Stanculescu, Dominic, Bergquist, Jonas · Frontiers in medicine · 2022 · DOI
This paper suggests that ME/CFS might develop through similar biological problems seen in people with severe critical illnesses. The researchers propose that four interconnected issues—reduced blood flow to tissues, damage to the gut lining, problems with pituitary gland function, and low thyroid hormone activity—could work together to create a cycle that keeps ME/CFS going. Understanding these connections could help develop better treatments.
This framework bridges critical illness and ME/CFS research, suggesting that studying mechanisms from better-understood critical conditions could unlock new diagnostic approaches and treatments for ME/CFS. By identifying potential biological cycles that maintain the disease, researchers may find strategic intervention points to break these cycles and improve outcomes.
This perspective does not prove that any of these mechanisms actually cause ME/CFS, nor does it demonstrate that the proposed pathways operate in ME/CFS patients. It is a hypothesis-generating synthesis without new experimental or clinical data, so the proposed mechanisms require direct validation through targeted research studies.
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
Stanculescu, Dominic & Bergquist, Jonas (2022). Perspective: Drawing on Findings From Critical Illness to Explain Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.. Frontiers in medicine. https://doi.org/10.3389/fmed.2022.818728
BibTeX
@article{mecfsatlas-stanculescu-2022-perspective-drawing,
author = {Stanculescu, Dominic and Bergquist, Jonas},
title = {Perspective: Drawing on Findings From Critical Illness to Explain Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {Frontiers in medicine},
year = {2022},
doi = {10.3389/fmed.2022.818728},
note = {PubMed: 35345768},
url = {https://www.mecfsatlas.com/evidence/stanculescu-2022-perspective-drawing},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/stanculescu-2022-perspective-drawing
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