Godlewska, Beata R, Sylvester, Amy L, Emir, Uzay E et al. · Molecular psychiatry · 2025 · DOI
Researchers used advanced brain scans to look at chemical differences in the brains and muscles of people with ME/CFS, long COVID, and healthy people. They found that people with ME/CFS had higher levels of lactate (a chemical related to energy use) in specific brain areas, suggesting their brains may be working harder to produce energy. People with long COVID showed different changes - lower levels of a chemical called choline in the brain. These findings suggest that ME/CFS and long COVID may have different underlying causes, even though they produce similar symptoms.
This study provides objective biological evidence of brain chemistry abnormalities in ME/CFS, supporting the theory that the condition involves real metabolic dysfunction rather than psychological causes. The finding that ME/CFS and long COVID have different metabolic signatures is particularly important because it suggests they may need different treatment approaches, and that lumping them together in research studies may obscure important findings about each condition.
This study does not prove that elevated lactate causes ME/CFS symptoms or that it is the only abnormality present. As a cross-sectional study, it cannot establish causation or whether these chemical changes develop before or after symptom onset. The findings are also limited to the specific brain regions examined and may not reflect whole-brain or systemic metabolic changes.
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
Godlewska, Beata R, Sylvester, Amy L, Emir, Uzay E, Sharpley, Ann L, Clarke, William T, Williams, Stephen R, et al. (2025). Brain and muscle chemistry in myalgic encephalitis/chronic fatigue syndrome (ME/CFS) and long COVID: a 7T magnetic resonance spectroscopy study.. Molecular psychiatry. https://doi.org/10.1038/s41380-025-03108-8
BibTeX
@article{mecfsatlas-godlewska-2025-brain-muscle,
author = {Godlewska, Beata R and Sylvester, Amy L and Emir, Uzay E and Sharpley, Ann L and Clarke, William T and Williams, Stephen R and Gonçalves, Ana Jorge and Raman, Betty and Valkovič, Ladislav and Cowen, Philip J},
title = {Brain and muscle chemistry in myalgic encephalitis/chronic fatigue syndrome (ME/CFS) and long COVID: a 7T magnetic resonance spectroscopy study.},
journal = {Molecular psychiatry},
year = {2025},
doi = {10.1038/s41380-025-03108-8},
note = {PubMed: 40652046},
url = {https://www.mecfsatlas.com/evidence/godlewska-2025-brain-muscle},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/godlewska-2025-brain-muscle
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