van Campen, C Linda M C, Rowe, Peter C, Visser, Frans C · Healthcare (Basel, Switzerland) · 2020 · DOI
This study looked at blood flow to the brain in 19 people with severe ME/CFS who have difficulty standing up (orthostatic intolerance). When patients tilted their heads up at a mild 20-degree angle for 15 minutes, blood flow to their brains dropped by an average of 27%. All 19 patients showed this abnormal reduction in brain blood flow, suggesting this shorter, gentler test could help diagnose the condition even in the most severely ill patients who cannot tolerate longer or more intense tests.
This research demonstrates that a shorter, less demanding tilt test (15 minutes at 20 degrees) can reliably detect abnormal cerebral blood flow in the most severely affected ME/CFS patients, including those who are largely bed-bound. This finding is clinically important because it enables objective measurement of a key pathophysiological mechanism in ME/CFS while remaining tolerable for patients with severe disease, potentially improving diagnosis and understanding of orthostatic dysfunction.
This study does not prove that reduced cerebral blood flow causes ME/CFS symptoms or that it is the primary mechanism of the disease. The small sample size and lack of a healthy control group limit generalizability. The study also does not establish whether this CBF reduction is specific to ME/CFS or occurs in other conditions causing orthostatic intolerance.
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
van Campen, C Linda M C, Rowe, Peter C, & Visser, Frans C (2020). Cerebral Blood Flow Is Reduced in Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients During Mild Orthostatic Stress Testing: An Exploratory Study at 20 Degrees of Head-Up Tilt Testing.. Healthcare (Basel, Switzerland). https://doi.org/10.3390/healthcare8020169
BibTeX
@article{mecfsatlas-van-campen-2020-cerebral-blood,
author = {van Campen, C Linda M C and Rowe, Peter C and Visser, Frans C},
title = {Cerebral Blood Flow Is Reduced in Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients During Mild Orthostatic Stress Testing: An Exploratory Study at 20 Degrees of Head-Up Tilt Testing.},
journal = {Healthcare (Basel, Switzerland)},
year = {2020},
doi = {10.3390/healthcare8020169},
note = {PubMed: 32545797},
url = {https://www.mecfsatlas.com/evidence/van-campen-2020-cerebral-blood},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/van-campen-2020-cerebral-blood
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