Dobryakova, Ekaterina, Genova, Helen M, DeLuca, John et al. · Frontiers in neurology · 2015 · DOI
This review examines why people with MS experience severe fatigue by looking at brain imaging studies and medication trials. The researchers propose that fatigue may result from a chemical imbalance in the brain involving dopamine, a messenger that helps different brain regions communicate with each other. They found that medications that boost dopamine can help reduce fatigue in various conditions, suggesting this chemical might be key to understanding fatigue.
Understanding dopamine's role in fatigue could lead to new treatments for ME/CFS patients, many of whom experience debilitating fatigue similar to MS. This hypothesis provides a testable biological mechanism that bridges neuroimaging findings with pharmacological responses, potentially opening pathways for targeted interventions. The inclusion of chronic fatigue syndrome in the dopamine discussion directly connects this MS research to ME/CFS populations.
This review does not prove that dopamine imbalance causes fatigue in ME/CFS—it primarily synthesizes existing MS literature and extrapolates to other conditions. The mechanism may differ between MS and ME/CFS given their distinct etiologies. Showing that dopamine-enhancing drugs help fatigue does not definitively establish dopamine deficiency as the primary cause, as these medications have multiple neurobiological effects.
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 →
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Primary citation
Dobryakova, Ekaterina, Genova, Helen M, DeLuca, John, & Wylie, Glenn R (2015). The dopamine imbalance hypothesis of fatigue in multiple sclerosis and other neurological disorders.. Frontiers in neurology. https://doi.org/10.3389/fneur.2015.00052
BibTeX
@article{mecfsatlas-dobryakova-2015-dopamine-imbalance,
author = {Dobryakova, Ekaterina and Genova, Helen M and DeLuca, John and Wylie, Glenn R},
title = {The dopamine imbalance hypothesis of fatigue in multiple sclerosis and other neurological disorders.},
journal = {Frontiers in neurology},
year = {2015},
doi = {10.3389/fneur.2015.00052},
note = {PubMed: 25814977},
url = {https://www.mecfsatlas.com/evidence/dobryakova-2015-dopamine-imbalance},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/dobryakova-2015-dopamine-imbalance
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