Lee, Jin-Seok, Sato, Wakiro, Son, Chang-Gue · Autoimmunity reviews · 2024 · DOI
Researchers combined results from 65 brain imaging studies involving over 1,500 ME/CFS patients to look for signs of inflammation in the brain. They used four different types of brain scans and found that specific brain regions—particularly the insular and thalamic regions that help process emotions and manage body functions—showed reduced activity in ME/CFS patients compared to healthy controls. These findings suggest that problems in how these brain regions communicate may help explain why ME/CFS causes fatigue and other characteristic symptoms.
This comprehensive synthesis provides the first meta-analytic evidence that specific deep brain regions show consistent dysfunction in ME/CFS, potentially pointing toward a biological mechanism underlying the disease. The study offers guidance for standardizing brain imaging research in ME/CFS and may help shift focus toward neurobiological rather than purely psychological explanations of the condition.
This meta-analysis does not prove that neuroinflammation directly causes ME/CFS symptoms—the studies reviewed measure associations, not causation. The findings cannot explain why some patients develop ME/CFS while others do not, nor do they establish whether brain abnormalities precede symptom onset or develop as a consequence of prolonged illness. Additionally, the heterogeneity across studies limits the ability to draw universally applicable conclusions.
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
Lee, Jin-Seok, Sato, Wakiro, & Son, Chang-Gue (2024). Brain-regional characteristics and neuroinflammation in ME/CFS patients from neuroimaging: A systematic review and meta-analysis.. Autoimmunity reviews. https://doi.org/10.1016/j.autrev.2023.103484
BibTeX
@article{mecfsatlas-lee-2024-brain-regional,
author = {Lee, Jin-Seok and Sato, Wakiro and Son, Chang-Gue},
title = {Brain-regional characteristics and neuroinflammation in ME/CFS patients from neuroimaging: A systematic review and meta-analysis.},
journal = {Autoimmunity reviews},
year = {2024},
doi = {10.1016/j.autrev.2023.103484},
note = {PubMed: 38016575},
url = {https://www.mecfsatlas.com/evidence/lee-2024-brain-regional},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/lee-2024-brain-regional
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