Modulatory effects of cognitive exertion on regional functional connectivity of the salience network in women with ME/CFS: A pilot study

Abstract Background A common symptom of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is post-exertional malaise (PEM). Various brain abnormalities have been observed in patients with ME/CFS, especially insular and limbic areas, but their link ME/CFS symptoms still unclear. This pilot study aimed at investigating the association between PEM changes functional connectivity (FC) two main networks: salience network (SN) default-mode (DMN). Methods total 16 women, 6 10 without underwent clinical MRI assessment before after cognitive exertion. Resting-state FC maps 7 seeds (3 for SN 4 DMN) measures fatigue, pain cognition were analysed repeated-measure models. FC-symptom change associations also investigated. Results Exertion induced increases compared to control group, while no found performance. At baseline, showed altered some DMN frontal areas stronger all left temporal medulla. Significantly higher than controls only right seed subcortical areas; these correlated worsening symptoms. Conclusions Cognitive exertion can induce ME/CFS-related These here associated strengthening insula involved reward processing control.