Weber-Fahr, Wolfgang, Dommke, Sandra, Sack, Markus et al. · Biological psychiatry · 2026 · DOI
This study looked at how the brain produces and uses energy in people with long COVID and cognitive problems. Using a special brain imaging scan, researchers found that people with long COVID have lower energy levels in a part of their brain called the cingulate cortex, and this energy shortage is linked to thinking and memory problems. The findings suggest that problems with how brain cells produce energy may be a key reason why some people experience cognitive difficulties after COVID-19.
This is the first direct neuroimaging evidence demonstrating impaired brain energy metabolism in post-COVID condition, providing biological support for mitochondrial dysfunction as a central pathophysiological mechanism. Since energy metabolism dysfunction is also hypothesized in ME/CFS, these findings may help explain cognitive symptoms in both conditions and could guide development of targeted therapies aimed at improving cellular energy production.
This study does not prove that mitochondrial dysfunction is the sole cause of cognitive symptoms in long COVID—it demonstrates an association between reduced brain ATP levels and cognitive impairment. The cross-sectional design cannot establish whether energy metabolism changes cause cognitive problems or result from them. Additionally, findings in long COVID may not directly translate to ME/CFS without specific studies in ME/CFS populations, though preliminary subgroup analysis suggests similar patterns.
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
Weber-Fahr, Wolfgang, Dommke, Sandra, Sack, Markus, Alzein, Nabil, Becker, Robert, Demirakca, Traute, et al. (2026). Reduced Adenosine Triphosphate-to-Phosphocreatine Ratios in Neuropsychiatric Post-COVID Condition: Evidence From <sup>31</sup>P Magnetic Resonance Spectroscopy.. Biological psychiatry. https://doi.org/10.1016/j.biopsych.2026.01.004
BibTeX
@article{mecfsatlas-weber-fahr-2026-reduced-adenosine,
author = {Weber-Fahr, Wolfgang and Dommke, Sandra and Sack, Markus and Alzein, Nabil and Becker, Robert and Demirakca, Traute and Ende, Gabriele and Schilling, Claudia},
title = {Reduced Adenosine Triphosphate-to-Phosphocreatine Ratios in Neuropsychiatric Post-COVID Condition: Evidence From <sup>31</sup>P Magnetic Resonance Spectroscopy.},
journal = {Biological psychiatry},
year = {2026},
doi = {10.1016/j.biopsych.2026.01.004},
note = {PubMed: 41525818},
url = {https://www.mecfsatlas.com/evidence/weber-fahr-2026-reduced-adenosine},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/weber-fahr-2026-reduced-adenosine
Contribute
Private, reviewed by a human. Not a public comment thread.