Shan, Zack Y, Kwiatek, Richard, Burnet, Richard et al. · Journal of magnetic resonance imaging : JMRI · 2016 · DOI
This study used brain MRI scans taken 6 years apart to compare 15 ME/CFS patients with 10 healthy people. Researchers found that patients with ME/CFS had progressive shrinkage of white matter (the brain's communication pathways) in a specific region called the inferior fronto-occipital fasciculus, while healthy controls showed no change. The amount of brain shrinkage in ME/CFS patients correlated with their symptom severity.
This longitudinal evidence suggests ME/CFS involves progressive neurobiological changes rather than static dysfunction, potentially validating patient experiences of worsening symptoms over time. Identifying specific brain regions affected may eventually enable biomarkers for diagnosis and monitoring of disease progression. Understanding these structural changes strengthens the case that ME/CFS is a biological condition affecting the central nervous system.
This study does not prove that white matter loss causes ME/CFS symptoms—the relationship may be bidirectional or both may result from an underlying process. The small sample size limits generalizability to all ME/CFS patients. The study cannot explain the mechanisms driving these brain changes or whether they are reversible.
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
Shan, Zack Y, Kwiatek, Richard, Burnet, Richard, Del Fante, Peter, Staines, Donald R, Marshall-Gradisnik, Sonya M, et al. (2016). Progressive brain changes in patients with chronic fatigue syndrome: A longitudinal MRI study.. Journal of magnetic resonance imaging : JMRI. https://doi.org/10.1002/jmri.25283
BibTeX
@article{mecfsatlas-shan-2016-progressive-brain,
author = {Shan, Zack Y and Kwiatek, Richard and Burnet, Richard and Del Fante, Peter and Staines, Donald R and Marshall-Gradisnik, Sonya M and Barnden, Leighton R},
title = {Progressive brain changes in patients with chronic fatigue syndrome: A longitudinal MRI study.},
journal = {Journal of magnetic resonance imaging : JMRI},
year = {2016},
doi = {10.1002/jmri.25283},
note = {PubMed: 27123773},
url = {https://www.mecfsatlas.com/evidence/shan-2016-progressive-brain},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/shan-2016-progressive-brain
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