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Preprint Hypothesis Version 1 Preserved in Portico This version is not peer-reviewed

Chronic Fatigue Syndrome and Multiple Sclerosis have Reduced Craniospinal Compliance and Dilated Pressurized Bridging Cortical Veins: A Hypothesis Illustrated with Two Case Studies

Version 1 : Received: 31 May 2023 / Approved: 31 May 2023 / Online: 31 May 2023 (14:31:49 CEST)

A peer-reviewed article of this Preprint also exists.

Bateman, G., & Bateman, A. (2023). Chronic fatigue syndrome and multiple sclerosis have reduced craniospinal compliance and dilated pressurized bridging cortical veins. Medical hypotheses, 111243. Bateman, G., & Bateman, A. (2023). Chronic fatigue syndrome and multiple sclerosis have reduced craniospinal compliance and dilated pressurized bridging cortical veins. Medical hypotheses, 111243.

Abstract

Chronic fatigue syndrome (CFS) and multiple sclerosis (MS) share similarities regarding their epidemiology, symptomatology and craniospinal physiology. Indeed, the cardinal feature of CFS, fatigue, is also a major factor in the symptomatology of the majority of MS patients. Recently, we have found that there is a significant reduction in the craniospinal compliance in MS which affects both the stiffness of the walls of the spinal canal and the walls of the cerebral venous system. This change in compliance brings about an alteration in the effectiveness of the pulse wave dampening in the craniospinal system. The result is an impedance mismatch between the cortical veins and their draining sinuses, leading to dilatation of these upstream veins. We deduce this dilatation can only be brought about by an increase in the pressure gradient between the vein lumen and the subarachnoid space (i.e. the transmural pressure gradient). We hypothesise that given the similarities between MS and CFS, a similar mechanism underlies the physiology of CFS. We present two case studies to highlight the expected findings in CFS patients if this hypothesis were proven to be correct.

Keywords

Chronic fatigue syndrome; myalgic encephalomyelitis; multiple sclerosis; cortical vein; venous pressure

Subject

Medicine and Pharmacology, Neuroscience and Neurology

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