Schmaling, Karen B, Lewis, David H, Fiedelak, Jessica I et al. · Psychosomatic medicine · 2003 · DOI
Researchers used brain imaging scans to compare how the brains of people with ME/CFS and healthy people work during a challenging listening and memory task. People with ME/CFS performed just as well on the task as healthy people, but reported feeling like they had to work much harder mentally. The brain scans showed that people with ME/CFS had a different pattern of brain activity—more spread out rather than focused in specific areas—suggesting their brains may be working less efficiently.
This study provides objective neuroimaging evidence that ME/CFS may involve inefficient brain function during cognitive tasks, potentially explaining the disproportionate mental fatigue patients experience despite normal task performance. Understanding these brain activation patterns could help validate cognitive complaints and guide development of targeted cognitive rehabilitation strategies.
This study does not establish causation or explain what causes the diffuse brain activation pattern in ME/CFS. It also does not determine whether this activation pattern is unique to ME/CFS, persistent over time, or related to post-exertional malaise, nor does it prove that the brain inefficiency is the primary cause of cognitive difficulties rather than a consequence of illness.
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
Schmaling, Karen B, Lewis, David H, Fiedelak, Jessica I, Mahurin, Roderick, & Buchwald, Dedra S (2003). Single-photon emission computerized tomography and neurocognitive function in patients with chronic fatigue syndrome.. Psychosomatic medicine. https://doi.org/10.1097/01.psy.0000038942.33335.9b
BibTeX
@article{mecfsatlas-schmaling-2003-single-photon,
author = {Schmaling, Karen B and Lewis, David H and Fiedelak, Jessica I and Mahurin, Roderick and Buchwald, Dedra S},
title = {Single-photon emission computerized tomography and neurocognitive function in patients with chronic fatigue syndrome.},
journal = {Psychosomatic medicine},
year = {2003},
doi = {10.1097/01.psy.0000038942.33335.9b},
note = {PubMed: 12554824},
url = {https://www.mecfsatlas.com/evidence/schmaling-2003-single-photon},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/schmaling-2003-single-photon
Contribute
Private, reviewed by a human. Not a public comment thread.