Soetekouw, P M, Lenders, J W, Bleijenberg, G et al. · Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 1999 · DOI
Researchers tested whether ME/CFS patients have problems with the part of the nervous system that automatically controls heart rate and blood pressure. They compared 37 ME/CFS patients to 38 healthy people using several tests (like standing up quickly, holding their breath, and doing mental math). The study found only minor differences, suggesting that major autonomic problems may not be the primary issue in ME/CFS, though some specific responses to stress were reduced.
Orthostatic intolerance and autonomic symptoms are common in ME/CFS, making autonomic dysfunction a plausible contributor to fatigue and exercise intolerance. This systematic assessment helps clarify whether autonomic problems represent a core pathophysiologic feature or a secondary symptom, which could influence treatment approaches and validate patient experiences of autonomic symptoms.
This study does not prove that autonomic dysfunction plays no role in ME/CFS—it only suggests that major gross alterations may be absent. The findings cannot establish causation, and negative or subtle findings do not rule out localized or region-specific autonomic abnormalities. Additionally, cross-sectional design cannot determine whether any detected differences are primary causes or consequences of the disease.
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
Soetekouw, P M, Lenders, J W, Bleijenberg, G, Thien, T, & van der Meer, J W (1999). Autonomic function in patients with chronic fatigue syndrome.. Clinical autonomic research : official journal of the Clinical Autonomic Research Society. https://doi.org/10.1007/BF02318380
BibTeX
@article{mecfsatlas-soetekouw-1999-autonomic-function,
author = {Soetekouw, P M and Lenders, J W and Bleijenberg, G and Thien, T and van der Meer, J W},
title = {Autonomic function in patients with chronic fatigue syndrome.},
journal = {Clinical autonomic research : official journal of the Clinical Autonomic Research Society},
year = {1999},
doi = {10.1007/BF02318380},
note = {PubMed: 10638807},
url = {https://www.mecfsatlas.com/evidence/soetekouw-1999-autonomic-function},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/soetekouw-1999-autonomic-function
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