Cook, D B, Lange, G, DeLuca, J et al. · The International journal of neuroscience · 2001 · DOI
This study looked at brain MRI scans from 48 ME/CFS patients to see if visible abnormalities in the brain were related to how physically impaired they felt. Researchers found that patients whose brain scans showed abnormalities reported being significantly more physically limited than those with normal-looking scans. This suggests ME/CFS may involve real, measurable changes in the brain rather than being purely psychological.
This study provides objective neuroimaging evidence that ME/CFS is associated with detectable brain abnormalities, countering suggestions that the illness is purely psychological or functional in nature. The correlation between visible brain changes and reported physical impairment strengthens the biological basis of ME/CFS and may help validate patient experiences of disability.
This study does not prove that brain abnormalities cause physical impairment—only that they are associated. The cross-sectional design captures only a single timepoint and cannot establish whether abnormalities precede, follow, or are independent of symptom severity. The study also does not identify which specific brain abnormalities drive functional decline or explain the mechanism underlying these relationships.
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
Cook, D B, Lange, G, DeLuca, J, & Natelson, B H (2001). Relationship of brain MRI abnormalities and physical functional status in chronic fatigue syndrome.. The International journal of neuroscience. https://doi.org/10.3109/00207450109149754
BibTeX
@article{mecfsatlas-cook-2001-relationship-brain,
author = {Cook, D B and Lange, G and DeLuca, J and Natelson, B H},
title = {Relationship of brain MRI abnormalities and physical functional status in chronic fatigue syndrome.},
journal = {The International journal of neuroscience},
year = {2001},
doi = {10.3109/00207450109149754},
note = {PubMed: 11328679},
url = {https://www.mecfsatlas.com/evidence/cook-2001-relationship-brain},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/cook-2001-relationship-brain
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