ME/CFS Evidence Browser — Classified Studies on Myalgic Encephalomyelitis

637 studies

1–20 of 637 studies

Sorted by evidence level and year

E0 ConsensusReviewPEM unclearSystematic-Review

The efficacy of exercise in patients with myalgic encephalomyelitis/chronic fatigue syndrome: A systematic review and meta-analysis.

Zhao, Liping, Gou, Bo, Zhang, Meng·Journal of psychosomatic research·2026

A systematic review of 17 randomized controlled trials (involving 1,944 patients) found that exercise was associated with reported improvements in fatigue, sleep quality, quality of life, depression, and anxiety in ME/CFS patients. However, exercise did not show significant benefits for heart and lung function or overall physical capacity. The review noted no major differences in safety or tolerability between exercise and control groups, though individual responses vary and respecting personal energy limits is emphasized.

InterventionsSleepPost-Exertional Malaise

E0 ConsensusReviewPEM unclearSystematic-Review

A systematic scoping review and conceptual analysis of new-onset fibromyalgia manifestations after non-hospitalized COVID-19: empirics, definitions, methodologies, pathophysiology, mapping of literature, and knowledge gaps.

Plaut, Shiloh·Journal of translational medicine·2026

This systematic review examined published studies on fibromyalgia-like symptoms that develop after mild COVID-19 infection. Researchers searched medical databases and found 228 studies reporting overlap between long COVID, chronic fatigue, and fibromyalgia, but noted that different studies use inconsistent definitions and methods, making it difficult to draw firm conclusions. The causes of these overlapping conditions remain unclear.

NeuroinflammationPain and SensitizationImmune SystemLong COVID Overlap

E0 ConsensusReviewPEM not requiredMeta-Analysis

Emotional and behavior problems in children and adolescents with chronic physical health conditions: an updated meta-analysis.

Pinquart, Martin·Journal of pediatric psychology·2026

This study looked at 1,337 research papers to understand how children with long-term health conditions—including chronic fatigue syndrome (ME/CFS)—experience emotional and behavioral challenges. Children with these conditions had higher rates of anxiety, depression, and behavior problems compared to healthy peers. The study found that parents reported more problems than teenagers themselves did, and that ME/CFS was particularly linked to emotional difficulties.

E0 ConsensusReviewPEM unclearMeta-Analysis

Neuroendocrine signature of ME/CFS: Meta-analytic evidence for bioactive cortisol deficit and exaggerated feedback sensitivity.

Woo, Tae-Wook, Choi, Yu-Jin, Kim, Jun-Yeol et al.·Molecular psychiatry·2026

A review of 46 studies involving 1,388 ME/CFS patients found that people with ME/CFS were observed to have lower cortisol (a stress hormone) measured in saliva, urine, and hair, and showed altered responses when given hormone-stimulation tests. The authors propose these findings may be associated with some ME/CFS symptoms like fatigue and sleep problems, though the clinical significance and how this relates to individual patient outcomes remains unclear.

Endocrine DisruptionBiomarkersSleepCognitive Impairment

E0 ConsensusReviewPEM unclearSystematic-Review

Pathophysiological mechanisms of post-exertional malaise: an integrative analysis based on the metabolism-immune-neuro interaction model.

Jin, Hongjiao, An, Yi, Huang, Jingwei et al.·Frontiers in immunology·2026

This systematic review proposes a framework for understanding post-exertional malaise (PEM)—the worsening of symptoms after mild activity—by examining how energy production, immune activation, and brain inflammation may be associated with each other in people with Long COVID and chronic fatigue conditions. The authors suggest that in vulnerable individuals, exercise may trigger an abnormal cascade involving damaged mitochondria (cellular energy factories), inflammatory molecules, and changes in how the brain perceives fatigue and pain. However, this is a theoretical model based on existing literature; individual mechanisms have not been directly tested in a single study.

NeuroinflammationEnergy MetabolismImmune SystemCognitive Impairment

E0 ConsensusReviewPEM unclearSystematic-Review

Recent Perspectives on the Physiological and Therapeutic Benefits of Placental Extracts in Chronic Noninfectious Diseases and Aging.

