Walitt, Brian, Singh, Komudi, LaMunion, Samuel R et al. · Nature communications · 2024 · DOI
This study carefully examined 17 people with ME/CFS that started after an infection and compared them to healthy controls to understand what's happening in their bodies and brains. Researchers found that people with ME/CFS have trouble with how their brain decides whether to exert effort (not because their muscles are weak, but because their brain's decision-making is altered), along with immune system changes showing ongoing response to past infections, and differences in how their cells use energy. These discoveries suggest ME/CFS involves multiple body systems working abnormally together, which could help guide future treatments.
This study provides the most detailed biological characterization of post-infectious ME/CFS to date, identifying specific measurable abnormalities in brain function, immune regulation, and cellular metabolism that could serve as biomarkers for diagnosis and treatment targets. Understanding that ME/CFS involves altered brain decision-making about effort (not simply weakness or central fatigue) reframes how physicians and patients should approach the disease and may guide development of mechanism-based interventions.
This study does not prove that catecholaminergic dysfunction or B-cell abnormalities directly cause ME/CFS symptoms—only that these abnormalities correlate with the disease. The small sample size and cross-sectional design prevent conclusions about whether these biomarkers are primary drivers versus secondary consequences of illness. The findings cannot yet be generalized to all ME/CFS or non-infectious ME/CFS cases.
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
Walitt, Brian, Singh, Komudi, LaMunion, Samuel R, Hallett, Mark, Jacobson, Steve, Chen, Kong, et al. (2024). Deep phenotyping of post-infectious myalgic encephalomyelitis/chronic fatigue syndrome.. Nature communications. https://doi.org/10.1038/s41467-024-45107-3
BibTeX
@article{mecfsatlas-walitt-2024-deep-phenotyping,
author = {Walitt, Brian and Singh, Komudi and LaMunion, Samuel R and Hallett, Mark and Jacobson, Steve and Chen, Kong and Enose-Akahata, Yoshimi and Apps, Richard and Barb, Jennifer J and Bedard, Patrick and Brychta, Robert J and Buckley, Ashura Williams and Burbelo, Peter D and Calco, Brice and Cathay, Brianna and Chen, Li and Chigurupati, Snigdha and Chen, Jinguo and Cheung, Foo and Chin, Lisa M K and Coleman, Benjamin W and Courville, Amber B and Deming, Madeleine S and Drinkard, Bart and Feng, Li Rebekah and Ferrucci, Luigi and Gabel, Scott A and Gavin, Angelique and Goldstein, David S and Hassanzadeh, Shahin and Horan, Sean C and Horovitz, Silvina G and Johnson, Kory R and Govan, Anita Jones and Knutson, Kristine M and Kreskow, Joy D and Levin, Mark and Lyons, Jonathan J and Madian, Nicholas and Malik, Nasir and Mammen, Andrew L and McCulloch, John A and McGurrin, Patrick M and Milner, Joshua D and Moaddel, Ruin and Mueller, Geoffrey A and Mukherjee, Amrita and Muñoz-Braceras, Sandra and Norato, Gina and Pak, Katherine and Pinal-Fernandez, Iago and Popa, Traian and Reoma, Lauren B and Sack, Michael N and Safavi, Farinaz and Saligan, Leorey N and Sellers, Brian A and Sinclair, Stephen and Smith, Bryan and Snow, Joseph and Solin, Stacey and Stussman, Barbara J and Trinchieri, Giorgio and Turner, Sara A and Vetter, C Stephenie and Vial, Felipe and Vizioli, Carlotta and Williams, Ashley and Yang, Shanna B and Center for Human Immunology, Autoimmunity, and Inflammation (CHI) Consortium and Nath, Avindra},
title = {Deep phenotyping of post-infectious myalgic encephalomyelitis/chronic fatigue syndrome.},
journal = {Nature communications},
year = {2024},
doi = {10.1038/s41467-024-45107-3},
note = {PubMed: 38383456},
url = {https://www.mecfsatlas.com/evidence/walitt-2024-deep-phenotyping},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/walitt-2024-deep-phenotyping
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