Miller, Andrew H, Jones, James F, Drake, Daniel F et al. · PloS one · 2014 · DOI
This study used brain imaging to look at a specific part of the brain called the basal ganglia, which helps control movement and reward responses. Researchers found that people with ME/CFS had less activity in certain regions of this brain area compared to healthy people, and the amount of reduced activity was related to how severe their fatigue symptoms were.
This study provides objective neuroimaging evidence that ME/CFS fatigue is associated with measurable brain dysfunction rather than being purely psychological. Understanding the basal ganglia's role in CFS fatigue could lead to more targeted treatments and may help validate ME/CFS as a biological disorder.
This study does not prove that basal ganglia dysfunction causes fatigue in ME/CFS—it shows correlation, not causation. It does not establish the relationship between immune activation and basal ganglia changes, nor does it demonstrate whether the observed brain differences are specific to ME/CFS or shared with other fatiguing conditions. The cross-sectional design means we cannot determine whether the brain abnormalities preceded or resulted from CFS symptoms.
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
Miller, Andrew H, Jones, James F, Drake, Daniel F, Tian, Hao, Unger, Elizabeth R, & Pagnoni, Giuseppe (2014). Decreased basal ganglia activation in subjects with chronic fatigue syndrome: association with symptoms of fatigue.. PloS one. https://doi.org/10.1371/journal.pone.0098156
BibTeX
@article{mecfsatlas-miller-2014-decreased-basal,
author = {Miller, Andrew H and Jones, James F and Drake, Daniel F and Tian, Hao and Unger, Elizabeth R and Pagnoni, Giuseppe},
title = {Decreased basal ganglia activation in subjects with chronic fatigue syndrome: association with symptoms of fatigue.},
journal = {PloS one},
year = {2014},
doi = {10.1371/journal.pone.0098156},
note = {PubMed: 24858857},
url = {https://www.mecfsatlas.com/evidence/miller-2014-decreased-basal},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/miller-2014-decreased-basal
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