = Kenneth | authorlink3 = Kenneth Friedman
<nowiki>| last4 = Gurwitt |</nowiki> first4 = Alan | authorlink4 = Alan Gurwitt

<nowiki>|</nowiki> display-authors = 3
<nowiki>|</nowiki> title = Myalgic Encephalomyelitis/Chronic Fatigue syndrome diagnosis and management in young people: A Primer
<nowiki>| journal = Frontiers in Pediatrics |</nowiki> volume = 5 | issue = 121 | page = 16-25
<nowiki>|</nowiki> date = 19 June 2017
<nowiki>|</nowiki> pmid = 28674681
<nowiki>|</nowiki> doi = 110.3389/fped.2017.00121
}}
</ref>

...

==References==
{{reflist}}

Stretching

2021-04-12T02:34:03Z

Nikolaspham:Minor stretching can be benefitial for ME/CFS patients. Stretching can help prevent excessive pooling of blood, which can lead to orthostatic intolerance

Stretching

2021-04-12T02:31:58Z

Nikolaspham:Short durations of stretching can be benefitial for ME/CFS patients. Stretching can also help prevent excessive pooling of blood, which can lead to orthostatic intolerance.

Guidelines for healthy, sedentary individuals are inappropriate for ME/CFS patients, as they can often cause post-exertional relapse. For the moderately impaired, 1-2 min of gentle stretching followed by rest is recommended as an exercise. If no symptoms of post-exertional relapse have occurred after stretching, short intervals of recumbent exercise can be utilized. <ref>

| last1 = Rowe | first1 = Peter | authorlink1 = Peter Rowe
| last2 = Rosemary | first2 = Underhill | authorlink2 = Rosemary Underhill
| last3 = Friedman | first3 = Kenneth | authorlink3 = Kenneth Friedman
| last4 = Gurwitt | first4 = Alan | authorlink4 = Alan Gurwitt

| display-authors = 3
| title = Myalgic Encephalomyelitis/Chronic Fatigue syndrome diagnosis and management in young people: A Primer
| journal = Frontiers in Pediatrics | volume = 5 | issue = 121 | page = 16-25
| date = 19 June 2017
| pmid = 28674681
| doi = 110.3389/fped.2017.00121
}}
</ref>

...

==References==
{{reflist}}

Stretching can help prevent excessive pooling of blood, which can lead to orthostatic intolerance.<ref>

| last1 = Rowe | first1 = Peter | authorlink1 = Peter Rowe
| last2 = Rosemary | first2 = Underhill | authorlink2 = Rosemary Underhill
| last3 = Friedman | first3 = Kenneth | authorlink3 = Kenneth Friedman
| last4 = Gurwitt | first4 = Alan | authorlink4 = Alan Gurwitt

| display-authors = 3
| title = Myalgic Encephalomyelitis/Chronic Fatigue syndrome diagnosis and management in young people: A Primer
| journal = Frontiers in Pediatrics | volume = 5 | issue = 121 | page = 16-25
| date = 19 June 2017
| pmid = 28674681
| doi = 110.3389/fped.2017.00121
}}
</ref>

...

==References==
{{reflist}}

Stretching

2021-04-12T02:24:11Z

Nikolaspham:Short durations of stretching can be benefitial for ME/CFS patients. Stretching can also help prevent excessive pooling of blood, which can lead to orthostatic intolerance.