Goldenberg, Don L · Expert review of neurotherapeutics · 2025 · DOI
This study shows that long COVID, fibromyalgia, and ME/CFS may all share a common underlying problem called central sensitization—where the nervous system becomes overly sensitive to pain and other sensations. Rather than being caused by organ damage or infection, these conditions seem to involve how the brain and nervous system process signals. The research suggests that treating these conditions with a coordinated team approach tailored to each person may be more effective than treating them as completely separate diseases.
This framework challenges the notion that ME/CFS, fibromyalgia, and long COVID are multiple unrelated diseases, potentially validating decades of patient and researcher experiences of symptom overlap. Recognizing these conditions as central sensitization syndromes may lead to more appropriate diagnostic approaches and treatment strategies tailored to nervous system dysfunction rather than searching for specific organ damage. This work could reduce diagnostic delays and improve quality of care for millions of patients.
This review does not prove that central sensitization is the sole cause of long COVID or ME/CFS, nor does it establish the mechanisms by which viral infection triggers this sensitization. The study is a narrative literature review and does not present new primary data, mechanistic studies, or randomized controlled trials testing specific treatments. Correlation between symptom profiles does not establish causation or exclude potential biological abnormalities that may underlie central sensitization.
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
Goldenberg, Don L (2025). The pivotal role of central sensitization in long COVID, fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome.. Expert review of neurotherapeutics. https://doi.org/10.1080/14737175.2025.2516097
BibTeX
@article{mecfsatlas-goldenberg-2025-pivotal-role,
author = {Goldenberg, Don L},
title = {The pivotal role of central sensitization in long COVID, fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome.},
journal = {Expert review of neurotherapeutics},
year = {2025},
doi = {10.1080/14737175.2025.2516097},
note = {PubMed: 40512228},
url = {https://www.mecfsatlas.com/evidence/goldenberg-2025-pivotal-role},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/goldenberg-2025-pivotal-role
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