Natelson, Benjamin H, Mao, Xiangling, Stegner, Aaron J et al. · Journal of the neurological sciences · 2017 · DOI
This study compared brain and spinal fluid measurements in people with ME/CFS and healthy controls to understand what physical changes occur in the condition. Researchers found that ME/CFS patients had lower levels of a protective brain chemical (glutathione), reduced blood flow to the brain, higher levels of lactate (a sign of energy problems), and more abnormalities in spinal fluid compared to healthy people. Importantly, these differences were the same whether or not ME/CFS patients also had depression or anxiety, suggesting psychiatric conditions are not making the disease worse.
This study provides objective evidence of neurobiological abnormalities in ME/CFS—findings that support the disease as a biological disorder rather than primarily psychiatric. The identification of measurable biomarkers (glutathione, lactate, cerebral blood flow, CSF abnormalities) could help validate ME/CFS diagnoses and guide future treatment development.
This study does not establish causation—lower glutathione and cerebral blood flow are associated with ME/CFS but the study does not prove these abnormalities cause the disease. The cross-sectional design cannot determine whether these biomarkers are primary drivers of illness or secondary consequences. The study also does not prove psychiatric comorbidity is never relevant to ME/CFS pathology, only that it may not exacerbate these specific neurobiological measures.
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
Natelson, Benjamin H, Mao, Xiangling, Stegner, Aaron J, Lange, Gudrun, Vu, Diana, Blate, Michelle, et al. (2017). Multimodal and simultaneous assessments of brain and spinal fluid abnormalities in chronic fatigue syndrome and the effects of psychiatric comorbidity.. Journal of the neurological sciences. https://doi.org/10.1016/j.jns.2017.02.046
BibTeX
@article{mecfsatlas-natelson-2017-multimodal-simultaneous,
author = {Natelson, Benjamin H and Mao, Xiangling and Stegner, Aaron J and Lange, Gudrun and Vu, Diana and Blate, Michelle and Kang, Guoxin and Soto, Eli and Kapusuz, Tolga and Shungu, Dikoma C},
title = {Multimodal and simultaneous assessments of brain and spinal fluid abnormalities in chronic fatigue syndrome and the effects of psychiatric comorbidity.},
journal = {Journal of the neurological sciences},
year = {2017},
doi = {10.1016/j.jns.2017.02.046},
note = {PubMed: 28320179},
url = {https://www.mecfsatlas.com/evidence/natelson-2017-multimodal-simultaneous},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/natelson-2017-multimodal-simultaneous
Contribute
Private, reviewed by a human. Not a public comment thread.