Sulheim, Dag, Hurum, Harald, Helland, Ingrid B et al. · BioPsychoSocial medicine · 2012 · DOI
This study followed 47 teenagers with ME/CFS over several months to see how they changed over time. Researchers found that most teens improved in their symptoms—including fatigue, pain, and brain fog—and these improvements happened at the same time their heart and nervous system function also improved. This suggests that problems with how the body regulates heart rate and blood pressure may be connected to ME/CFS symptoms.
This study provides evidence that autonomic nervous system dysfunction in adolescent ME/CFS is not static but improves alongside clinical recovery, suggesting that addressing circulatory abnormalities may be therapeutically relevant. The correlation between symptom improvement and objective cardiovascular changes strengthens the case that ME/CFS has biological underpinnings rather than being purely psychological.
This study does not prove that autonomic dysfunction *causes* ME/CFS symptoms—only that they improve together. The small sample size and lack of a control group limit generalizability, and the wide range of follow-up times (3-17 months) makes it unclear what timeline of improvement is typical. The study does not identify what triggered the improvements observed.
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
Sulheim, Dag, Hurum, Harald, Helland, Ingrid B, Thaulow, Erik, & Wyller, Vegard Bruun (2012). Adolescent chronic fatigue syndrome; a follow-up study displays concurrent improvement of circulatory abnormalities and clinical symptoms.. BioPsychoSocial medicine. https://doi.org/10.1186/1751-0759-6-10
BibTeX
@article{mecfsatlas-sulheim-2012-adolescent-chronic,
author = {Sulheim, Dag and Hurum, Harald and Helland, Ingrid B and Thaulow, Erik and Wyller, Vegard Bruun},
title = {Adolescent chronic fatigue syndrome; a follow-up study displays concurrent improvement of circulatory abnormalities and clinical symptoms.},
journal = {BioPsychoSocial medicine},
year = {2012},
doi = {10.1186/1751-0759-6-10},
note = {PubMed: 22436201},
url = {https://www.mecfsatlas.com/evidence/sulheim-2012-adolescent-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/sulheim-2012-adolescent-chronic
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