Thapaliya, Kiran, Marshall-Gradisnik, Sonya, Inderyas, Maira et al. · Frontiers in neuroscience · 2026 · DOI
Researchers used a brain imaging technique called DTI-ALPS to measure how well the brain clears waste during sleep in 31 ME/CFS patients and 27 healthy controls. They observed that ME/CFS patients had lower measurements than controls, and these measurements were associated with worse sleep disturbance and concentration problems. However, this is a preliminary study in a small group, and it remains unclear whether reduced glymphatic function actually causes ME/CFS symptoms or is simply correlated with them.
This is the first application of DTI-ALPS imaging to ME/CFS, offering a potential biomarker for a proposed pathway (glymphatic dysfunction) that could underlie cognitive and sleep symptoms central to the disease. If replicated in larger cohorts, altered glymphatic function could guide future therapeutic targets aimed at enhancing brain waste clearance during sleep.
This study does not establish that impaired glymphatic function causes ME/CFS symptoms or cognitive decline; it demonstrates an association in a small cross-sectional sample. It does not confirm the glymphatic system as a mechanism of ME/CFS pathogenesis, nor does it provide evidence for any treatment. The findings require replication in larger, longitudinally followed cohorts before clinical implications can be drawn.
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, Inderyas, Maira, & Barnden, Leighton (2026). Disrupted glymphatic function and its relationship with sleep and cognitive impairment in ME/CFS assessed via DTI-ALPS.. Frontiers in neuroscience. https://doi.org/10.3389/fnins.2026.1875420
BibTeX
@article{mecfsatlas-thapaliya-2026-disrupted-glymphatic,
author = {Thapaliya, Kiran and Marshall-Gradisnik, Sonya and Inderyas, Maira and Barnden, Leighton},
title = {Disrupted glymphatic function and its relationship with sleep and cognitive impairment in ME/CFS assessed via DTI-ALPS.},
journal = {Frontiers in neuroscience},
year = {2026},
doi = {10.3389/fnins.2026.1875420},
note = {PubMed: 42403482},
url = {https://www.mecfsatlas.com/evidence/thapaliya-2026-disrupted-glymphatic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-07-08. https://www.mecfsatlas.com/evidence/thapaliya-2026-disrupted-glymphatic
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