Thapaliya, Kiran, Marshall-Gradisnik, Sonya, Eaton-Fitch, Natalie et al. · The American journal of medicine · 2025 · DOI
Researchers used advanced brain imaging to measure chemical imbalances in ME/CFS and long COVID patients compared to healthy people. They found that two important brain chemicals—glutamate and N-acetyl-aspartate—were significantly higher in patients with both conditions. These chemical imbalances were connected to how severe patients' symptoms were, suggesting that abnormal brain chemistry may play a role in the exhaustion and other symptoms these patients experience.
This is among the first studies directly measuring brain neurochemical abnormalities in both ME/CFS and long COVID, providing objective biological evidence for the neurological basis of these conditions. Finding similar neurochemical patterns in both diseases strengthens the scientific understanding of their shared pathophysiology and may eventually guide treatment development. The correlation between brain chemistry and symptom severity validates that patient-reported symptoms have measurable biological underpinnings.
This study does not prove that glutamate imbalance causes ME/CFS or long COVID symptoms—only that an association exists. It measures neurochemistry in only one brain region (posterior cingulate cortex), so abnormalities may exist elsewhere in the brain. The small sample size means findings need replication in larger populations before drawing definitive conclusions about disease mechanisms.
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
Thapaliya, Kiran, Marshall-Gradisnik, Sonya, Eaton-Fitch, Natalie, Eftekhari, Zeinab, Inderyas, Maira, & Barnden, Leighton (2025). Imbalanced Brain Neurochemicals in Long COVID and ME/CFS: A Preliminary Study Using MRI.. The American journal of medicine. https://doi.org/10.1016/j.amjmed.2024.04.007
BibTeX
@article{mecfsatlas-thapaliya-2025-imbalanced-brain,
author = {Thapaliya, Kiran and Marshall-Gradisnik, Sonya and Eaton-Fitch, Natalie and Eftekhari, Zeinab and Inderyas, Maira and Barnden, Leighton},
title = {Imbalanced Brain Neurochemicals in Long COVID and ME/CFS: A Preliminary Study Using MRI.},
journal = {The American journal of medicine},
year = {2025},
doi = {10.1016/j.amjmed.2024.04.007},
note = {PubMed: 38588934},
url = {https://www.mecfsatlas.com/evidence/thapaliya-2025-imbalanced-brain},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/thapaliya-2025-imbalanced-brain
Contribute
Private, reviewed by a human. Not a public comment thread.