Sakudo, Akikazu, Kato, Yukiko Hakariya, Tajima, Seiki et al. · Clinica chimica acta; international journal of clinical chemistry · 2009 · DOI
Researchers used a special light-based scanning tool to examine the thumbs of ME/CFS patients and healthy people, looking for differences in blood and oxygen levels. They found that ME/CFS patients had higher oxygen-carrying proteins in their blood, less water in their tissues, and signs of faster energy use in their cells. These findings suggest that ME/CFS patients' bodies may be working harder than usual, even at rest.
This study provides potential objective biomarkers—measurable physical changes—that could help validate ME/CFS as a physiological condition rather than purely psychological. If confirmed, these spectroscopic markers might eventually assist in diagnosis and help researchers understand why ME/CFS patients experience fatigue despite apparent metabolic hyperactivity.
This study does not prove that elevated oxyhemoglobin or altered cytochrome c oxidase causes ME/CFS fatigue, only that associations exist. It does not establish whether these thumb changes reflect whole-body metabolism or are localized phenomena. The findings are correlational and do not explain the clinical mechanism behind fatigue, nor do they determine whether these changes are primary disease features or secondary consequences.
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
Sakudo, Akikazu, Kato, Yukiko Hakariya, Tajima, Seiki, Kuratsune, Hirohiko, & Ikuta, Kazuyoshi (2009). Visible and near-infrared spectral changes in the thumb of patients with chronic fatigue syndrome.. Clinica chimica acta; international journal of clinical chemistry. https://doi.org/10.1016/j.cca.2009.02.010
BibTeX
@article{mecfsatlas-sakudo-2009-visible-near,
author = {Sakudo, Akikazu and Kato, Yukiko Hakariya and Tajima, Seiki and Kuratsune, Hirohiko and Ikuta, Kazuyoshi},
title = {Visible and near-infrared spectral changes in the thumb of patients with chronic fatigue syndrome.},
journal = {Clinica chimica acta; international journal of clinical chemistry},
year = {2009},
doi = {10.1016/j.cca.2009.02.010},
note = {PubMed: 19248775},
url = {https://www.mecfsatlas.com/evidence/sakudo-2009-visible-near},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/sakudo-2009-visible-near
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