Shan, Zack Y, Mohamed, Abdalla Z, Andersen, Thu et al. · Frontiers in neurology · 2022 · DOI
This study used advanced brain imaging to investigate whether ME/CFS is caused by a problem with how the brain's blood vessels respond to neural activity. Researchers scanned the brains of 288 people—including those with ME/CFS, chronic fatigue, fibromyalgia, and healthy controls—while they performed tasks and held their breath, measuring blood flow and brain chemicals. The goal was to find distinctive brain patterns that could objectively diagnose ME/CFS and understand what goes wrong in this disease.
ME/CFS currently lacks objective diagnostic tests and established biological mechanisms, leaving patients without biomarker confirmation and researchers without clear therapeutic targets. This study addresses both gaps by investigating a plausible neurobiological mechanism and developing a machine learning-based diagnostic tool that could provide patients with objective biological validation and accelerate targeted treatment development. Success could transform ME/CFS from a diagnosis of exclusion to one based on measurable brain physiology.
As a protocol paper describing planned methodology rather than results, this study does not yet prove that NVC dysfunction causes ME/CFS—it can only correlate neuroimaging patterns with diagnosis. Even if differences are found, abnormal NVC would be associated with ME/CFS but not necessarily causal. Cross-sectional design cannot establish whether observed brain changes precede symptom onset or result from chronic 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
Shan, Zack Y, Mohamed, Abdalla Z, Andersen, Thu, Rendall, Shae, Kwiatek, Richard A, Fante, Peter Del, et al. (2022). Multimodal MRI of myalgic encephalomyelitis/chronic fatigue syndrome: A cross-sectional neuroimaging study toward its neuropathophysiology and diagnosis.. Frontiers in neurology. https://doi.org/10.3389/fneur.2022.954142
BibTeX
@article{mecfsatlas-shan-2022-multimodal-mri,
author = {Shan, Zack Y and Mohamed, Abdalla Z and Andersen, Thu and Rendall, Shae and Kwiatek, Richard A and Fante, Peter Del and Calhoun, Vince D and Bhuta, Sandeep and Lagopoulos, Jim},
title = {Multimodal MRI of myalgic encephalomyelitis/chronic fatigue syndrome: A cross-sectional neuroimaging study toward its neuropathophysiology and diagnosis.},
journal = {Frontiers in neurology},
year = {2022},
doi = {10.3389/fneur.2022.954142},
note = {PubMed: 36188362},
url = {https://www.mecfsatlas.com/evidence/shan-2022-multimodal-mri},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/shan-2022-multimodal-mri
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