Collins Hutchinson, Meagan L, Liang, Emily, Fuster, Emily et al. · Autonomic neuroscience : basic & clinical · 2025 · DOI
This study looked at 84 women with connective tissue disorders (HSD/h-EDS) to understand how much autonomic nervous system problems they experience and how these affect their quality of life. The researchers found that these women had severe autonomic symptoms, with nearly 60% also having POTS and about 26% having ME/CFS. Overall, their quality of life was significantly worse than patients with other serious conditions like multiple sclerosis or rheumatoid arthritis.
ME/CFS affects over one-quarter of this HSD/h-EDS cohort, highlighting an important comorbidity overlap that clinicians should recognize. The severe autonomic dysfunction documented here provides objective evidence that HSD/h-EDS patients with ME/CFS experience significant physiological burden beyond fatigue alone. Understanding these interconnected conditions may help improve diagnosis, symptom management, and quality-of-life outcomes for ME/CFS patients with underlying connective tissue disorders.
This study does not establish causality between HSD/h-EDS and ME/CFS, nor does it clarify whether autonomic dysfunction drives ME/CFS symptoms or vice versa. The cross-sectional design captures a single time point and cannot determine the temporal relationship between condition onsets. The all-female, physician-diagnosed cohort may not represent all HSD/h-EDS presentations, limiting generalizability to other populations.
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
Collins Hutchinson, Meagan L, Liang, Emily, Fuster, Emily, & Blitshteyn, Svetlana (2025). Autonomic symptom burden, comorbidities and quality of life in women with Hypermobility Spectrum Disorders and hypermobile Ehlers-Danlos syndrome.. Autonomic neuroscience : basic & clinical. https://doi.org/10.1016/j.autneu.2025.103356
BibTeX
@article{mecfsatlas-collins-hutchinson-2025-autonomic-symptom,
author = {Collins Hutchinson, Meagan L and Liang, Emily and Fuster, Emily and Blitshteyn, Svetlana},
title = {Autonomic symptom burden, comorbidities and quality of life in women with Hypermobility Spectrum Disorders and hypermobile Ehlers-Danlos syndrome.},
journal = {Autonomic neuroscience : basic & clinical},
year = {2025},
doi = {10.1016/j.autneu.2025.103356},
note = {PubMed: 41118678},
url = {https://www.mecfsatlas.com/evidence/collins-hutchinson-2025-autonomic-symptom},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/collins-hutchinson-2025-autonomic-symptom
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