Chaudhuri, Abhijit, Behan, Peter O · Lancet (London, England) · 2004 · DOI
This review examines fatigue in various neurological diseases, including ME/CFS. The authors explain that fatigue can result from problems in muscle function (where muscles can't sustain effort) or problems in the brain and nervous system (where the brain perceives activities as requiring excessive effort). They suggest that imbalances in stress hormones and disrupted communication between key brain regions may underlie persistent fatigue.
This review provides a comprehensive framework for understanding the neurobiological basis of fatigue in ME/CFS, distinguishing it from simple muscle weakness and highlighting potential roles of the hypothalamic-pituitary-adrenal axis and central nervous system dysfunction. For patients and researchers, it establishes that ME/CFS fatigue is a genuine neurological phenomenon with identifiable pathophysiological mechanisms rather than a purely psychological condition.
As a narrative review rather than a primary research study, this work does not present new experimental data or clinical trials; it synthesizes existing knowledge and cannot definitively prove causation or establish the relative importance of proposed mechanisms. The review does not provide specific diagnostic biomarkers or validated treatment protocols for ME/CFS. It also does not clarify why some individuals develop persistent central fatigue after stress while others do not.
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
Chaudhuri, Abhijit & Behan, Peter O (2004). Fatigue in neurological disorders.. Lancet (London, England). https://doi.org/10.1016/S0140-6736(04)15794-2
BibTeX
@article{mecfsatlas-chaudhuri-2004-fatigue-neurological,
author = {Chaudhuri, Abhijit and Behan, Peter O},
title = {Fatigue in neurological disorders.},
journal = {Lancet (London, England)},
year = {2004},
doi = {10.1016/S0140-6736(04)15794-2},
note = {PubMed: 15043967},
url = {https://www.mecfsatlas.com/evidence/chaudhuri-2004-fatigue-neurological},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/chaudhuri-2004-fatigue-neurological
Contribute
Private, reviewed by a human. Not a public comment thread.