How to diagnose brain inflammmation?

[chger]

Hello,

Do you Know what is the best Way to Check if There is some Kind of low grade / autoimmune / neuro inflammation of the brain?

I Read about PET / SPECT and Liquor punction. Then There are many different ANAs to brain Tissue and cytokines

What is the most *robust* test for detection of general inflammation processes in the brain?

I would like to go a Top down approach, instead of starting with Too detailed Tests

Thanks!

 

[Zebra]

Hi @chger

I don't know the answers to your questions, but I expect others on PR have suggestions. Or perhaps they can point you to authors or researchers on the subject of neuro inflammation.

So the purpose of my response here is to "bump" this thread back up where folks will see it.

Hope this action will help!
Z

 

[JES]

You can't, at least not without special equipment. The Japanese made a groundbreaking study a couple of years ago where PET scan showed neuroinflammation in ME/CFS patients (source). But the methods are experimental, there is no standardized diagnostic method and no way to get this test done unless in a clinical trial. So the answer is no way to diagnose, but I believe Jarred Younger is working on new methods to measure brain temperature etc, you might want to Google what he is up to.

 

[uglevod]

by symtoms: bugs in brain(inflammation) always correlate with fatigue levels

 

[PhoenixDown]

The Japanese made a groundbreaking study a couple of years ago where PET scan showed neuroinflammation in ME/CFS patients (source).

The problem with that source is that they define ME as just fatigue which is incorrect.

Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a disease characterized by chronic, profound, disabling, an. unexplained fatigue.

The results can not be generalized to true ME. It's flawed research. They should only select patients who get worse / crash / experience payback after exercise.

 

[JES]

The results can not be generalized to true ME. It's flawed research. They should only select patients who get worse / crash / experience payback after exercise.

But it's not really a problem in this context unless you suggest that the generalized population with fatigue have profound neuroinflammation, but ME/CFS patients do not. Usually when you expand your study to cover a larger subgroup you lose the signal and any significant finding gets diluted. If neuroinflammation is present in this larger group you propose of "just" fatigued individuals, then it is an even more significant finding and it almost certainly applies to ME as well. Also there is no such thing as true ME, there is a bunch of man-made definitions of what ME is and everyone differs slightly.

 

[PhoenixDown]

I should have said "They should only select patients who get worse / crash / experience payback after exercise. for the ME group, and still have a fatigue group and a healthy control group".

If neuroinflammation is present in this larger group you propose of "just" fatigued individuals, then it is an even more significant finding and it almost certainly applies to ME as wel

How would that help ME patients? At best it would get them a diagnosis of Chronic Fatigue which could lead to inappropriate treatments such as CBT and GET.

 

[Pyrrhus]

The Japanese made a groundbreaking study a couple of years ago where PET scan showed neuroinflammation in ME/CFS patients (source). But the methods are experimental, there is no standardized diagnostic method and no way to get this test done unless in a clinical trial.

Yes, this is the only approach to detect neuroinflammation, as originally defined in 2006. In the few years since the Japanese study, a number of new PET tracers have been developed that are more sensitive and specific for neuroinflammation, as originally defined in 2006. Although this PET procedure is still being improved, the conclusions of such PET studies are well established.

Unfortunately, Jarred Younger uses his own definition of neuroinflammation, not the 2006 definition. The 2006 definition does NOT necessarily imply an elevated brain temperature, although it is consistent with it.

 

[chger]

@Pyrrhus are you aware of Any specialists currently using PET Scans specifically for ME/CFS in Western Europe?

Because i Doubt a *normal* radiologist might Not know what to look for especially.
Or is it even helpful to do this Scan, when There is no therapy option to reduce the inflammation...

 

[Pyrrhus]

@Pyrrhus are you aware of Any specialists currently using PET Scans specifically for ME/CFS in Western Europe?

Unfortunately, these type of PET scans are not yet available for patients anywhere, as the test requires special PET tracers that have not yet been approved for regular use. They have been used in many research studies, though.

I would guess that one of the newer PET tracers may be approved in the next 10 years in the US, but that's not a sure thing. Even once it is approved, only large hospitals would be able to afford these tests, because it requires a special scanner, a particle accelerator, and on-site chemists.

Best of luck.

 

[chger]

Thanks pyrrhus.

Was doing some research in how other Auto immune brain conditions are Diagnosed.
E.g in Case of MS a detection of inflamed regions is possible by contrast MRI and also to see the function of Blood brain Barrier.

This Kind of MRI would be available. But the question is if it is suitable for detection of Neuro inflammation. Do you Know sth about this ?

 

[RU72]

I had a SPECT Scan years ago, which demonstrated profuse hypoperfusion, possibly attributed to Lyme-related encephalopathy. No doctor to date has suggested any treatment. In fact, the results are often dismissed.

 

[Pyrrhus]

in Case of MS a detection of inflamed regions is possible by contrast MRI and also to see the function of Blood brain Barrier.

This Kind of MRI would be available. But the question is if it is suitable for detection of Neuro inflammation. Do you Know sth about this ?

Unfortunately, neuroinflammation is not detectable using MRI. Some people have valiantly tried to find hints of neuroinflammation using a form of MRI called magnetic resonance spectroscopy (MRS). They failed.

MRI can only detect the late stages of inflammation, when blood-borne immune cells start infiltrating the brain in large numbers.

This applies equally well in multiple sclerosis (MS). This is why it is impossible to objectively diagnose MS in the early stages. Only in the later stage of MS can abnormalities be occasionally seen on brain MRI's. And even then, it's hit-or-miss. Sometimes you have to do multiple MRI's over several months before you finally get an MRI that shows an abnormality.

Hope this helps.

 

[chger]

Thank you, does Not look Too promising then unfortunately...

Also i did some research on Blood brain Barrier. And it seems in certain conditions like brain Cancer or stroke the Barrier is conpromised which can be detected by contrast enhanced MRI.
Just guessing that a compromised blood brain barrier could be a potential root for inflammation processes as substances like bacteria toxines from the blood could diffuse in the brain more easily.

Would you think it makes sense to Search for a compromised blood brain Barrier with this MRI?
Also, do you know if the Blood brain Barrier function is more easily to detect on MRI than neuroinflammation ?

 

[Biarritz13]

Maybe this : https://www.cortechslabs.com/products/neuroquant/