Nguyen, Chinh Bkrong, Kumar, Surendra, Zucknick, Manuela et al. · Brain, behavior, and immunity · 2019 · DOI
This study looked at blood samples from teenagers with ME/CFS to understand how their immune systems and stress-response chemicals differ from healthy teenagers. Researchers found two distinct subgroups of ME/CFS patients based on immune activity and a stress hormone called norepinephrine. Patients with lower norepinephrine levels had more severe fatigue, while those with higher levels showed different patterns of immune dysfunction.
This research provides biological evidence that ME/CFS comprises distinct immunological and neurological subtypes, which could explain why patients respond differently to treatments. Identifying patients by norepinephrine levels and immune profiles may enable personalized treatment strategies and improve clinical trial design by reducing heterogeneity.
This study does not prove that norepinephrine dysfunction or immune dysregulation causes ME/CFS—it identifies associations in a small adolescent cohort that may not generalize to all ME/CFS populations. The cross-sectional gene expression analysis cannot establish temporal relationships or causality. Results require replication in larger, longitudinal studies before clinical applications.
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
Nguyen, Chinh Bkrong, Kumar, Surendra, Zucknick, Manuela, Kristensen, Vessela N, Gjerstad, Johannes, Nilsen, Hilde, et al. (2019). Associations between clinical symptoms, plasma norepinephrine and deregulated immune gene networks in subgroups of adolescent with Chronic Fatigue Syndrome.. Brain, behavior, and immunity. https://doi.org/10.1016/j.bbi.2018.11.008
BibTeX
@article{mecfsatlas-nguyen-2019-associations-between,
author = {Nguyen, Chinh Bkrong and Kumar, Surendra and Zucknick, Manuela and Kristensen, Vessela N and Gjerstad, Johannes and Nilsen, Hilde and Wyller, Vegard Bruun},
title = {Associations between clinical symptoms, plasma norepinephrine and deregulated immune gene networks in subgroups of adolescent with Chronic Fatigue Syndrome.},
journal = {Brain, behavior, and immunity},
year = {2019},
doi = {10.1016/j.bbi.2018.11.008},
note = {PubMed: 30419269},
url = {https://www.mecfsatlas.com/evidence/nguyen-2019-associations-between},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/nguyen-2019-associations-between
Contribute
Private, reviewed by a human. Not a public comment thread.