Puri, B K, Jakeman, P M, Agour, M et al. · The British journal of radiology · 2012 · DOI
Researchers used a specialized MRI brain scan to compare 26 ME/CFS patients with 26 healthy volunteers. They found that patients had smaller volumes of brain tissue in specific areas related to vision, memory, and movement coordination. These structural changes in the brain may help explain why ME/CFS patients often experience memory problems and other cognitive difficulties.
This was the largest voxel-based morphometry study in ME/CFS at the time of publication, providing objective neuroimaging evidence that structural brain changes occur in the condition. These findings validate patients' reports of memory and cognitive problems and suggest that ME/CFS involves measurable neurobiological alterations, supporting the view of ME/CFS as an organic neurological disorder rather than purely psychiatric.
This study does not establish whether the observed brain volume changes cause ME/CFS symptoms, result from the disease process, or are secondary to factors like inactivity or symptom severity. The cross-sectional design cannot determine if these changes precede symptom onset or develop after illness begins. The findings are correlational and do not prove that normalizing these brain volumes would improve symptoms.
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
Puri, B K, Jakeman, P M, Agour, M, Gunatilake, K D R, Fernando, K A C, Gurusinghe, A I, et al. (2012). Regional grey and white matter volumetric changes in myalgic encephalomyelitis (chronic fatigue syndrome): a voxel-based morphometry 3 T MRI study.. The British journal of radiology. https://doi.org/10.1259/bjr/93889091
BibTeX
@article{mecfsatlas-puri-2012-regional-grey,
author = {Puri, B K and Jakeman, P M and Agour, M and Gunatilake, K D R and Fernando, K A C and Gurusinghe, A I and Treasaden, I H and Waldman, A D and Gishen, P},
title = {Regional grey and white matter volumetric changes in myalgic encephalomyelitis (chronic fatigue syndrome): a voxel-based morphometry 3 T MRI study.},
journal = {The British journal of radiology},
year = {2012},
doi = {10.1259/bjr/93889091},
note = {PubMed: 22128128},
url = {https://www.mecfsatlas.com/evidence/puri-2012-regional-grey},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/puri-2012-regional-grey
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