Boissoneault, Jeff, Letzen, Janelle, Robinson, Michael et al. · Brain imaging and behavior · 2019 · DOI
This study looked at blood flow in the brain and heart rate patterns in women with ME/CFS compared to healthy women. The researchers found that women with ME/CFS who had better blood flow to the brain and more variable heart rates tended to have less severe fatigue. These findings suggest that how well the body's circulatory and nervous systems are working may be connected to how tired people with ME/CFS feel.
This study identifies objective physiological markers—cerebral blood flow and heart rate variability—that correlate with fatigue severity in ME/CFS. Understanding these biological associations could eventually lead to new therapeutic targets and objective tools to measure treatment response and disease progression in ME/CFS patients.
This study does not prove that low blood flow or heart rate variability causes ME/CFS fatigue; it only shows associations in a small group at one point in time. The cross-sectional design cannot establish causality or determine whether improving blood flow and heart rate variability would actually reduce fatigue. The study also cannot be generalized beyond the 14 women with CFS who participated.
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 →
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Primary citation
Boissoneault, Jeff, Letzen, Janelle, Robinson, Michael, & Staud, Roland (2019). Cerebral blood flow and heart rate variability predict fatigue severity in patients with chronic fatigue syndrome.. Brain imaging and behavior. https://doi.org/10.1007/s11682-018-9897-x
BibTeX
@article{mecfsatlas-boissoneault-2019-cerebral-blood,
author = {Boissoneault, Jeff and Letzen, Janelle and Robinson, Michael and Staud, Roland},
title = {Cerebral blood flow and heart rate variability predict fatigue severity in patients with chronic fatigue syndrome.},
journal = {Brain imaging and behavior},
year = {2019},
doi = {10.1007/s11682-018-9897-x},
note = {PubMed: 29855991},
url = {https://www.mecfsatlas.com/evidence/boissoneault-2019-cerebral-blood},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/boissoneault-2019-cerebral-blood
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