Murga Gandasegui, Iñigo, Aranburu Laka, Larraitz, Gargiulo, Pascual-Ángel et al. · Medicina (Kaunas, Lithuania) · 2021 · DOI
This review examines whether ME/CFS is primarily a neurological disorder by looking at brain imaging studies and tests of the autonomic nervous system (the part that controls automatic body functions like heart rate). The authors found that while brain imaging shows various changes in ME/CFS patients, these changes aren't specific enough to diagnose the condition on their own. However, specialized tests measuring heart rate variability and immune responses show promise as potential biomarkers that could help identify and monitor ME/CFS.
This review provides a comprehensive framework supporting ME/CFS as a neurobiological disorder rather than psychiatric, which validates patient experiences and encourages appropriate clinical evaluation. The identification of autonomic dysregulation as a central mechanism and potential biomarkers offers hope for objective diagnostic tools and targeted treatment approaches that have been lacking in ME/CFS care.
This systematic review does not establish that any single neuroimaging or autonomic test can definitively diagnose ME/CFS, nor does it prove that dysautonomia is the sole pathological mechanism. The identified biomarkers show promise but require prospective validation studies with defined sensitivity and specificity thresholds before clinical implementation.
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
Murga Gandasegui, Iñigo, Aranburu Laka, Larraitz, Gargiulo, Pascual-Ángel, Gómez-Esteban, Juan-Carlos, & Lafuente Sánchez, José-Vicente (2021). Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Neurological Entity?. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina57101030
BibTeX
@article{mecfsatlas-murga-gandasegui-2021-myalgic-encephalomyelitis,
author = {Murga Gandasegui, Iñigo and Aranburu Laka, Larraitz and Gargiulo, Pascual-Ángel and Gómez-Esteban, Juan-Carlos and Lafuente Sánchez, José-Vicente},
title = {Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Neurological Entity?},
journal = {Medicina (Kaunas, Lithuania)},
year = {2021},
doi = {10.3390/medicina57101030},
note = {PubMed: 34684066},
url = {https://www.mecfsatlas.com/evidence/murga-gandasegui-2021-myalgic-encephalomyelitis},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/murga-gandasegui-2021-myalgic-encephalomyelitis
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