Block, W, Träber, F, Kuhl, C K et al. · RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin · 1998 · DOI
Researchers used a special MRI scanner to measure how muscles use energy during exercise by looking at chemical changes in the calf. They found that healthy people used two different types of energy pathways during exercise, while people with ME/CFS showed unusual resting energy levels but normal recovery after exercise—unlike patients with genetic metabolic disorders, whose muscles recovered very slowly.
This study provides objective bioenergetic evidence that ME/CFS muscle metabolism differs from both healthy controls and primary metabolic myopathies, potentially supporting a distinct pathophysiological mechanism. The finding that ME/CFS patients normalize PCr recovery—unlike genetic metabolic disorders—suggests different underlying mechanisms, which could guide future research into muscle energy utilization in ME/CFS.
This study does not prove that altered resting PCr levels cause ME/CFS symptoms or functional impairment, as it only shows correlation without mechanistic evidence. The cross-sectional design cannot establish whether these metabolic patterns are primary disease features or secondary consequences of deconditioning or illness duration. The small ME/CFS sample size and lack of detailed phenotyping limit generalizability to all ME/CFS presentations.
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
Block, W, Träber, F, Kuhl, C K, Keller, E, Lamerichs, R, Karitzky, J, et al. (1998). [31P-mr spectroscopy of peripheral skeletal musculature under load: demonstration of normal energy metabolites compared with metabolic muscle diseases].. RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin. https://doi.org/10.1055/s-2007-1015121
BibTeX
@article{mecfsatlas-block-1998-31p-spectroscopy,
author = {Block, W and Träber, F and Kuhl, C K and Keller, E and Lamerichs, R and Karitzky, J and Rink, H and Schild, H H},
title = {[31P-mr spectroscopy of peripheral skeletal musculature under load: demonstration of normal energy metabolites compared with metabolic muscle diseases].},
journal = {RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin},
year = {1998},
doi = {10.1055/s-2007-1015121},
note = {PubMed: 9551111},
url = {https://www.mecfsatlas.com/evidence/block-1998-31p-spectroscopy},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/block-1998-31p-spectroscopy
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