Josev, Elisha K, Malpas, Charles B, Seal, Marc L et al. · Brain imaging and behavior · 2020 · DOI
Researchers compared how the brains of teenagers with ME/CFS and healthy teenagers responded to a mentally demanding task using brain imaging. Both groups showed similar changes in brain activity and felt more tired after the mental effort. However, teenagers with ME/CFS started out more fatigued, performed worse on thinking tasks overall, and may have less energy available to draw from when their brain works hard.
This is one of the few brain imaging studies examining ME/CFS in adolescents, an understudied population. Understanding whether ME/CFS involves different brain mechanisms—or rather a reduced capacity to access normal energy reserves—helps inform how cognitive exertion should be managed in young people and guides future research into the biological basis of the illness.
This study does not prove that cognitive exertion causes permanent brain damage or that the brain dysfunction observed is unique to ME/CFS. The cross-sectional design cannot establish causation, and the lack of brain-behavior correlations suggests the relationship between connectivity changes and fatigue/cognitive symptoms is more complex than currently understood. Small sample size limits generalizability.
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
Josev, Elisha K, Malpas, Charles B, Seal, Marc L, Scheinberg, Adam, Lubitz, Lionel, Rowe, Kathy, et al. (2020). Resting-state functional connectivity, cognition, and fatigue in response to cognitive exertion: a novel study in adolescents with chronic fatigue syndrome.. Brain imaging and behavior. https://doi.org/10.1007/s11682-019-00119-2
BibTeX
@article{mecfsatlas-josev-2020-resting-state,
author = {Josev, Elisha K and Malpas, Charles B and Seal, Marc L and Scheinberg, Adam and Lubitz, Lionel and Rowe, Kathy and Knight, Sarah J},
title = {Resting-state functional connectivity, cognition, and fatigue in response to cognitive exertion: a novel study in adolescents with chronic fatigue syndrome.},
journal = {Brain imaging and behavior},
year = {2020},
doi = {10.1007/s11682-019-00119-2},
note = {PubMed: 31102168},
url = {https://www.mecfsatlas.com/evidence/josev-2020-resting-state},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/josev-2020-resting-state
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