Christopoulos, Elena M, Tantanis, Darcy, Huang, Katherine et al. · Journal of translational medicine · 2025 · DOI
This review examined 118 research studies to understand how blood flow to the brain changes in ME/CFS patients, particularly those who also experience orthostatic intolerance (difficulty maintaining blood pressure when standing). Researchers found that blood flow to the brain is often reduced in both conditions, and when patients have both ME/CFS and orthostatic intolerance together, the reduction in brain blood flow appears to be even more pronounced. This finding suggests that measuring brain blood flow might help doctors track how severe the disease is.
This systematic review provides comprehensive evidence that cerebral blood flow abnormalities are a measurable biological feature of ME/CFS, potentially useful for disease monitoring and severity assessment. The finding that comorbid orthostatic intolerance amplifies CBF reductions highlights the importance of screening and addressing OI in ME/CFS patients, and calls attention to a commonly overlooked confounding factor in prior ME/CFS research.
This review does not establish that reduced cerebral blood flow causes ME/CFS symptoms or that normalizing CBF will cure the disease. It cannot determine causation from the identified associations, and the heterogeneity of measurement methods across studies means findings should be interpreted cautiously. It also does not prove that CBF measurement alone is sufficient for diagnosis or prognosis in individual 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
Christopoulos, Elena M, Tantanis, Darcy, Huang, Katherine, Schneider-Futschik, Elena K, Gooley, Paul R, Moneghetti, Kegan J, et al. (2025). Mapping cerebral blood flow in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and orthostatic intolerance: insights from a systematic review.. Journal of translational medicine. https://doi.org/10.1186/s12967-025-06954-w
BibTeX
@article{mecfsatlas-christopoulos-2025-mapping-cerebral,
author = {Christopoulos, Elena M and Tantanis, Darcy and Huang, Katherine and Schneider-Futschik, Elena K and Gooley, Paul R and Moneghetti, Kegan J and Armstrong, Christopher W},
title = {Mapping cerebral blood flow in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and orthostatic intolerance: insights from a systematic review.},
journal = {Journal of translational medicine},
year = {2025},
doi = {10.1186/s12967-025-06954-w},
note = {PubMed: 40859389},
url = {https://www.mecfsatlas.com/evidence/christopoulos-2025-mapping-cerebral},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/christopoulos-2025-mapping-cerebral
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