Holden, Sean, Maksoud, Rebekah, Eaton-Fitch, Natalie et al. · Journal of translational medicine · 2020 · DOI
This review looked at 19 studies examining whether the power-generating structures in our cells (called mitochondria) work differently in people with ME/CFS compared to healthy people. While many studies found some differences in how these cellular power plants function, the results were inconsistent across different research groups, making it hard to draw clear conclusions about whether mitochondrial problems actually cause ME/CFS.
Understanding whether mitochondrial dysfunction plays a role in ME/CFS is crucial because it could eventually lead to new diagnostic tests and targeted treatments. This review synthesizes what we currently know from multiple studies to identify where evidence is strong and where more research is needed to solve the ME/CFS puzzle.
This review does not prove that mitochondrial abnormalities cause ME/CFS or that they are not involved—it merely shows that current studies have not yet provided consistent enough evidence to make firm conclusions. The inconsistencies across studies mean we cannot yet rely on mitochondrial measures as a diagnostic biomarker or therapeutic target.
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
Holden, Sean, Maksoud, Rebekah, Eaton-Fitch, Natalie, Cabanas, Hélène, Staines, Donald, & Marshall-Gradisnik, Sonya (2020). A systematic review of mitochondrial abnormalities in myalgic encephalomyelitis/chronic fatigue syndrome/systemic exertion intolerance disease.. Journal of translational medicine. https://doi.org/10.1186/s12967-020-02452-3
BibTeX
@article{mecfsatlas-holden-2020-systematic-review,
author = {Holden, Sean and Maksoud, Rebekah and Eaton-Fitch, Natalie and Cabanas, Hélène and Staines, Donald and Marshall-Gradisnik, Sonya},
title = {A systematic review of mitochondrial abnormalities in myalgic encephalomyelitis/chronic fatigue syndrome/systemic exertion intolerance disease.},
journal = {Journal of translational medicine},
year = {2020},
doi = {10.1186/s12967-020-02452-3},
note = {PubMed: 32727475},
url = {https://www.mecfsatlas.com/evidence/holden-2020-systematic-review},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/holden-2020-systematic-review
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