Bourke, Julius H, Wodehouse, Theresa, Clark, Lucy V et al. · Journal of psychosomatic research · 2021 · DOI
This study tested whether ME/CFS and fibromyalgia involve a condition called 'central sensitisation,' where the nervous system becomes overly sensitive to pain signals. Researchers compared pain sensitivity in 19 ME/CFS patients, 19 fibromyalgia patients, and 20 healthy people using physical tests. They found that 84% of ME/CFS patients and 95% of fibromyalgia patients showed signs of central sensitisation, while none of the healthy controls did.
This study provides objective biological evidence that ME/CFS and fibromyalgia may share a common underlying mechanism—central sensitisation—rather than being purely psychological conditions. Understanding this shared pathophysiology could help researchers develop targeted treatments and validate ME/CFS as a medical condition with measurable physiological changes.
This study does not prove that central sensitisation causes ME/CFS or fibromyalgia—it only shows an association. It does not clarify whether central sensitisation develops as a result of the illness, precedes it, or is a consequence of symptom-related changes in behaviour or activity. The small sample size and recruitment from secondary care clinics may not represent all ME/CFS patients.
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
Bourke, Julius H, Wodehouse, Theresa, Clark, Lucy V, Constantinou, Elena, Kidd, Bruce L, Langford, Richard, et al. (2021). Central sensitisation in chronic fatigue syndrome and fibromyalgia; a case control study.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2021.110624
BibTeX
@article{mecfsatlas-bourke-2021-central-sensitisation,
author = {Bourke, Julius H and Wodehouse, Theresa and Clark, Lucy V and Constantinou, Elena and Kidd, Bruce L and Langford, Richard and Mehta, Vivek and White, Peter D},
title = {Central sensitisation in chronic fatigue syndrome and fibromyalgia; a case control study.},
journal = {Journal of psychosomatic research},
year = {2021},
doi = {10.1016/j.jpsychores.2021.110624},
note = {PubMed: 34600309},
url = {https://www.mecfsatlas.com/evidence/bourke-2021-central-sensitisation},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/bourke-2021-central-sensitisation
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