Vermeulen, Ruud C W, Kurk, Ruud M, Visser, Frans C et al. · Journal of translational medicine · 2010 · DOI
This study compared how well people with ME/CFS and healthy controls performed during two exercise tests done 24 hours apart. Patients became exhausted at much lower exercise levels than controls, and performed even worse on the second test. Surprisingly, when researchers tested the energy-producing structures (mitochondria) in patients' blood cells, they appeared to work normally, suggesting the problem may lie elsewhere in the energy production process.
This study provides evidence that ME/CFS patients suffer from a real physiological limitation in energy production during exercise, not a psychological problem. It narrows the search for the cause by showing the defect is not in the basic mitochondrial enzyme machinery itself, pointing toward other mechanisms that regulate energy metabolism in ME/CFS.
This study does not identify what actually causes the impaired ATP synthesis in ME/CFS patients' muscles, only that it is not due to defects in the core oxidative phosphorylation enzymes. The normal PBMC function does not conclusively rule out abnormalities in muscle mitochondria specifically, as blood cells and muscle cells may differ. The study cannot determine whether the energy deficit is the cause or consequence of ME/CFS symptoms.
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
Vermeulen, Ruud C W, Kurk, Ruud M, Visser, Frans C, Sluiter, Wim, & Scholte, Hans R (2010). Patients with chronic fatigue syndrome performed worse than controls in a controlled repeated exercise study despite a normal oxidative phosphorylation capacity.. Journal of translational medicine. https://doi.org/10.1186/1479-5876-8-93
BibTeX
@article{mecfsatlas-vermeulen-2010-patients-chronic,
author = {Vermeulen, Ruud C W and Kurk, Ruud M and Visser, Frans C and Sluiter, Wim and Scholte, Hans R},
title = {Patients with chronic fatigue syndrome performed worse than controls in a controlled repeated exercise study despite a normal oxidative phosphorylation capacity.},
journal = {Journal of translational medicine},
year = {2010},
doi = {10.1186/1479-5876-8-93},
note = {PubMed: 20937116},
url = {https://www.mecfsatlas.com/evidence/vermeulen-2010-patients-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/vermeulen-2010-patients-chronic
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