Peres, M F P, Zukerman, E, Young, W B et al. · Cephalalgia : an international journal of headache · 2002 · DOI
This study looked at fatigue in 63 patients with chronic migraine headaches. The researchers found that most of these patients experienced significant fatigue, and many met the diagnostic criteria for chronic fatigue syndrome (CFS). The study suggests that fatigue and migraines may be connected conditions that should be recognized and treated together.
This study demonstrates substantial overlap between chronic migraine and CFS, with the majority of migraine patients meeting CFS diagnostic criteria. Understanding this comorbidity relationship is crucial for both ME/CFS and migraine specialists, as it suggests shared pathophysiological mechanisms and has implications for how patients are diagnosed and treated across both conditions.
This study does not establish causality or directionality—it cannot determine whether migraine causes fatigue, fatigue causes migraines, or whether both stem from a common underlying mechanism. The absence of controls means we cannot determine if fatigue prevalence in CM patients is significantly higher than in the general population or other chronic conditions. Cross-sectional design also cannot establish whether fatigue precedes or follows migraine onset.
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
Peres, M F P, Zukerman, E, Young, W B, & Silberstein, S D (2002). Fatigue in chronic migraine patients.. Cephalalgia : an international journal of headache. https://doi.org/10.1046/j.1468-2982.2002.00426.x
BibTeX
@article{mecfsatlas-peres-2002-fatigue-chronic,
author = {Peres, M F P and Zukerman, E and Young, W B and Silberstein, S D},
title = {Fatigue in chronic migraine patients.},
journal = {Cephalalgia : an international journal of headache},
year = {2002},
doi = {10.1046/j.1468-2982.2002.00426.x},
note = {PubMed: 12421157},
url = {https://www.mecfsatlas.com/evidence/peres-2002-fatigue-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/peres-2002-fatigue-chronic
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