{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T02:30:28Z","timestamp":1780626628655,"version":"3.54.1"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1184219"],"award-info":[{"award-number":["GNT1184219"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Human Brain Mapping"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Myalgic encephalomyelitis\/chronic fatigue syndrome (ME\/CFS) is a debilitating disorder with suspected neuroinflammatory pathophysiology. However, previous diffusion tensor imaging (DTI) studies have reported inconsistent white matter abnormalities in ME\/CFS, and specific white matter inflammatory changes remain poorly characterised. This study employed an advanced diffusion\u2010based neuroinflammation imaging (NII) model to investigate white matter neuroinflammation in ME\/CFS. Diffusion MRI data from 67 ME\/CFS patients (median age, 38; and 54 women) and 67 rigorously matched healthy controls (HCs) (median age 38; and 52 women) were analysed. Seven NII\u2010derived metrics were computed: hindered water ratio (NII\u2010HR), restricted fraction (NII\u2010RF), fibre fraction (NII\u2010FF), axial diffusivity (NII\u2010AD), radial diffusivity (NII\u2010RD), mean diffusivity (NII\u2010MD) and fractional anisotropy (NII\u2010FA). Conventional DTI metrics were also calculated. Tract\u2010based spatial statistics were used to perform voxel\u2010wise group comparisons, and multiple regression analysis was conducted to examine the relationship between NII\/DTI metrics and clinical measures of mental health, physical health, sleep quality, disability, disease severity and disease duration. Compared to HCs, ME\/CFS patients exhibited widespread white matter abnormalities, including significantly lower NII\u2010HR and NII\u2010RF, and significantly higher NII\u2010FF, NII\u2010AD, NII\u2010MD and NII\u2010FA across association, commissural and projection fibres. Additionally, some regions showed decreased NII\u2010AD and NII\u2010MD in ME\/CFS. Lower NII\u2010RF, NII\u2010AD and NII\u2010MD in ME\/CFS were significantly associated with worse mental health, while lower NII\u2010RF was also associated with a higher level of disability. Among ME\/CFS patients, higher NII\u2010FF was associated with lower disease severity. Conventional DTI showed minimal group differences and no significant clinical associations. This study provides in\u00a0vivo evidence of white matter neuroinflammation in ME\/CFS, characterised by cerebral edema (reduced NII\u2010HR), cellular infiltration (reduced NII\u2010RF) and axonal reorganisation (increased NII\u2010FF). This suggests NII\u2010derived indices may serve as sensitive biomarkers for neuroinflammation in ME\/CFS.<\/jats:p>","DOI":"10.1002\/hbm.70505","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T08:20:59Z","timestamp":1773649259000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evidence of White Matter Neuroinflammation in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: A Diffusion\u2010Based Neuroinflammation Imaging Study"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2664-8310","authenticated-orcid":false,"given":"Qiang","family":"Yu","sequence":"first","affiliation":[{"name":"Thompson Institute University of the Sunshine Coast  Birtinya Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiana","family":"Kothe","sequence":"additional","affiliation":[{"name":"Thompson Institute University of the 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Institute of Technology Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zack Y.","family":"Shan","sequence":"additional","affiliation":[{"name":"Thompson Institute University of the Sunshine Coast  Birtinya Queensland 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