Razumovsky, Alexander Y, DeBusk, Karen, Calkins, Hugh et al. · Journal of neuroimaging : official journal of the American Society of Neuroimaging · 2003
When people with ME/CFS stand up quickly, they often experience dizziness and fainting. This study used ultrasound to measure blood flow in the brain during a tilt test and compared it between ME/CFS patients and healthy people. The researchers found that blood flow patterns in the brain were actually similar between the two groups, even though ME/CFS patients felt symptoms faster.
Understanding why ME/CFS patients experience postural symptoms is crucial for developing targeted treatments. This study helps clarify the mechanisms behind orthostatic intolerance by showing that abnormal brain blood flow patterns may not be the primary cause, redirecting researchers to investigate other physiological mechanisms.
This study does not prove that cerebral blood flow plays no role in ME/CFS symptoms—only that the pattern of blood flow changes during tilt testing does not differ significantly from controls. The lower CO2 levels in ME/CFS patients at test termination suggest other factors (such as hyperventilation or metabolic changes) may contribute to symptoms, but causation cannot be established from this observational data. The study also cannot explain why ME/CFS patients develop symptoms faster despite similar hemodynamic parameters.
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
Razumovsky, Alexander Y, DeBusk, Karen, Calkins, Hugh, Snader, Sally, Lucas, Katherine E, Vyas, Pranav, et al. (2003). Cerebral and systemic hemodynamics changes during upright tilt in chronic fatigue syndrome.. Journal of neuroimaging : official journal of the American Society of Neuroimaging. https://pubmed.ncbi.nlm.nih.gov/12593133/
BibTeX
@article{mecfsatlas-razumovsky-2003-cerebral-systemic,
author = {Razumovsky, Alexander Y and DeBusk, Karen and Calkins, Hugh and Snader, Sally and Lucas, Katherine E and Vyas, Pranav and Hanley, Daniel F and Rowe, Peter C},
title = {Cerebral and systemic hemodynamics changes during upright tilt in chronic fatigue syndrome.},
journal = {Journal of neuroimaging : official journal of the American Society of Neuroimaging},
year = {2003},
note = {PubMed: 12593133},
url = {https://www.mecfsatlas.com/evidence/razumovsky-2003-cerebral-systemic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/razumovsky-2003-cerebral-systemic
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