Su, Jiasheng, Thapaliya, Kiran, Eaton-Fitch, Natalie et al. · Brain connectivity · 2023 · DOI
This study used brain imaging (fMRI) to examine how different brain networks communicate in people with ME/CFS compared to healthy controls. Researchers found that people with ME/CFS have different patterns of brain connectivity, particularly in networks involved in attention and the brain's rest-state activity. Importantly, the study discovered that two different diagnostic criteria for ME/CFS (ICC and Fukuda) appear to identify distinct brain differences, suggesting they may represent different disease types.
This is the first neuroimaging evidence that two clinically distinct ME/CFS diagnostic criteria (ICC vs. Fukuda) reflect different objective brain connectivity patterns, validating the newer ICC diagnostic approach. This finding may help researchers better understand ME/CFS heterogeneity and could guide development of subtype-specific treatments. For patients, it suggests that different ME/CFS subtypes may have different underlying brain mechanisms affecting cognition and sleep-wake regulation.
This study cannot establish causation—it shows correlation between connectivity patterns and diagnostic criteria, not whether altered connectivity causes ME/CFS symptoms or results from the disease. The findings are limited to the specific networks examined and may not generalize to all ME/CFS populations or capture the full complexity of brain dysfunction. Cross-sectional design means we cannot determine if these brain changes are stable over time or how they evolve with disease progression.
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
Su, Jiasheng, Thapaliya, Kiran, Eaton-Fitch, Natalie, Marshall-Gradisnik, Sonya, & Barnden, Leighton (2023). Connectivity Between Salience and Default Mode Networks and Subcortical Nodes Distinguishes Between Two Classes of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.. Brain connectivity. https://doi.org/10.1089/brain.2022.0049
BibTeX
@article{mecfsatlas-su-2023-connectivity-between,
author = {Su, Jiasheng and Thapaliya, Kiran and Eaton-Fitch, Natalie and Marshall-Gradisnik, Sonya and Barnden, Leighton},
title = {Connectivity Between Salience and Default Mode Networks and Subcortical Nodes Distinguishes Between Two Classes of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {Brain connectivity},
year = {2023},
doi = {10.1089/brain.2022.0049},
note = {PubMed: 36352819},
url = {https://www.mecfsatlas.com/evidence/su-2023-connectivity-between},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/su-2023-connectivity-between
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