Polli, Andrea, Van Oosterwijck, Jessica, Nijs, Jo et al. · Clinical therapeutics · 2019 · DOI
This study looked at whether oxidative stress (cellular damage from normal metabolism) is related to pain in ME/CFS patients, and how it connects to the vagus nerve, which helps control the body's relaxation response. Researchers had ME/CFS patients and healthy people do a mild exercise test and measured their pain, oxidative stress levels, and nerve activity before and after. They found that oxidative stress was linked to pain in ME/CFS patients, but unlike healthy people, ME/CFS patients didn't show improvements in pain or oxidative stress after exercise.
This research provides evidence for a biological mechanism—oxidative stress—that may contribute to pain symptoms in ME/CFS, potentially validating long-standing patient reports of pain. The finding that oxidative stress doesn't respond to exercise as it does in healthy people suggests ME/CFS involves different physiological processes during activity, which could inform safer activity recommendations.
This study does not prove that oxidative stress causes pain in ME/CFS; it only shows an association. The lack of exercise-induced changes in oxidative stress doesn't rule out oxidative stress's role in the condition—baseline levels may still be abnormal. Results apply only to women and cannot be generalized to men with ME/CFS.
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
Polli, Andrea, Van Oosterwijck, Jessica, Nijs, Jo, Marusic, Uros, De Wandele, Inge, Paul, Lorna, et al. (2019). Relationship Between Exercise-induced Oxidative Stress Changes and Parasympathetic Activity in Chronic Fatigue Syndrome: An Observational Study in Patients and Healthy Subjects.. Clinical therapeutics. https://doi.org/10.1016/j.clinthera.2018.12.012
BibTeX
@article{mecfsatlas-polli-2019-relationship-between,
author = {Polli, Andrea and Van Oosterwijck, Jessica and Nijs, Jo and Marusic, Uros and De Wandele, Inge and Paul, Lorna and Meeus, Mira and Moorkens, Greta and Lambrecht, Luc and Ickmans, Kelly},
title = {Relationship Between Exercise-induced Oxidative Stress Changes and Parasympathetic Activity in Chronic Fatigue Syndrome: An Observational Study in Patients and Healthy Subjects.},
journal = {Clinical therapeutics},
year = {2019},
doi = {10.1016/j.clinthera.2018.12.012},
note = {PubMed: 30665828},
url = {https://www.mecfsatlas.com/evidence/polli-2019-relationship-between},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/polli-2019-relationship-between
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