Wyller, Vegard B, Helland, Ingrid B · BioPsychoSocial medicine · 2013 · DOI
This study looked at how the nervous system controls heart rate in teenagers with ME/CFS and how this relates to their symptoms and disability. Researchers tested 38 teenagers using a tilt test (lying flat then tilting upright) while measuring heart rate changes, and asked them about their symptoms. They found that disability in ME/CFS comes from multiple symptoms—not just fatigue—and that problems with heart rate control are linked to certain symptoms like brain fog and sensitivity to stimulation.
This study highlights that ME/CFS disability stems from multiple symptoms beyond fatigue and that objective measures of autonomic dysfunction (heart rate responses) correlate with specific symptom patterns. Understanding these relationships may help clinicians recognize which symptom clusters are most disabling and could guide more targeted treatment approaches for adolescents with ME/CFS.
This study cannot establish causation—it only shows associations between autonomic measures and symptoms. The cross-sectional design means we cannot determine whether autonomic dysregulation causes symptoms or results from them. Additionally, the study uses a broad case definition not requiring accompanying symptoms, which may limit generalizability to patients meeting stricter diagnostic criteria.
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
Wyller, Vegard B & Helland, Ingrid B (2013). Relationship between autonomic cardiovascular control, case definition, clinical symptoms, and functional disability in adolescent chronic fatigue syndrome: an exploratory study.. BioPsychoSocial medicine. https://doi.org/10.1186/1751-0759-7-5
BibTeX
@article{mecfsatlas-wyller-2013-relationship-between,
author = {Wyller, Vegard B and Helland, Ingrid B},
title = {Relationship between autonomic cardiovascular control, case definition, clinical symptoms, and functional disability in adolescent chronic fatigue syndrome: an exploratory study.},
journal = {BioPsychoSocial medicine},
year = {2013},
doi = {10.1186/1751-0759-7-5},
note = {PubMed: 23388153},
url = {https://www.mecfsatlas.com/evidence/wyller-2013-relationship-between},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/wyller-2013-relationship-between
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