Chen, Emily, Rudder, Tamera, Nwankwere, Charles et al. · Frontiers in neuroscience · 2025 · DOI
This study compared pain sensitivity and fatigue in people with ME/CFS, Gulf War Illness, and chronic fatigue to understand what causes their symptoms. Researchers found that people with ME/CFS and Gulf War Illness have increased pain sensitivity (measured by pressing on their skin), and their pain and internal body sensations are closely linked. However, pain sensitivity didn't strongly correlate with fatigue levels, suggesting that fatigue may involve different mechanisms than pain.
This study challenges the assumption that pain and fatigue in ME/CFS are driven by the same underlying mechanism, suggesting instead that dysfunction in the brain's pain-control systems may explain heightened pain sensitivity while fatigue may require separate investigation. Understanding these distinct pathways could guide development of targeted treatments and improve diagnostic approaches for ME/CFS and related illnesses.
This study does not prove that brain dysfunction causes ME/CFS or establish causation—it only shows correlation between pain sensitivity measures and symptoms. The weak correlation between pain sensitivity and fatigue does not rule out shared pathophysiology; it may simply indicate that dolorimetry is not the best measure of the underlying mechanism. The findings cannot be generalized beyond the studied populations, and cross-sectional design prevents temporal relationships from being established.
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
Chen, Emily, Rudder, Tamera, Nwankwere, Charles, & Baraniuk, James N (2025). Fatigue, interoplastic and nociplastic distress in myalgic encephalomyelitis/chronic fatigue syndrome, Gulf War Illness, and chronic idiopathic fatigue.. Frontiers in neuroscience. https://doi.org/10.3389/fnins.2025.1530652
BibTeX
@article{mecfsatlas-chen-2025-fatigue-interoplastic,
author = {Chen, Emily and Rudder, Tamera and Nwankwere, Charles and Baraniuk, James N},
title = {Fatigue, interoplastic and nociplastic distress in myalgic encephalomyelitis/chronic fatigue syndrome, Gulf War Illness, and chronic idiopathic fatigue.},
journal = {Frontiers in neuroscience},
year = {2025},
doi = {10.3389/fnins.2025.1530652},
note = {PubMed: 40927423},
url = {https://www.mecfsatlas.com/evidence/chen-2025-fatigue-interoplastic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/chen-2025-fatigue-interoplastic
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