van Campen, C Linda M C, Rowe, Peter C, Visser, Frans C · Clinical neurophysiology practice · 2021 · DOI
This study looked at blood flow to the brain in ME/CFS patients during and after a tilt test (where people are tilted upright). Researchers found that when ME/CFS patients were tilted, blood flow to their brain decreased abnormally, and importantly, it did not fully recover even after returning to lying down—unlike their heart's ability to recover. The severity of this delayed blood flow recovery was directly related to how sick the patient was, with the most severely ill patients showing the slowest recovery.
This study provides objective physiological evidence that ME/CFS involves persistent cerebral blood flow impairment that outlasts cardiac recovery after orthostatic stress, with severity-dependent patterns. These findings have direct clinical implications for post-exertional management advice, suggesting that severely ill patients may need extended supine rest after physical or orthostatic stressors to allow cerebral blood flow recovery.
This study does not prove that reduced cerebral blood flow causes ME/CFS symptoms, only that the association exists in this patient population. It cannot establish whether delayed CBF recovery is a primary ME/CFS mechanism or a secondary consequence of the disease. The small sample size and lack of healthy controls limit generalizability of the findings.
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 (2021). Cerebral blood flow remains reduced after tilt testing in myalgic encephalomyelitis/chronic fatigue syndrome patients.. Clinical neurophysiology practice. https://doi.org/10.1016/j.cnp.2021.09.001
BibTeX
@article{mecfsatlas-van-campen-2021-cerebral-blood,
author = {van Campen, C Linda M C and Rowe, Peter C and Visser, Frans C},
title = {Cerebral blood flow remains reduced after tilt testing in myalgic encephalomyelitis/chronic fatigue syndrome patients.},
journal = {Clinical neurophysiology practice},
year = {2021},
doi = {10.1016/j.cnp.2021.09.001},
note = {PubMed: 34667909},
url = {https://www.mecfsatlas.com/evidence/van-campen-2021-cerebral-blood},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/van-campen-2021-cerebral-blood
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