Staud, Roland · Current rheumatology reports · 2012 · DOI
Fatigue in rheumatic diseases like ME/CFS, fibromyalgia, and lupus comes from both physical body problems and mental/central nervous system factors, not just one or the other. Doctors can measure physical fatigue through muscle tests and mental fatigue through questionnaires. Importantly, pain and mood problems are often stronger predictors of fatigue than the disease activity itself, and treatments for both medication and lifestyle changes can help.
This study is important for ME/CFS patients and researchers because it provides a clinical framework for understanding fatigue as a multifactorial symptom involving both measurable peripheral mechanisms and central nervous system dysfunction. By emphasizing that psychological factors and pain are key drivers of fatigue independent of disease markers, it validates patient experiences and suggests that fatigue severity does not necessarily correlate with objective disease activity—a critical insight for personalized treatment approaches.
This narrative review does not establish causal mechanisms or provide new experimental evidence about fatigue pathophysiology in ME/CFS specifically. It does not prove which central or peripheral mechanisms are most important in individual patients, nor does it demonstrate that any single treatment strategy is universally effective across all rheumatic diseases. The review cannot determine whether fatigue causes pain and mood problems or vice versa.
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
Staud, Roland (2012). Peripheral and central mechanisms of fatigue in inflammatory and noninflammatory rheumatic diseases.. Current rheumatology reports. https://doi.org/10.1007/s11926-012-0277-z
BibTeX
@article{mecfsatlas-staud-2012-peripheral-central,
author = {Staud, Roland},
title = {Peripheral and central mechanisms of fatigue in inflammatory and noninflammatory rheumatic diseases.},
journal = {Current rheumatology reports},
year = {2012},
doi = {10.1007/s11926-012-0277-z},
note = {PubMed: 22802155},
url = {https://www.mecfsatlas.com/evidence/staud-2012-peripheral-central},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/staud-2012-peripheral-central
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