Zhou, Hong, Yu, Wenwen, Lei, Jiaming et al. · Experimental and therapeutic medicine · 2026 · DOI
This review examines why people feel extreme fatigue and how doctors can better manage it. The authors explain that fatigue involves problems with how the body makes energy, stress chemicals in the body, and the immune system. They discuss how new technologies and teamwork between different medical specialists—plus telemedicine—can help patients with chronic fatigue syndrome and other conditions feel better.
This review is relevant to ME/CFS patients and researchers because it synthesizes current understanding of fatigue mechanisms—particularly mitochondrial dysfunction, energy metabolism abnormalities, and immune system dysregulation—conditions that characterize ME/CFS pathophysiology. The emphasis on multidisciplinary, individualized management and telemedicine accessibility addresses real barriers to care that ME/CFS patients face. The call for improved fatigue assessment models and biomarker-driven interventions aligns with the field's need for objective diagnostic criteria.
This review does not establish causation or test specific hypotheses through original research; it synthesizes existing knowledge without presenting new primary data. It does not validate any particular diagnostic test, biomarker, or treatment intervention for ME/CFS specifically. The broad scope across multiple fatigue-causing conditions means conclusions cannot be assumed to apply equally to ME/CFS without disease-specific evidence.
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 →
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Primary citation
Zhou, Hong, Yu, Wenwen, Lei, Jiaming, Chang, Runzhi, Cheng, Yingjia, Wang, Guorui, et al. (2026). Pathophysiological mechanisms of fatigue and multidisciplinary management strategies (Review).. Experimental and therapeutic medicine. https://doi.org/10.3892/etm.2026.13086
BibTeX
@article{mecfsatlas-zhou-2026-pathophysiological-mechanisms,
author = {Zhou, Hong and Yu, Wenwen and Lei, Jiaming and Chang, Runzhi and Cheng, Yingjia and Wang, Guorui and Lin, Li},
title = {Pathophysiological mechanisms of fatigue and multidisciplinary management strategies (Review).},
journal = {Experimental and therapeutic medicine},
year = {2026},
doi = {10.3892/etm.2026.13086},
note = {PubMed: 41694112},
url = {https://www.mecfsatlas.com/evidence/zhou-2026-pathophysiological-mechanisms},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/zhou-2026-pathophysiological-mechanisms
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