Lewis, D H, Mayberg, H S, Fischer, M E et al. · Radiology · 2001 · DOI
Researchers used brain imaging scans to look for differences in blood flow to the brain in people with ME/CFS compared to their identical twins who don't have the disease. They found that the brain scans of people with ME/CFS looked very similar to those of their healthy twins, suggesting that ME/CFS may not cause detectable changes in how blood flows through the brain at rest.
This study addresses whether ME/CFS produces detectable neuroimaging changes that could serve as biological markers of the disease. The use of identical twins as controls is particularly valuable because it eliminates genetic and many environmental confounders, making it a rigorous approach to distinguishing disease-specific from background variation. Understanding whether the brain shows structural or functional abnormalities in ME/CFS is important for validating it as an organic condition.
This negative finding does not prove that ME/CFS has no brain involvement—it only shows that resting rCBF patterns measured by SPECT do not reliably distinguish affected from unaffected twins. Other imaging modalities (fMRI, PET, structural MRI), challenge protocols (post-exertional malaise testing), or dynamic measures of cerebral blood flow might reveal differences not apparent on resting scans. The absence of visually detectable abnormalities does not rule out subtle metabolic or functional disturbances.
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
Lewis, D H, Mayberg, H S, Fischer, M E, Goldberg, J, Ashton, S, Graham, M M, et al. (2001). Monozygotic twins discordant for chronic fatigue syndrome: regional cerebral blood flow SPECT.. Radiology. https://doi.org/10.1148/radiology.219.3.r01jn18766
BibTeX
@article{mecfsatlas-lewis-2001-monozygotic-twins,
author = {Lewis, D H and Mayberg, H S and Fischer, M E and Goldberg, J and Ashton, S and Graham, M M and Buchwald, D},
title = {Monozygotic twins discordant for chronic fatigue syndrome: regional cerebral blood flow SPECT.},
journal = {Radiology},
year = {2001},
doi = {10.1148/radiology.219.3.r01jn18766},
note = {PubMed: 11376266},
url = {https://www.mecfsatlas.com/evidence/lewis-2001-monozygotic-twins},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/lewis-2001-monozygotic-twins
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