Shan, Zack Y, Barnden, Leighton R, Kwiatek, Richard A et al. · Journal of translational medicine · 2020 · DOI
This study reviewed 63 brain imaging research papers published over 30 years to identify what brain abnormalities are consistently found in ME/CFS patients. Researchers found that ME/CFS is commonly associated with unusual patterns of brain activity during thinking tasks and problems in the brain stem (the part controlling basic body functions). The findings suggest that the brains of people with ME/CFS may not be delivering oxygen and nutrients to active brain areas as efficiently as they should.
This comprehensive review provides the first systematic assessment of brain imaging findings in ME/CFS, helping distinguish genuine disease markers from isolated observations. Identifying consistent neurobiological abnormalities could eventually support objective diagnosis and guide development of targeted treatments. Understanding brain dysfunction may validate ME/CFS as a neurological condition and support patients seeking medical recognition.
This review does not establish whether observed brain abnormalities cause ME/CFS symptoms or result from the illness; the direction of causality remains unknown. The study cannot prove these findings apply to all ME/CFS patients, as many studies used small samples and varied diagnostic criteria. It also does not explain the underlying mechanisms or identify which abnormalities might be most useful for clinical diagnosis.
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, Barnden, Leighton R, Kwiatek, Richard A, Bhuta, Sandeep, Hermens, Daniel F, & Lagopoulos, Jim (2020). Neuroimaging characteristics of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a systematic review.. Journal of translational medicine. https://doi.org/10.1186/s12967-020-02506-6
BibTeX
@article{mecfsatlas-shan-2020-neuroimaging-characteristics,
author = {Shan, Zack Y and Barnden, Leighton R and Kwiatek, Richard A and Bhuta, Sandeep and Hermens, Daniel F and Lagopoulos, Jim},
title = {Neuroimaging characteristics of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a systematic review.},
journal = {Journal of translational medicine},
year = {2020},
doi = {10.1186/s12967-020-02506-6},
note = {PubMed: 32873297},
url = {https://www.mecfsatlas.com/evidence/shan-2020-neuroimaging-characteristics},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/shan-2020-neuroimaging-characteristics
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