Effects of PUFA supplementation evidenced by brain imaging

It is instructive to review a brain (lipid) hypothesis put forward by the late Professor David F. Horrobin (6 October 1939 – 1 April 2003) regarding the aetiology and potential treatment of post-viral fatigue syndrome,whichnowadays would be subsumed under the heading of myalgic encephalomyelitis (or chronic fatigue syndrome). Horrobin suggested that abnormalities in fatty acids played a key role in the pathophysiology of this disorder (Horrobin, 1990). Indeed, a randomized, double-blind, placebo-controlled three-month trial of fatty acids (including gamma-linolenic acid, eicosapentaenoic acid, docosahexaenoic acid and linoleic acid) by Behan, Behan and Horrobin, in 63 adults suffering from post-viral fatigue syndrome, gave positive results in favour of the PUFA supplementation (Behan et al., 1990)). Unfortunately structural brain MRI changes were not assessed during this randomized, double-blind, placebo-controlled trial,but subsequentlyapilot study has indicated that eicosapentaenoic acidrich PUFA supplementation in myalgic encephalomyelitis may be associated with beneficial brain changes, with a reduction in the size of the lateral ventricles (Puri et al., 2004). The question of whether, at baseline, myalgic encephalomyelitis is associated with changes in brain structure compared with unaffectedageandgender-matchedcontrols has been addressed by a number of studies; the most recent and largest voxel-based morphometry study of 26 patients and 26 matched controls has shown that this disease appears to be associated with reduced grey matter in the occipital lobes, right angular gyrus and left parahippocampal gyrus, and reduced white matter in the left occipital lobe (Puri et al., 2011).