Josev, Elisha K, Chen, Jian, Seal, Marc et al. · Journal of neuroscience research · 2023 · DOI
Researchers used advanced brain imaging to look for structural changes in the brains of teenagers recently diagnosed with ME/CFS compared to healthy peers. While teens with ME/CFS showed worse fatigue, pain, sleep quality, and cognitive problems like slower thinking speed, the brain scans did not reveal significant differences in white matter (the brain tissue that carries signals between brain regions). This suggests that early-stage ME/CFS in teenagers may not involve obvious structural brain changes, unlike what has been found in adult ME/CFS patients.
Understanding whether ME/CFS causes detectable brain changes is crucial for establishing objective biomarkers and validating the biological basis of the disease. This study provides important evidence that early-stage pediatric ME/CFS may have a different neurobiological signature than adult ME/CFS, which could influence how we approach diagnosis, prognosis, and treatment strategies in young patients.
This study does not prove that white matter changes never occur in pediatric ME/CFS—only that they may not be present in the early stages following diagnosis. The small sample size and cross-sectional design prevent conclusions about causation or whether brain changes develop over time. The findings also do not explain the mechanisms behind the cognitive and symptom-related impairments observed in these adolescents.
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, Chen, Jian, Seal, Marc, Scheinberg, Adam, Cole, Rebecca C, Rowe, Katherine, et al. (2023). What lies beneath: White matter microstructure in pediatric myalgic encephalomyelitis/chronic fatigue syndrome using diffusion MRI.. Journal of neuroscience research. https://doi.org/10.1002/jnr.25223
BibTeX
@article{mecfsatlas-josev-2023-what-lies,
author = {Josev, Elisha K and Chen, Jian and Seal, Marc and Scheinberg, Adam and Cole, Rebecca C and Rowe, Katherine and Lubitz, Lionel and Knight, Sarah J},
title = {What lies beneath: White matter microstructure in pediatric myalgic encephalomyelitis/chronic fatigue syndrome using diffusion MRI.},
journal = {Journal of neuroscience research},
year = {2023},
doi = {10.1002/jnr.25223},
note = {PubMed: 37331007},
url = {https://www.mecfsatlas.com/evidence/josev-2023-what-lies},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/josev-2023-what-lies
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