Spence, V A, Khan, F, Belch, J J · The American journal of medicine · 2000 · DOI
This study looked at how blood vessels in ME/CFS patients respond to a natural chemical in the body called acetylcholine, which helps control blood vessel widening and narrowing. Researchers compared blood vessel responses in ME/CFS patients versus healthy people and found that ME/CFS patients showed an unusually strong reaction. This finding suggests that the nervous system's control of blood vessels may work differently in ME/CFS.
Autonomic nervous system dysfunction is increasingly recognized as a significant feature of ME/CFS, and this study provides early objective evidence of abnormal vascular control. Understanding how blood vessel regulation differs in ME/CFS may explain some symptoms like postural intolerance and could inform future diagnostic approaches or therapeutic targets.
This study does not prove that enhanced cholinergic sensitivity causes ME/CFS or is the primary mechanism of the disease. It cannot establish whether this finding is specific to ME/CFS, whether it is present in all ME/CFS patients, or what clinical consequences this abnormality has for individual patients. The correlation between this vascular finding and ME/CFS symptoms remains unestablished.
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
Spence, V A, Khan, F, & Belch, J J (2000). Enhanced sensitivity of the peripheral cholinergic vascular response in patients with chronic fatigue syndrome.. The American journal of medicine. https://doi.org/10.1016/s0002-9343(00)00407-1
BibTeX
@article{mecfsatlas-spence-2000-enhanced-sensitivity,
author = {Spence, V A and Khan, F and Belch, J J},
title = {Enhanced sensitivity of the peripheral cholinergic vascular response in patients with chronic fatigue syndrome.},
journal = {The American journal of medicine},
year = {2000},
doi = {10.1016/s0002-9343(00)00407-1},
note = {PubMed: 10924652},
url = {https://www.mecfsatlas.com/evidence/spence-2000-enhanced-sensitivity},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/spence-2000-enhanced-sensitivity
Contribute
Private, reviewed by a human. Not a public comment thread.