Wong, R, Lopaschuk, G, Zhu, G et al. · Chest · 1992 · DOI
This study used a special imaging technique (31P NMR spectroscopy) to examine how muscles use energy during exercise in people with ME/CFS compared to healthy volunteers. Patients with ME/CFS became exhausted much faster during exercise (about 8 minutes versus 11 minutes) and had lower levels of ATP, the main energy molecule muscles use. The patterns of energy use looked similar between groups, but happened much more quickly in the ME/CFS group.
This mechanistic study provides objective evidence that ME/CFS involves a real defect in how muscles produce energy during exercise, not a psychological problem or deconditioning alone. Demonstrating accelerated energy depletion at the cellular level validates patient experiences of rapid exhaustion and points toward potential future treatments targeting muscle metabolism.
This study does not prove that the observed muscle metabolic defect causes the overwhelming fatigue patients experience at rest, nor does it establish the underlying cause of the metabolic impairment itself. The findings are correlational and limited to exercise response in one muscle; they do not explain whether similar defects occur in other tissues or whether post-exertional malaise involves the same mechanism.
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
Wong, R, Lopaschuk, G, Zhu, G, Walker, D, Catellier, D, Burton, D, et al. (1992). Skeletal muscle metabolism in the chronic fatigue syndrome. In vivo assessment by 31P nuclear magnetic resonance spectroscopy.. Chest. https://doi.org/10.1378/chest.102.6.1716
BibTeX
@article{mecfsatlas-wong-1992-skeletal-muscle,
author = {Wong, R and Lopaschuk, G and Zhu, G and Walker, D and Catellier, D and Burton, D and Teo, K and Collins-Nakai, R and Montague, T},
title = {Skeletal muscle metabolism in the chronic fatigue syndrome. In vivo assessment by 31P nuclear magnetic resonance spectroscopy.},
journal = {Chest},
year = {1992},
doi = {10.1378/chest.102.6.1716},
note = {PubMed: 1446478},
url = {https://www.mecfsatlas.com/evidence/wong-1992-skeletal-muscle},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/wong-1992-skeletal-muscle
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