Xinliang, Zhang, Dudnik, Elena N, Gavrikov, Leonid K et al.·Current medicinal chemistry·2026

This systematic review examined studies on placental extracts—cell-free preparations derived from human or animal placenta—as potential treatments for various chronic diseases including metabolic disorders and liver disease. The review reports that these extracts were associated with improvements in liver function, muscle preservation, and metabolic markers in the studies reviewed; one study also mentioned chronic fatigue syndrome among the conditions examined. However, the authors note that large-scale, rigorously designed trials are needed to confirm whether these treatments actually work, and the quality of evidence underlying these associations remains unclear.

Energy MetabolismInterventions

E0 ConsensusGuidelinePEM unclearGuideline

[Psychiatric and psychotherapeutic recommendations for long/post-COVID and ME/CFS: a narrative review of international guidelines].

Kaya, Gizem, Kroehn-Liedtke, Franziska, Kalinowski, Olivia et al.·Der Nervenarzt·2026

This review examined what major international health organizations recommend about mental health care and psychological treatments for ME/CFS and long COVID. The guidelines agree that while mental health support can help manage symptoms, it is not a cure for these conditions. They emphasize the importance of individualized, paced approaches to activity rather than pushing patients to exercise harder, especially when postexertional malaise (worsening after activity) is present.

Post-Exertional Malaise

E0 ConsensusReviewPEM unclearSystematic-Review

Evaluating working memory functioning in individuals with myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review and meta-analysis.

Penson, Maddison, Kelly, Kate·Psychology, health & medicine·2026

This study reviewed 34 research papers to understand how ME/CFS affects working memory—the ability to hold and use information in your mind briefly. The researchers found that people with ME/CFS have significant difficulties with verbal working memory (remembering words and language), but their ability to remember visual information (like images or patterns) appeared similar to people without ME/CFS. This suggests that cognitive problems in ME/CFS may affect certain types of thinking more than others.

Cognitive Impairment

E0 ConsensusReviewPEM requiredSystematic-Review

Potential application of brain-gut axis-based treatments in Long COVID and ME/CFS: a case-based systematic review.

Kim, Do-Young, Youn, Jaeyoung, Kang, Naeun et al.·Journal of translational medicine·2026

This study looked at how treating the connection between the brain and gut might help people with ME/CFS and Long COVID. Researchers reviewed eight previous studies testing different treatments—including special nerve stimulation and probiotics—and also followed one patient who improved with a type of needle stimulation. Many of these treatments showed promise in reducing fatigue and post-exertional malaise, possibly by helping restore healthy gut bacteria and reduce brain inflammation.

NeuroinflammationPost-Exertional Malaise

E0 ConsensusGuidelinePEM unclearGuideline

Clinical practice guideline for long COVID prevention and treatment.

Cao, Bin, Soriano, Joan B, Wang, Quanyi et al.·The European respiratory journal·2026

This guideline summarizes the best available evidence on preventing and treating long COVID (also called post-COVID syndrome). A large international team of experts reviewed research studies and patient experiences to create 10 practical recommendations for doctors. The main suggestions include using vaccines or antivirals early during acute COVID infection to prevent long COVID, avoiding certain medications that don't help, and recommending probiotics, cognitive behavioral therapy for fatigue, and rehabilitation as helpful treatments.

Post-Exertional Malaise

E0 ConsensusReviewPEM unclearSystematic-Review

Comparative effectiveness of non-pharmacological traditional Chinese medicine therapies for chronic fatigue syndrome: a systematic review and network meta-analysis.

Zhang, Yihan, Zhou, You, Xu, Hangying et al.·Frontiers in medicine·2026

A systematic review of 29 studies examined whether traditional Chinese medicine therapies—including massage, moxibustion, and cupping—were associated with improvements in fatigue, sleep, anxiety, and depression in people with chronic fatigue syndrome. The review reported that massage and moxibustion showed associations with reduced fatigue and mood symptoms, while cupping was associated with better sleep quality, though the authors note these findings should be interpreted cautiously given limitations in the underlying studies.

InterventionsSleep

E0 ConsensusReviewPEM unclearReview-Narrative

[Post-COVID: An inventory focusing on the key complaints PEM and POTS].

