Cordero, D L, Sisto, S A, Tapp, W N et al. · Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 1996 · DOI
This study compared how the nervous system controls heart rate in people with ME/CFS versus healthy volunteers during and after treadmill walking. Researchers found that people with ME/CFS had weaker parasympathetic (rest-and-recover) nervous system activity during walking, and this activity dropped even further after exercise stopped. This abnormality might help explain why ME/CFS patients feel worse after physical activity.
This study provides physiological evidence that ME/CFS involves dysfunction of the parasympathetic nervous system—the body's 'rest-and-recover' system—which could mechanistically explain post-exertional malaise, a hallmark symptom. Understanding autonomic abnormalities may eventually lead to targeted treatments and help validate ME/CFS as a biological condition rather than a psychological one.
This study does not prove that reduced vagal power *causes* post-exertional malaise, only that the two are associated. The small sample size and heterogeneity within ME/CFS patients limit generalizability. The study also does not clarify whether vagal dysfunction is a primary defect or a secondary consequence of chronic illness.
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
Cordero, D L, Sisto, S A, Tapp, W N, LaManca, J J, Pareja, J G, & Natelson, B H (1996). Decreased vagal power during treadmill walking in patients with chronic fatigue syndrome.. Clinical autonomic research : official journal of the Clinical Autonomic Research Society. https://doi.org/10.1007/BF02556303
BibTeX
@article{mecfsatlas-cordero-1996-decreased-vagal,
author = {Cordero, D L and Sisto, S A and Tapp, W N and LaManca, J J and Pareja, J G and Natelson, B H},
title = {Decreased vagal power during treadmill walking in patients with chronic fatigue syndrome.},
journal = {Clinical autonomic research : official journal of the Clinical Autonomic Research Society},
year = {1996},
doi = {10.1007/BF02556303},
note = {PubMed: 8985621},
url = {https://www.mecfsatlas.com/evidence/cordero-1996-decreased-vagal},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/cordero-1996-decreased-vagal
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