Badhwar, Smriti, Pereira, Tania J, Kerr, Kathleen et al. · Autonomic neuroscience : basic & clinical · 2025 · DOI
This study compared how the nervous systems of ME/CFS patients, Long COVID patients, and healthy people respond to physical stress tests like breathing different air mixtures and tilting upright. The researchers found that ME/CFS and Long COVID patients had different patterns of problems: ME/CFS patients showed difficulty controlling blood flow to the brain during one test, which was linked to coordination problems, while Long COVID patients had lower oxygen levels when upright and their nervous systems didn't adapt as well.
This mechanistic study provides the first direct evidence that ME/CFS and Long COVID, despite clinical similarities, may involve distinct physiological dysfunction patterns—one affecting brain blood flow control and coordination, the other affecting oxygen handling during position changes. Understanding these differences could guide more targeted diagnostic approaches and inform why some Long COVID patients progress to ME/CFS.
This pilot study does not prove these mechanisms cause the symptom burden in ME/CFS or Long COVID, only that they are associated. The small sample size (12 ME/CFS, 9 Long COVID) limits statistical power and generalizability, particularly to severe ME/CFS patients who were excluded. The study cannot establish whether observed differences reflect disease severity, duration, distinct pathophysiology, or unique aspects of COVID-19 infection.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Badhwar, Smriti, Pereira, Tania J, Kerr, Kathleen, Bray, Riina, Tabassum, Farah, Sergio, Lauren, et al. (2025). Autonomic phenotyping, brain blood flow control, and cognitive-motor-integration in Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome: A pilot study.. Autonomic neuroscience : basic & clinical. https://doi.org/10.1016/j.autneu.2025.103358
BibTeX
@article{mecfsatlas-badhwar-2025-autonomic-phenotyping,
author = {Badhwar, Smriti and Pereira, Tania J and Kerr, Kathleen and Bray, Riina and Tabassum, Farah and Sergio, Lauren and Edgell, Heather},
title = {Autonomic phenotyping, brain blood flow control, and cognitive-motor-integration in Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome: A pilot study.},
journal = {Autonomic neuroscience : basic & clinical},
year = {2025},
doi = {10.1016/j.autneu.2025.103358},
note = {PubMed: 41138391},
url = {https://www.mecfsatlas.com/evidence/badhwar-2025-autonomic-phenotyping},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/badhwar-2025-autonomic-phenotyping
Contribute
Private, reviewed by a human. Not a public comment thread.