Hensel, Ole, Pfrommer, Laura, Furch, Peggy et al.·MMW Fortschritte der Medizin·2026

This is a narrative review (a summary of existing research rather than a new study) that examined long-term effects of COVID-19, with a focus on post-exertional malaise (PEM) and postural tachycardia syndrome (POTS). The authors report that in people with post-COVID, PEM—a worsening of symptoms after exertion—was observed in approximately 86% of patients, and POTS-related symptoms in up to 82%. The review suggests pacing and symptom-focused treatments may help, though these are early findings from a narrative synthesis rather than definitive evidence.

InterventionsAutonomic Nervous SystemDiagnosticsLong COVID Overlap

E0 ConsensusReviewPEM unclearReview-Narrative

[Herbal treatment options for post-viral symptoms and long COVID].

Krassnig, Katharina, Bauer, Rudolf, Glasl, Sabine et al.·Wiener medizinische Wochenschrift (1946)·2026

This review examined herbal medicines and plant-based treatments that may help with long COVID and post-viral symptoms, including ME/CFS. The authors looked at nearly 100 scientific papers and clinical experience to identify which herbs might help with common symptoms like fatigue, brain fog, breathing problems, digestive issues, and loss of smell. They found that several traditional plant remedies appear to help manage these symptoms based on available evidence and doctors' real-world experience.

Post-Exertional Malaise

E0 ConsensusReviewPEM unclearReview-Narrative

Digital Approaches for Managing Brain Fog in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Interventions, Monitoring, and Future Directions.

Araja, Diana, Murovska, Modra, Krumina, Angelika et al.·Life (Basel, Switzerland)·2026

This review examined how digital tools—such as apps and online platforms—might help people with ME/CFS monitor and manage 'brain fog', a common cognitive difficulty patients report. The authors found that while some digital assessment tools show promise, most approaches for using technology to help with brain fog remain under-studied and limited in evidence. Digital monitoring and rehabilitation approaches are less well-established than cognitive assessment tools.

InterventionsDiagnosticsCognitive Impairment

E0 ConsensusReviewPEM unclearSystematic-Review

Systematic literature review: treatment of postural orthostatic tachycardia syndrome (POTS).

Schiweck, Nicole, Langer, Katharina, Maier, Andrea et al.·Clinical autonomic research : official journal of the Clinical Autonomic Research Society·2026

This review examined treatments for POTS (postural orthostatic tachycardia syndrome), a condition where your heart rate jumps significantly when you stand up, causing dizziness and fatigue. POTS is common in people with ME/CFS. The researchers looked at 45 studies and found that simple first-line treatments like compression socks, physical training, extra salt, and a vagus nerve stimulation device may help, while certain medications like ivabradine and beta-blockers also showed promise in some studies.

Autonomic Nervous System

E0 ConsensusReviewPEM unclearSystematic-Review

Use of artificial intelligence and machine learning for the management of fibromyalgia: a scoping review.

Clempi Almeida E Silva, Ana Laura, Reis, Victor Hugo Palhares Flávio, Lamoglia, Antonieta Santos Andrade et al.·The Journal of manual & manipulative therapy·2026

This review looked at 43 studies from 2011–2024 to see how artificial intelligence (AI) and machine learning can help diagnose fibromyalgia and other conditions like ME/CFS. Researchers found that AI tools can identify unique patterns in brain scans, genes, eye imaging, and blood markers that differ between sick patients and healthy people. While some AI models showed very high accuracy (up to 100%), most studies tested only small groups of patients, so we need bigger, more rigorous research before these tools can be used reliably in clinics.

Diagnostics

E0 ConsensusReviewPEM requiredEditorial

Myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia - overlap, differences, and emerging insights.

Murovska, Modra, Krumina, Angelika, Araja, Diana et al.·Journal of translational medicine·2026

ME/CFS and fibromyalgia are two different but often overlapping illnesses that cause severe fatigue, pain, and other debilitating symptoms. While they share many similarities, ME/CFS has a distinctive feature called post-exertional malaise—where activity makes symptoms dramatically worse for hours or days—while fibromyalgia does not. This review shows that the two conditions have different immune system patterns and may require different treatment approaches.

Severe MEImmune SystemCognitive ImpairmentPost-Exertional Malaise

E0 ConsensusReviewPEM unclearSystematic-Review

Chronic fatigue syndrome: From etiology and mechanism to diagnosis and treatment.

