Eccles, Jessica A, Owens, Andrew P, Mathias, Christopher J et al. · Frontiers in neuroscience · 2015 · DOI
This review examines how physical differences in the body's automatic nervous system—the system that controls heart rate, blood pressure, and stress responses—may explain why some people experience anxiety more easily. The authors focus on three conditions: joint hypermobility (loose joints due to collagen differences), postural tachycardia syndrome (rapid heart rate when standing), and fainting with emotional stress. They propose that differences in how the brain controls these bodily functions may make people more vulnerable to anxiety and related conditions.
Many ME/CFS patients report comorbid anxiety and autonomic dysfunction symptoms (orthostatic intolerance, heart rate variability). This review proposes a mechanistic framework linking these seemingly separate symptoms through shared brain-body dysregulation, suggesting that anxiety in ME/CFS may reflect underlying constitutional differences in autonomic control rather than purely psychological origins. Understanding these connections could improve diagnosis, stratification, and treatment of both conditions.
This review does not prove causation—that autonomic differences *cause* anxiety—only that they are associated. It does not provide evidence specific to ME/CFS pathology or establish whether autonomic differences are primary causes or secondary consequences of chronic illness. The review synthesizes existing literature rather than presenting new primary data, so findings reflect the strengths and limitations of cited studies.
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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