van Campen, C Linda M C, Rowe, Peter C, Visser, Frans C · Frontiers in pediatrics · 2023 · DOI
This study tested whether a gentler tilt test could detect blood flow problems in teenagers with ME/CFS, since the standard aggressive tilt test sometimes causes fainting in young patients. Researchers found that a mild 20-degree tilt reduced blood flow to the brain almost as much as the standard 70-degree tilt, but caused far fewer problems like fainting. This suggests doctors might be able to use a gentler test to diagnose blood flow issues in young ME/CFS patients.
Many teenagers with ME/CFS cannot tolerate standard diagnostic tilt tests because they risk fainting. This study shows doctors may have a safer alternative that still detects the abnormal blood flow patterns characteristic of ME/CFS, potentially making diagnosis more accessible for young patients and reducing the risk of serious complications during testing.
This study does not prove that the 20-degree test should replace the 70-degree test for diagnosing POTS, since POTS-specific heart rate responses were better captured at 70 degrees. It also does not establish whether CBF measurements are better than current diagnostic criteria for classifying orthostatic intolerance, only that both angles detect CBF reduction. The cross-sectional design cannot demonstrate whether CBF reduction causes symptoms or has prognostic value.
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 (2023). Comparison of a 20 degree and 70 degree tilt test in adolescent myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients.. Frontiers in pediatrics. https://doi.org/10.3389/fped.2023.1169447
BibTeX
@article{mecfsatlas-van-campen-2023-comparison-degree,
author = {van Campen, C Linda M C and Rowe, Peter C and Visser, Frans C},
title = {Comparison of a 20 degree and 70 degree tilt test in adolescent myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients.},
journal = {Frontiers in pediatrics},
year = {2023},
doi = {10.3389/fped.2023.1169447},
note = {PubMed: 37252045},
url = {https://www.mecfsatlas.com/evidence/van-campen-2023-comparison-degree},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/van-campen-2023-comparison-degree
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