van der Schaaf, Marieke E, Geerligs, Linda, Toni, Ivan et al. · Psychological medicine · 2024 · DOI
This study looked at how fatigue and pain affect different networks in the brain of ME/CFS patients by taking brain scans at rest. The researchers found that fatigue and pain involve different brain circuits, suggesting they may be caused by different mechanisms. After cognitive behavioral therapy (CBT), patients who improved showed better communication between brain regions associated with movement and the brain's resting network.
Understanding that fatigue and pain involve different brain networks could help clinicians develop more targeted treatments for ME/CFS. These findings provide biological markers that might eventually help predict which patients will benefit most from CBT, potentially improving treatment outcomes.
This study does not prove that CBT works by changing these brain networks, only that improvements are associated with network changes. The correlational design cannot establish causation—we cannot conclude that network changes cause symptom improvement or vice versa. The study does not establish whether similar findings would apply to other ME/CFS treatments.
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 der Schaaf, Marieke E, Geerligs, Linda, Toni, Ivan, Knoop, Hans, & Oosterman, Joukje M (2024). Disentangling pain and fatigue in chronic fatigue syndrome: a resting state connectivity study before and after cognitive behavioral therapy.. Psychological medicine. https://doi.org/10.1017/S0033291723003690
BibTeX
@article{mecfsatlas-van-der-schaaf-2024-disentangling-pain,
author = {van der Schaaf, Marieke E and Geerligs, Linda and Toni, Ivan and Knoop, Hans and Oosterman, Joukje M},
title = {Disentangling pain and fatigue in chronic fatigue syndrome: a resting state connectivity study before and after cognitive behavioral therapy.},
journal = {Psychological medicine},
year = {2024},
doi = {10.1017/S0033291723003690},
note = {PubMed: 38193344},
url = {https://www.mecfsatlas.com/evidence/van-der-schaaf-2024-disentangling-pain},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/van-der-schaaf-2024-disentangling-pain
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