Wise, Shelby, Ross, Amanda, Brown, Abigail et al. · Journal of health psychology · 2017 · DOI
This study looked at fatigue in people with POTS (postural orthostatic tachycardia syndrome), a condition that shares many symptoms with ME/CFS. Researchers asked 138 young people with POTS to describe their fatigue and brain fog using questionnaires. They found that fatigue comes in multiple forms and that people with POTS fall into two groups: those with mild symptoms and those with severe symptoms, with the severe group experiencing much worse brain fog and activity limitations.
Since ME/CFS and POTS share overlapping symptoms including severe fatigue, understanding how fatigue manifests in POTS may illuminate similar mechanisms in ME/CFS and help clinicians better stratify patients into subgroups for more targeted treatment. Identifying distinct fatigue phenotypes could enable personalized management approaches and improve research design by accounting for symptom heterogeneity.
This study does not demonstrate that POTS causes ME/CFS or vice versa, nor does it identify the biological mechanisms underlying multidimensional fatigue in either condition. The cross-sectional design cannot establish causality, and findings in a young POTS population may not generalize to ME/CFS patients or older age groups. The study does not define or measure post-exertional malaise specifically.
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
Wise, Shelby, Ross, Amanda, Brown, Abigail, Evans, Meredyth, & Jason, Leonard (2017). An assessment of fatigue in patients with postural orthostatic tachycardia syndrome.. Journal of health psychology. https://doi.org/10.1177/1359105315613624
BibTeX
@article{mecfsatlas-wise-2017-assessment-fatigue,
author = {Wise, Shelby and Ross, Amanda and Brown, Abigail and Evans, Meredyth and Jason, Leonard},
title = {An assessment of fatigue in patients with postural orthostatic tachycardia syndrome.},
journal = {Journal of health psychology},
year = {2017},
doi = {10.1177/1359105315613624},
note = {PubMed: 26537521},
url = {https://www.mecfsatlas.com/evidence/wise-2017-assessment-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/wise-2017-assessment-fatigue
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