Rayhan, Rakib U, Ravindran, Murugan K, Baraniuk, James N · Frontiers in physiology · 2013 · DOI
This study found that migraines are very common in people with ME/CFS and Gulf War Illness—occurring in about 8 out of 10 ME/CFS patients and 6 out of 10 Gulf War Illness patients, compared to only 1 out of 8 healthy people. The researchers suggest that both conditions may affect how the brain and nervous system process pain, and that doctors should routinely check for and treat migraines in patients with these illnesses.
This study establishes that migraine is a prevalent and significant co-morbidity in ME/CFS that warrants systematic clinical evaluation and treatment. Identifying common mechanisms between ME/CFS and GWI could help clarify the pathophysiology of post-infectious and environmentally-triggered illness and inform therapeutic approaches.
This study demonstrates association, not causation—it does not prove that abnormal central nervous system function causes migraines in these populations. The cross-sectional design cannot establish whether migraine develops before, after, or concurrent with ME/CFS/GWI symptom onset. It also does not identify specific underlying biological mechanisms or predict which patients will develop migraines.
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
Rayhan, Rakib U, Ravindran, Murugan K, & Baraniuk, James N (2013). Migraine in gulf war illness and chronic fatigue syndrome: prevalence, potential mechanisms, and evaluation.. Frontiers in physiology. https://doi.org/10.3389/fphys.2013.00181
BibTeX
@article{mecfsatlas-rayhan-2013-migraine-gulf,
author = {Rayhan, Rakib U and Ravindran, Murugan K and Baraniuk, James N},
title = {Migraine in gulf war illness and chronic fatigue syndrome: prevalence, potential mechanisms, and evaluation.},
journal = {Frontiers in physiology},
year = {2013},
doi = {10.3389/fphys.2013.00181},
note = {PubMed: 23898301},
url = {https://www.mecfsatlas.com/evidence/rayhan-2013-migraine-gulf},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/rayhan-2013-migraine-gulf
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