Thapaliya, Kiran, Inderyas, Maira, Barnden, Leighton · Methods in molecular biology (Clifton, N.J.) · 2025 · DOI
Quick Summary
This review examines different brain imaging techniques that have been used to study ME/CFS and detect changes in the brain. Researchers have used three main types of imaging: MRI (which takes detailed pictures of brain structure), PET and SPECT (which show how brain activity and chemicals function). These studies have found subtle but measurable differences in the brains of people with ME/CFS compared to healthy controls.
Why It Matters
Neuroimaging provides objective, biological evidence that ME/CFS involves measurable brain changes, which can help validate the condition as a neurological disorder rather than purely psychological. Understanding which imaging techniques most reliably detect these changes helps guide future research and may eventually support clinical diagnosis. This review synthesizes diverse imaging methodologies to help researchers choose appropriate tools for investigating ME/CFS pathophysiology.
Observed Findings
Various neuroimaging techniques have detected structural brain alterations in ME/CFS populations
Functional abnormalities have been identified using imaging methods that assess brain activity and connectivity
Neurochemical changes have been observed through PET and SPECT imaging
Tissue microstructural alterations are detectable through advanced MRI methods
These brain changes, while subtle, are measurable in vivo in people with ME/CFS
Inferred Conclusions
Multiple neuroimaging modalities can detect objective brain changes in ME/CFS, supporting a biological basis for the condition
Different imaging techniques capture complementary information about structural, functional, and neurochemical brain alterations
Neuroimaging methods have potential value for understanding ME/CFS pathophysiology
Standardization and refinement of imaging protocols may strengthen the evidence base for brain involvement in ME/CFS
Remaining Questions
Which neuroimaging findings are most specific and sensitive for ME/CFS diagnosis across diverse patient populations?
What This Study Does Not Prove
This review does not establish causation—detecting brain changes does not prove what causes them or whether they are primary or secondary to other ME/CFS processes. The presence of subtle neuroimaging abnormalities does not automatically translate to clinical diagnostic utility or explain specific symptoms. This is a methods review rather than original research, so it does not present new experimental data of its own.
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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