White-matter changes associated with a synergetic treatment for myalgic encephalomyelitis/chronic fatigue syndrome

Abstract

Objectives: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex and debilitating chronic illness for which there are no well-accepted treatments, aside from some preliminary trials and symptom management strategies, such as low-dose naltrexone and NICE guidelines. A clinician administered a synergistic off-label treatment (SOT) involving spironolactone, colchicine, low-dose naltrexone, and multivitamins to ME/CFS patients, resulting in reported symptom improvement. This study sought to investigate neuroimaging characteristics linked with the treatment. Methods: A group of treatment-naive patients (N = 8, control) was selected to age–and sex-match eight patients who had received the treatment (SOT). Diffusion-weighted imaging data and clinical measures from the two groups were compared. Results: Compared to the control group, the SOT group showed reduced depression (Bonferroni corrected P value (PBonf) =.04) and mental deficit symptoms (PBonf =.02). Furthermore, the SOT group at post-treatment showed significantly reduced clinical scores (PBonf