Stewart, J M · Pediatric research · 2000 · DOI
This study looked at how the nervous system controls heart rate and blood pressure in adolescents with ME/CFS and POTS when they stand up or tilt their head upward. Researchers found that both groups had similar problems: their bodies couldn't properly regulate heart rate through the vagus nerve (which normally helps calm the heart), and their blood vessels were overly tense. This mismatch may explain why these patients experience dizziness, rapid heartbeat, and fatigue when standing.
This study provides mechanistic evidence that ME/CFS and POTS share a common autonomic dysfunction—specifically impaired vagal nerve function and excessive sympathetic activity—suggesting they may involve related pathophysiology. Understanding these specific nervous system abnormalities helps validate patient symptoms as physiological rather than psychological and may guide development of targeted treatments for orthostatic intolerance and dysautonomia in ME/CFS.
This cross-sectional study cannot establish causation—it shows that autonomic dysfunction is present in ME/CFS and POTS but does not prove whether it causes the illness or develops as a consequence of it. The study is limited to adolescents, so findings may not generalize to adults with ME/CFS. Small sample sizes and lack of detailed case definitions (e.g., post-exertional malaise criteria) limit confidence in the comparability of the CFS group to modern ME/CFS populations.
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
Stewart, J M (2000). Autonomic nervous system dysfunction in adolescents with postural orthostatic tachycardia syndrome and chronic fatigue syndrome is characterized by attenuated vagal baroreflex and potentiated sympathetic vasomotion.. Pediatric research. https://doi.org/10.1203/00006450-200008000-00016
BibTeX
@article{mecfsatlas-stewart-2000-autonomic-nervous,
author = {Stewart, J M},
title = {Autonomic nervous system dysfunction in adolescents with postural orthostatic tachycardia syndrome and chronic fatigue syndrome is characterized by attenuated vagal baroreflex and potentiated sympathetic vasomotion.},
journal = {Pediatric research},
year = {2000},
doi = {10.1203/00006450-200008000-00016},
note = {PubMed: 10926298},
url = {https://www.mecfsatlas.com/evidence/stewart-2000-autonomic-nervous},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/stewart-2000-autonomic-nervous
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