van Campen, C Linda M C, Verheugt, Freek W A, Rowe, Peter C et al. · Clinical neurophysiology practice · 2020 · DOI
This study measured blood flow to the brain in ME/CFS patients while they were tilted upright for 30 minutes. Researchers found that blood flow to the brain dropped significantly more in ME/CFS patients (24-29%) compared to healthy people (7%), even in patients whose heart rate and blood pressure stayed normal. The more symptoms patients experienced from standing, the greater their blood flow reduction.
This study provides objective physiological evidence that orthostatic intolerance symptoms in ME/CFS are associated with reduced blood flow to the brain, even in patients without traditional cardiovascular abnormalities. These findings support considering ME/CFS as a disorder of cerebral perfusion and may improve diagnostic criteria and guide treatment development targeting blood flow restoration.
This study demonstrates association between CBF reduction and OI symptoms but cannot establish causation—it is unclear whether reduced blood flow causes symptoms or is a consequence of other ME/CFS pathology. The cross-sectional design cannot determine whether CBF reduction is a primary defect or secondary to other physiological abnormalities. Results apply primarily to the studied population and may not generalize to all ME/CFS patients.
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, Verheugt, Freek W A, Rowe, Peter C, & Visser, Frans C (2020). Cerebral blood flow is reduced in ME/CFS during head-up tilt testing even in the absence of hypotension or tachycardia: A quantitative, controlled study using Doppler echography.. Clinical neurophysiology practice. https://doi.org/10.1016/j.cnp.2020.01.003
BibTeX
@article{mecfsatlas-van-campen-2020-cerebral-blood-2,
author = {van Campen, C Linda M C and Verheugt, Freek W A and Rowe, Peter C and Visser, Frans C},
title = {Cerebral blood flow is reduced in ME/CFS during head-up tilt testing even in the absence of hypotension or tachycardia: A quantitative, controlled study using Doppler echography.},
journal = {Clinical neurophysiology practice},
year = {2020},
doi = {10.1016/j.cnp.2020.01.003},
note = {PubMed: 32140630},
url = {https://www.mecfsatlas.com/evidence/van-campen-2020-cerebral-blood-2},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/van-campen-2020-cerebral-blood-2
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