Jason, Leonard A, Boulton, Aaron, Porter, Nicole S et al. · Behavioral medicine (Washington, D.C.) · 2010 · DOI
This study looked at 100 people with ME/CFS to see if they experience fatigue in different ways. Researchers used a questionnaire to measure five different types of fatigue and found that patients naturally fell into distinct groups based on their fatigue patterns. The results show that ME/CFS affects people differently—some experience mostly one type of fatigue heavily, while others have combinations of different fatigue types.
Identifying subgroups of ME/CFS patients based on fatigue patterns could enable more personalized treatment approaches and better clinical trial design by matching interventions to specific fatigue phenotypes. Understanding that patients experience different combinations of fatigue types—beyond postexertional malaise and brain fog—validates the complexity patients report and may explain why one-size-fits-all treatments often fail.
This study does not identify the biological mechanisms causing different fatigue patterns in ME/CFS, nor does it prove that these fatigue subgroups respond differently to any specific treatment. The cross-sectional design means we cannot determine whether fatigue patterns change over time or whether these clusters are stable characteristics of individual patients.
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
Jason, Leonard A, Boulton, Aaron, Porter, Nicole S, Jessen, Tricia, Njoku, Mary Gloria, & Friedberg, Fred (2010). Classification of myalgic encephalomyelitis/chronic fatigue syndrome by types of fatigue.. Behavioral medicine (Washington, D.C.). https://doi.org/10.1080/08964280903521370
BibTeX
@article{mecfsatlas-jason-2010-classification-myalgic,
author = {Jason, Leonard A and Boulton, Aaron and Porter, Nicole S and Jessen, Tricia and Njoku, Mary Gloria and Friedberg, Fred},
title = {Classification of myalgic encephalomyelitis/chronic fatigue syndrome by types of fatigue.},
journal = {Behavioral medicine (Washington, D.C.)},
year = {2010},
doi = {10.1080/08964280903521370},
note = {PubMed: 20185398},
url = {https://www.mecfsatlas.com/evidence/jason-2010-classification-myalgic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/jason-2010-classification-myalgic
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