Kakuda, Wataru, Momosaki, Ryo, Yamada, Naoki et al. · Internal medicine (Tokyo, Japan) · 2016 · DOI
Researchers tested a brain stimulation technique called high-frequency rTMS on seven patients with ME/CFS. This non-invasive procedure uses magnetic pulses to stimulate a specific area of the brain involved in fatigue. Most patients experienced improvements in their fatigue symptoms, with only two experiencing mild side effects that required reducing the stimulation intensity.
This study explores a novel non-pharmacological intervention targeting the brain mechanisms underlying ME/CFS fatigue, offering potential hope for patients with limited treatment options. By investigating the prefrontal cortex as a therapeutic target, the research contributes to our understanding of how brain function relates to fatigue severity in ME/CFS.
This small case series does not prove that rTMS is an effective treatment for ME/CFS—it provides only preliminary evidence. The study lacks a control group or placebo comparison, so we cannot determine whether improvements resulted from the stimulation itself or from placebo effect and natural fluctuation. Long-term efficacy and optimal treatment protocols remain unestablished.
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
Kakuda, Wataru, Momosaki, Ryo, Yamada, Naoki, & Abo, Masahiro (2016). High-frequency rTMS for the Treatment of Chronic Fatigue Syndrome: A Case Series.. Internal medicine (Tokyo, Japan). https://doi.org/10.2169/internalmedicine.55.7354
BibTeX
@article{mecfsatlas-kakuda-2016-high-frequency,
author = {Kakuda, Wataru and Momosaki, Ryo and Yamada, Naoki and Abo, Masahiro},
title = {High-frequency rTMS for the Treatment of Chronic Fatigue Syndrome: A Case Series.},
journal = {Internal medicine (Tokyo, Japan)},
year = {2016},
doi = {10.2169/internalmedicine.55.7354},
note = {PubMed: 27904120},
url = {https://www.mecfsatlas.com/evidence/kakuda-2016-high-frequency},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/kakuda-2016-high-frequency
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