van Campen, C Linda M C, Rowe, Peter C, Visser, Frans C · Medicina (Kaunas, Lithuania) · 2023 · DOI
This study found that ME/CFS patients with worsening symptoms had larger problems with blood flow to their brain during a standing-up test (tilt test). When researchers compared patients at two visits, those who got sicker showed a bigger drop in brain blood flow (from 19% to 31%), while patients who stayed stable showed no change in blood flow reduction. The more severe a patient's ME/CFS became, the greater the reduction in blood flow to the brain.
This research provides objective physiological evidence linking ME/CFS disease severity to measurable brain blood flow abnormalities, potentially validating patient-reported symptom worsening with biological markers. Understanding this relationship may help clinicians assess disease progression and could inform future therapeutic targets aimed at improving cerebral perfusion in ME/CFS.
While the study suggests a possible causal relationship between CBF reduction and symptom worsening, it cannot definitively prove causation—the direction of causality remains uncertain, and both may be consequences of underlying disease mechanisms. The study also does not establish whether CBF reduction is the primary cause of symptoms or a secondary manifestation of ME/CFS pathology.
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). Worsening Symptoms Is Associated with Larger Cerebral Blood Flow Abnormalities during Tilt-Testing in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina59122153
BibTeX
@article{mecfsatlas-van-campen-2023-worsening-symptoms,
author = {van Campen, C Linda M C and Rowe, Peter C and Visser, Frans C},
title = {Worsening Symptoms Is Associated with Larger Cerebral Blood Flow Abnormalities during Tilt-Testing in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).},
journal = {Medicina (Kaunas, Lithuania)},
year = {2023},
doi = {10.3390/medicina59122153},
note = {PubMed: 38138257},
url = {https://www.mecfsatlas.com/evidence/van-campen-2023-worsening-symptoms},
}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-worsening-symptoms
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