Thapaliya, Kiran, Marshall-Gradisnik, Sonya, Barth, Markus et al. · Frontiers in neuroscience · 2023 · DOI
Researchers used advanced MRI scans to examine a part of the brain called the brainstem in patients with ME/CFS and long COVID, comparing them to healthy people. They found that both patient groups had larger volumes in certain brainstem areas compared to healthy controls. The size of specific brainstem regions also correlated with symptom severity, particularly pain and breathing difficulties.
This study provides objective neuroimaging evidence that ME/CFS and long COVID involve measurable brain structure changes, which helps validate the neurobiological basis of these conditions. Finding correlations between brainstem volume and specific symptoms (pain, breathing difficulty) offers potential biomarkers and suggests the brainstem's role in the symptom pathophysiology, which could inform future therapeutic targets.
This study does not prove that brainstem volume changes cause ME/CFS or long COVID symptoms—correlation alone cannot establish causation. The small sample size (10 ME/CFS, 8 long COVID patients) limits statistical power and generalizability to the broader patient population. It also does not explain whether these volume changes develop during illness or are pre-existing factors.
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 →
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Primary citation
Thapaliya, Kiran, Marshall-Gradisnik, Sonya, Barth, Markus, Eaton-Fitch, Natalie, & Barnden, Leighton (2023). Brainstem volume changes in myalgic encephalomyelitis/chronic fatigue syndrome and long COVID patients.. Frontiers in neuroscience. https://doi.org/10.3389/fnins.2023.1125208
BibTeX
@article{mecfsatlas-thapaliya-2023-brainstem-volume,
author = {Thapaliya, Kiran and Marshall-Gradisnik, Sonya and Barth, Markus and Eaton-Fitch, Natalie and Barnden, Leighton},
title = {Brainstem volume changes in myalgic encephalomyelitis/chronic fatigue syndrome and long COVID patients.},
journal = {Frontiers in neuroscience},
year = {2023},
doi = {10.3389/fnins.2023.1125208},
note = {PubMed: 36937672},
url = {https://www.mecfsatlas.com/evidence/thapaliya-2023-brainstem-volume},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/thapaliya-2023-brainstem-volume
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