Miwa, Kunihisa, Inoue, Yukichi · IBRO neuroscience reports · 2023 · DOI
This small study tested a brain stimulation treatment called repetitive transcranial magnetic stimulation (rTMS) in 30 ME/CFS patients. The treatment targeted specific areas of the brain involved in movement and decision-making. After treatment, most patients reported improvements in their ability to do daily activities, reduced dizziness when standing, better balance, and less pain.
ME/CFS lacks approved treatments and many available options have limited evidence. This study explores a novel neuromodulatory approach targeting postulated CNS dysfunction in ME/CFS, potentially offering hope for patients with debilitating orthostatic intolerance and balance problems that severely restrict daily functioning.
This study does not establish that rTMS is definitively effective for ME/CFS because it lacks a control group (placebo or sham rTMS), making placebo effects and natural symptom fluctuation impossible to rule out. The small sample size, single-arm design, and lack of long-term follow-up data mean results may not generalize to the broader ME/CFS population or demonstrate lasting benefit. Observational studies cannot prove causation.
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
Miwa, Kunihisa & Inoue, Yukichi (2023). Repetitive transcranial magnetic stimulation ameliorates symptoms in patients with myalgic encephalomyelitis (chronic fatigue syndrome).. IBRO neuroscience reports. https://doi.org/10.1016/j.ibneur.2023.10.008
BibTeX
@article{mecfsatlas-miwa-2023-repetitive-transcranial,
author = {Miwa, Kunihisa and Inoue, Yukichi},
title = {Repetitive transcranial magnetic stimulation ameliorates symptoms in patients with myalgic encephalomyelitis (chronic fatigue syndrome).},
journal = {IBRO neuroscience reports},
year = {2023},
doi = {10.1016/j.ibneur.2023.10.008},
note = {PubMed: 38025661},
url = {https://www.mecfsatlas.com/evidence/miwa-2023-repetitive-transcranial},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/miwa-2023-repetitive-transcranial
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