Maksoud, Rebekah, du Preez, Stanley, Eaton-Fitch, Natalie et al. · PloS one · 2020 · DOI
This review examined 55 studies that used brain imaging techniques to look for physical differences in the brains of people with ME/CFS compared to healthy people. The researchers found evidence that ME/CFS affects how the nervous system works, including changes in brain structure and blood flow. However, the findings weren't consistent across all studies, meaning scientists still don't have a complete picture of what's happening in the brain.
This is the first comprehensive systematic review consolidating neuroimaging evidence for ME/CFS, providing an important bridge between patient symptoms and measurable brain changes. Establishing objective neurological biomarkers through neuroimaging could validate ME/CFS as a biological illness and guide future diagnostic and therapeutic strategies.
This review does not prove that observed brain changes cause ME/CFS symptoms, as most studies are correlational rather than causal. The inconsistency of findings across studies means no single neurological marker has been established as a definitive diagnostic feature of ME/CFS. The review also cannot explain why neuroimaging changes occur or whether they are primary pathological processes or secondary responses to illness.
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
Maksoud, Rebekah, du Preez, Stanley, Eaton-Fitch, Natalie, Thapaliya, Kiran, Barnden, Leighton, Cabanas, Hélène, et al. (2020). A systematic review of neurological impairments in myalgic encephalomyelitis/ chronic fatigue syndrome using neuroimaging techniques.. PloS one. https://doi.org/10.1371/journal.pone.0232475
BibTeX
@article{mecfsatlas-maksoud-2020-systematic-review,
author = {Maksoud, Rebekah and du Preez, Stanley and Eaton-Fitch, Natalie and Thapaliya, Kiran and Barnden, Leighton and Cabanas, Hélène and Staines, Donald and Marshall-Gradisnik, Sonya},
title = {A systematic review of neurological impairments in myalgic encephalomyelitis/ chronic fatigue syndrome using neuroimaging techniques.},
journal = {PloS one},
year = {2020},
doi = {10.1371/journal.pone.0232475},
note = {PubMed: 32353033},
url = {https://www.mecfsatlas.com/evidence/maksoud-2020-systematic-review},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/maksoud-2020-systematic-review
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