Xu, Qing, Zhao, Mengyu, Wang, Qin et al.·Journal of psychiatric research·2026

This review article summarizes current knowledge about ME/CFS, a long-lasting illness characterized by extreme fatigue that rest doesn't improve, along with muscle pain, sore throat, and mood problems. The article examines what might cause ME/CFS, how doctors can better diagnose it, and what treatments may help. The authors note that ME/CFS cases are increasing worldwide, especially since COVID-19, and that current treatments have limited effectiveness.

Post-Exertional Malaise

E0 ConsensusDiagnosticPEM requiredMethods-Paper

Recommended long COVID outcome measures and their implications for clinical trial design, with a focus on post-exertional malaise.

Soares, Letícia, Davis, Hannah, Spier, Ezra et al.·EBioMedicine·2026

This paper provides guidance for researchers designing clinical trials to test treatments for long COVID, with special attention to post-exertional malaise (PEM)—a key symptom where people feel much worse after physical or mental activity. The authors recommend that trials should carefully measure patients at the start, track them over time, include a placebo group for comparison, and make sure patients in different treatment groups have similar severity of illness. The paper highlights that the field urgently needs funding to develop better ways to measure these outcomes before large-scale treatment trials can succeed.

Post-Exertional Malaise

E0 ConsensusReviewPEM unclearSystematic-Review

Exercise interventions for physical function, psychological health, and quality of life in patients with myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia: A systematic review and network meta-analysis.

Gao, Jiawen, Liu, Yunyang, Wang, Shun et al.·Journal of psychosomatic research·2026

This study looked at 57 different research trials involving over 4,200 patients with ME/CFS and fibromyalgia to find out which types of exercise work best. The researchers found that different exercises help with different symptoms: combined exercise and high-intensity interval training (HIIT) are best for improving physical fitness and quality of life, aerobic exercise and combined exercise help most with anxiety and depression, and aquatic (water-based) exercise works best for pain relief. The type of exercise matters much more than how often or how long you do it.

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Evidence Atlas

Evidence browser

The efficacy of exercise in patients with myalgic encephalomyelitis/chronic fatigue syndrome: A systematic review and meta-analysis.

A systematic scoping review and conceptual analysis of new-onset fibromyalgia manifestations after non-hospitalized COVID-19: empirics, definitions, methodologies, pathophysiology, mapping of literature, and knowledge gaps.

Emotional and behavior problems in children and adolescents with chronic physical health conditions: an updated meta-analysis.

Neuroendocrine signature of ME/CFS: Meta-analytic evidence for bioactive cortisol deficit and exaggerated feedback sensitivity.

Pathophysiological mechanisms of post-exertional malaise: an integrative analysis based on the metabolism-immune-neuro interaction model.

Recent Perspectives on the Physiological and Therapeutic Benefits of Placental Extracts in Chronic Noninfectious Diseases and Aging.

[Psychiatric and psychotherapeutic recommendations for long/post-COVID and ME/CFS: a narrative review of international guidelines].

Evaluating working memory functioning in individuals with myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review and meta-analysis.

Potential application of brain-gut axis-based treatments in Long COVID and ME/CFS: a case-based systematic review.

Clinical practice guideline for long COVID prevention and treatment.

Comparative effectiveness of non-pharmacological traditional Chinese medicine therapies for chronic fatigue syndrome: a systematic review and network meta-analysis.

[Post-COVID: An inventory focusing on the key complaints PEM and POTS].

[Herbal treatment options for post-viral symptoms and long COVID].

Digital Approaches for Managing Brain Fog in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Interventions, Monitoring, and Future Directions.

Systematic literature review: treatment of postural orthostatic tachycardia syndrome (POTS).

Use of artificial intelligence and machine learning for the management of fibromyalgia: a scoping review.

Myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia - overlap, differences, and emerging insights.

Chronic fatigue syndrome: From etiology and mechanism to diagnosis and treatment.

Recommended long COVID outcome measures and their implications for clinical trial design, with a focus on post-exertional malaise.

Exercise interventions for physical function, psychological health, and quality of life in patients with myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia: A systematic review and network meta-analysis.

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