Oosterman, Joukje M, van der Schaaf, Marieke, de Kleijn, Willemien P E et al. · Journal of psychosomatic research · 2025 · DOI
This study looked at how fatigue and pain affect thinking and memory problems in people with ME/CFS. Researchers tested 1,375 patients on tasks like reaction time and attention, and found that both fatigue severity and pain severity were linked to worse cognitive performance. The effects were stronger in older patients, suggesting that age may play a role in how much fatigue and pain impact thinking abilities.
Understanding which ME/CFS symptoms most affect cognition helps patients and clinicians prioritize symptom management strategies. This research suggests that treating pain and fatigue together, rather than separately, may be important for preserving cognitive function. The age-related findings could inform how cognitive difficulties are evaluated and managed differently across the lifespan of ME/CFS patients.
This study cannot establish causation—it only shows that fatigue and pain are associated with lower cognitive performance, not that they directly cause it. The cross-sectional design means researchers cannot determine whether severe symptoms harm cognition, whether reduced cognitive function worsens symptoms, or whether a third factor affects both. This research does not prove that reducing fatigue and pain will improve cognition.
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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