Transcranial sonography in the diagnosis, followup and treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Marco Ruggiero¹, Maria G., Fiore¹*, Stefano Magherini², Silvia Esposito1, Gabriele Morucci², Massimo Gulisano² and Stefania Pacini² ¹Department of Experimental Pathology and Oncology, University of Firenze. Viale Morgagni 50, 50134 Firenze, Italy. 2Department of Anatomy, Histology and Forensic Medicine, University of Firenze. Viale Morgagni 85, 50134 Firenze, Italy. Author for correspondence: Prof. Marco Ruggiero, MD, PhD Department of Experimental Pathology and Oncology Viale Morgagni 50, 50134 Firenze, Italy E-mail: marco.ruggiero@unifi.it Keywords: Transcranial sonography, Chronic Fatigue Syndrome, Myalgic Encephalomyelitis. Acknowledgements: This study was funded by a grant from the Progetto di Ricerca di Interesse Nazionale (PRIN) 2009 to M.R. and S.P. Abstract We used a modified transcranial sonography technique to study the cortex of the temporal lobe, a brain region involved in the processing of functions that are often compromised in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) patients. We studied the meninges, the subarachnoidal space and the cortex. The spatial resolution and the ability to visualize structures of 200-300 µm size, led us to hypothesize that the linear structures parallel to the subarachnoidal space could be referred to the neuronal layers of the cortex. In real-time mode, we could observe pulsation of the meninges and the cortex synchronous with the heart beat and independent of blood flow. This pulsation was more evident at the level of the meninges, but it was also appreciable at the level of the layers of the cortex and it was not accompanied by any type of flow. In addition to these findings, we observed that the subject undergoing the procedure experienced a series of changes that might prove potentially useful in the treatment of ME/CFS. In particular, we observed a decrease of tachycardia accompanied by an increase in systolic blood pressure and by a significant increase in muscle strength measured by the degree of muscle fibre shortening at the level of the biceps brachii. These findings, together with the low cost and simplicity of the procedure, suggest that modified transcranial sonography has a significant potential in the study and treatment of ME/CFS. Invest in ME (Charity Nr. 1114035) www.investinme.org Page 23 of 108
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