Nemat-Gorgani, Mohsen, Jensen, Michael Anthony, Davis, Ronald Wayne · International journal of molecular sciences · 2025 · DOI
Your brain has a cleaning system called the glymphatic system that removes toxic waste buildup, especially during sleep. This review suggests that this cleaning system may not be working properly in ME/CFS, which could explain symptoms like fatigue and brain fog. If the glymphatic system is involved in ME/CFS, new treatments designed to fix this cleaning process might help patients feel better.
ME/CFS lacks established biomarkers and effective treatments, with 90% of patients remaining undiagnosed. Identifying the glymphatic system as a potential contributor opens a new avenue for understanding disease mechanisms and developing targeted therapeutics that could meaningfully improve patient outcomes.
This review does not provide experimental evidence that glymphatic dysfunction actually occurs in ME/CFS patients—it proposes a hypothesis based on theoretical reasoning and research in other diseases. The study does not demonstrate causation or prove that treating glymphatic dysfunction would effectively treat ME/CFS. Direct neuroimaging and biochemical studies in ME/CFS populations would be needed to establish this mechanism.
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 →
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Primary citation
Nemat-Gorgani, Mohsen, Jensen, Michael Anthony, & Davis, Ronald Wayne (2025). Glymphatic System Dysregulation as a Key Contributor to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.. International journal of molecular sciences. https://doi.org/10.3390/ijms262311524
BibTeX
@article{mecfsatlas-nemat-gorgani-2025-glymphatic-system,
author = {Nemat-Gorgani, Mohsen and Jensen, Michael Anthony and Davis, Ronald Wayne},
title = {Glymphatic System Dysregulation as a Key Contributor to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {International journal of molecular sciences},
year = {2025},
doi = {10.3390/ijms262311524},
note = {PubMed: 41373677},
url = {https://www.mecfsatlas.com/evidence/nemat-gorgani-2025-glymphatic-system},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/nemat-gorgani-2025-glymphatic-system
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