Chaves-Filho, Adriano José Maia, Macedo, Danielle S, de Lucena, David Freitas et al. · Behavioural brain research · 2019 · DOI
This review examined how depression and ME/CFS might share common causes in the brain, specifically through immune cells called microglia. Researchers found that when these brain immune cells become overactive, they may trigger both depression and the fatigue characteristic of ME/CFS. The study suggests that reducing this immune activation could potentially help treat both conditions.
This review proposes a unifying biological mechanism—microglial activation and neuroinflammation—that could explain why depression and ME/CFS frequently occur together. If validated, it could shift treatment approaches from managing symptoms separately to targeting the shared immune dysfunction underlying both conditions, potentially improving outcomes for patients with comorbid depression and ME/CFS.
This systematic review does not prove that microglial activation directly causes depression or ME/CFS in humans, as most evidence comes from animal models and indirect clinical markers. It does not establish whether microglial activation is primary (initiating disease) or secondary (resulting from other pathological processes), and cannot confirm that reducing microglial activation will effectively treat these conditions in patients. The review correlates microglial activity with symptoms but does not demonstrate causation through controlled human trials.
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
Chaves-Filho, Adriano José Maia, Macedo, Danielle S, de Lucena, David Freitas, & Maes, Michael (2019). Shared microglial mechanisms underpinning depression and chronic fatigue syndrome and their comorbidities.. Behavioural brain research. https://doi.org/10.1016/j.bbr.2019.111975
BibTeX
@article{mecfsatlas-chaves-filho-2019-shared-microglial,
author = {Chaves-Filho, Adriano José Maia and Macedo, Danielle S and de Lucena, David Freitas and Maes, Michael},
title = {Shared microglial mechanisms underpinning depression and chronic fatigue syndrome and their comorbidities.},
journal = {Behavioural brain research},
year = {2019},
doi = {10.1016/j.bbr.2019.111975},
note = {PubMed: 31136774},
url = {https://www.mecfsatlas.com/evidence/chaves-filho-2019-shared-microglial},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/chaves-filho-2019-shared-microglial
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