Djaldetti, R, Ziv, I, Achiron, A et al. · Neurology · 1996 · DOI
Researchers developed a test to measure fatigue by checking how quickly a person's muscle strength drops during repeated effort. They tested this in people with multiple sclerosis (MS), people with ME/CFS, and healthy volunteers. People with MS showed more muscle fatigue than those with ME/CFS or no illness, especially if their MS affected movement control.
This study provides a quantitative method for measuring fatigue that could help distinguish between fatigue mechanisms in different neurological conditions. For ME/CFS research, the comparison with MS fatigue is valuable because it suggests different underlying mechanisms—MS fatigue relates to pyramidal (motor control) dysfunction, whereas ME/CFS fatigue may have different neurobiological origins.
This study does not prove that ME/CFS and MS fatigue are fundamentally different conditions or share no mechanisms. The very small CFS sample (n=4) makes strong conclusions about CFS fatigue unreliable. Cross-sectional design means causality cannot be established, and the study cannot explain whether pyramidal dysfunction causes fatigue or both result from a common underlying process.
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
Djaldetti, R, Ziv, I, Achiron, A, & Melamed, E (1996). Fatigue in multiple sclerosis compared with chronic fatigue syndrome: A quantitative assessment.. Neurology. https://doi.org/10.1212/wnl.46.3.632
BibTeX
@article{mecfsatlas-djaldetti-1996-fatigue-multiple,
author = {Djaldetti, R and Ziv, I and Achiron, A and Melamed, E},
title = {Fatigue in multiple sclerosis compared with chronic fatigue syndrome: A quantitative assessment.},
journal = {Neurology},
year = {1996},
doi = {10.1212/wnl.46.3.632},
note = {PubMed: 8618658},
url = {https://www.mecfsatlas.com/evidence/djaldetti-1996-fatigue-multiple},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/djaldetti-1996-fatigue-multiple
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