Monro, Jean A, Puri, Basant K · Molecular neurobiology · 2018 · DOI
This paper argues that ME/CFS is caused by biological problems in the brain and body rather than primarily psychological factors. The authors reviewed evidence showing that ME/CFS involves issues with immune chemicals, infections, brain barrier function, and how cells use energy. They suggest that treatments targeting these biological problems—such as supplements, antivirals, and immune therapies—should be studied instead of or alongside psychological approaches.
This paper challenges the prevailing psychological model of ME/CFS and advocates for biological research into disease mechanisms and treatments. For patients, it validates the concept that ME/CFS has physical, measurable causes. For researchers, it outlines specific molecular targets and potential therapeutic approaches worthy of investigation, helping redirect research funding and clinical focus toward biological interventions.
This editorial does not present new experimental data and cannot prove causation for any proposed mechanism. It is a literature review and opinion piece, so individual claims require validation through primary research studies. The paper does not establish which proposed mechanisms are most important or which biological treatments are actually effective in practice.
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
Monro, Jean A & Puri, Basant K (2018). A Molecular Neurobiological Approach to Understanding the Aetiology of Chronic Fatigue Syndrome (Myalgic Encephalomyelitis or Systemic Exertion Intolerance Disease) with Treatment Implications.. Molecular neurobiology. https://doi.org/10.1007/s12035-018-0928-9
BibTeX
@article{mecfsatlas-monro-2018-molecular-neurobiological,
author = {Monro, Jean A and Puri, Basant K},
title = {A Molecular Neurobiological Approach to Understanding the Aetiology of Chronic Fatigue Syndrome (Myalgic Encephalomyelitis or Systemic Exertion Intolerance Disease) with Treatment Implications.},
journal = {Molecular neurobiology},
year = {2018},
doi = {10.1007/s12035-018-0928-9},
note = {PubMed: 29411266},
url = {https://www.mecfsatlas.com/evidence/monro-2018-molecular-neurobiological},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/monro-2018-molecular-neurobiological
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