Demitrack, M A, Gold, P W, Dale, J K et al. · Biological psychiatry · 1992 · DOI
This study measured chemical messengers in the blood and spinal fluid of people with ME/CFS and compared them to healthy individuals. Researchers found that people with ME/CFS had lower levels of one chemical (MHPG, related to stress response) and higher levels of another (5-HIAA, related to mood regulation). These differences suggest ME/CFS may have biological markers that distinguish it from purely psychiatric conditions.
This early mechanistic study provided evidence that ME/CFS has measurable biological abnormalities, helping validate it as a distinct medical syndrome rather than a psychiatric disorder. Understanding monoamine metabolism dysfunction may eventually lead to targeted treatments and better diagnostic biomarkers for patients.
This study does not prove that monoamine metabolite abnormalities *cause* ME/CFS symptoms or that restoring normal levels would resolve the illness. The cross-sectional design cannot establish whether these changes precede disease onset or result from it. Correlation between metabolite levels and specific symptoms was not 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
Demitrack, M A, Gold, P W, Dale, J K, Krahn, D D, Kling, M A, & Straus, S E (1992). Plasma and cerebrospinal fluid monoamine metabolism in patients with chronic fatigue syndrome: preliminary findings.. Biological psychiatry. https://doi.org/10.1016/0006-3223(92)90187-5
BibTeX
@article{mecfsatlas-demitrack-1992-plasma-cerebrospinal,
author = {Demitrack, M A and Gold, P W and Dale, J K and Krahn, D D and Kling, M A and Straus, S E},
title = {Plasma and cerebrospinal fluid monoamine metabolism in patients with chronic fatigue syndrome: preliminary findings.},
journal = {Biological psychiatry},
year = {1992},
doi = {10.1016/0006-3223(92)90187-5},
note = {PubMed: 1282370},
url = {https://www.mecfsatlas.com/evidence/demitrack-1992-plasma-cerebrospinal},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/demitrack-1992-plasma-cerebrospinal
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