Singh, Tanoj Bahadur, Marshall-Gradisnik, Sonya, Barnden, Leighton et al. · Frontiers in medicine · 2026 · DOI
Researchers used specialized brain imaging scans (DTI and DKI) to observe differences in brain tissue structure between people with ME/CFS, people with long COVID, and healthy controls. They found that ME/CFS and long COVID showed microstructural changes in different brain regions, though the study is cross-sectional and cannot explain why these changes occur or what role they play in symptoms. These are preliminary findings that require replication in larger groups.
By analogy with long COVID findings, this study may contribute to understanding whether ME/CFS involves detectable brain tissue microstructural changes. Identifying distinct patterns between ME/CFS and long COVID could help clarify whether shared symptoms (fatigue, cognitive impairment, post-exertional malaise) arise from similar or different neuropathological mechanisms, potentially informing future diagnostic or mechanistic research.
This cross-sectional study does not establish causation—it cannot show whether microstructural changes cause symptoms, result from illness duration, or represent a consequence of activity limitation. It does not confirm a mechanism of symptom generation. The study does not generalise beyond the specific sample tested (37 ME/CFS, 19 long COVID participants). Relevance of long COVID findings to ME/CFS pathophysiology requires direct validation in ME/CFS-focused cohorts.
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
Singh, Tanoj Bahadur, Marshall-Gradisnik, Sonya, Barnden, Leighton, Eaton-Fitch, Natalie, Huynh, Tuong Hieu, Inderyas, Maira, et al. (2026). Microstructural alterations in brain tissue of ME/CFS and long COVID using diffusion tensor imaging and diffusion kurtosis imaging.. Frontiers in medicine. https://doi.org/10.3389/fmed.2026.1824498
BibTeX
@article{mecfsatlas-singh-2026-microstructural-alterations,
author = {Singh, Tanoj Bahadur and Marshall-Gradisnik, Sonya and Barnden, Leighton and Eaton-Fitch, Natalie and Huynh, Tuong Hieu and Inderyas, Maira and Thapaliya, Kiran},
title = {Microstructural alterations in brain tissue of ME/CFS and long COVID using diffusion tensor imaging and diffusion kurtosis imaging.},
journal = {Frontiers in medicine},
year = {2026},
doi = {10.3389/fmed.2026.1824498},
note = {PubMed: 42539798},
url = {https://www.mecfsatlas.com/evidence/singh-2026-microstructural-alterations},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-08-05. https://www.mecfsatlas.com/evidence/singh-2026-microstructural-alterations
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