Evidence browser

E2 ModerateBehavioralPEM not requiredCross-Sectional

Unintended Consequences of not Specifying Exclusionary Illnesses for Systemic Exertion Intolerance Disease.

Jason, Leonard A, Sunnquist, Madison, Kot, Bobby et al.·Diagnostics (Basel, Switzerland)·2015

Researchers studied a new proposed name and definition for ME/CFS called SEID (Systemic Exertion Intolerance Disease). They found that the new definition was much looser than the old one and incorrectly labeled people with depression and other illnesses as having SEID when they didn't actually have ME/CFS. This means the new definition could overestimate how many people have ME/CFS.

Diagnostics

Effects of early childhood trauma on hypothalamic-pituitary-adrenal (HPA) axis function in patients with Chronic Fatigue Syndrome.

Kempke, Stefan, Luyten, Patrick, De Coninck, Sarah et al.·Psychoneuroendocrinology·2015

This study looked at whether traumatic experiences in childhood are connected to how the body's stress system (the HPA axis) works in people with ME/CFS. Researchers measured stress hormone levels in 40 women with ME/CFS and tested how their bodies responded to stress. They found that emotional neglect in childhood was linked to a blunted (reduced) stress response, suggesting that some ME/CFS patients may have a stress system that doesn't react normally to challenges.

Endocrine Disruption

E2 ModerateCohortPEM not requiredCase-Control

Specific and number of comorbidities are associated with increased levels of temporomandibular pain intensity and duration.

Dahan, Haissam, Shir, Yoram, Velly, Ana et al.·The journal of headache and pain·2015

This study examined how jaw pain (temporomandibular disorder) relates to other chronic pain conditions, particularly in people with ME/CFS. Researchers found that people with jaw pain who also had migraine or ME/CFS experienced more severe and longer-lasting jaw pain. Having multiple pain conditions at the same time was linked to worse jaw pain symptoms.

Pain and Sensitization

Increased risk of chronic fatigue syndrome in patients with migraine: A retrospective cohort study.

Lau, Chi-ieong, Lin, Che-Chen, Chen, Wei-Hung et al.·Journal of psychosomatic research·2015

This study found that people with migraine headaches are 1.5 times more likely to develop ME/CFS than people without migraine. The risk was even higher in older adults (age 65+), who were more than twice as likely to develop ME/CFS if they had migraines. The more frequently someone had migraines, the higher their risk of developing ME/CFS appeared to be.

E2 ModerateDiagnosticPEM unclearMethods-Paper

Issues in Estimating Rates of Pediatric Chronic Fatigue Syndrome and Myalgic Encephalomyelitis in a Community-based Sample.

Jason, Leonard A, Katz, Ben Z, Mears, Cynthia et al.·Avicenna journal of neuropsychophysiology·2015

This study looked at how common ME/CFS is in children living in regular communities, not just in doctor's offices. Researchers used a two-step approach: first they screened children for ME/CFS-like symptoms, then they did detailed medical and mental health evaluations to confirm diagnoses. The study also compared children with ME/CFS to healthy children without the condition.

Diagnostics

Cognitive ImpairmentPost-Exertional Malaise

Chronic Fatigue Syndrome versus Systemic Exertion Intolerance Disease.

Jason, Leonard A, Sunnquist, Madison, Brown, Abigail et al.·Fatigue : biomedicine, health & behavior·2015

Researchers compared different ways of diagnosing ME/CFS by testing 796 patients using a new diagnostic system called SEID (Systemic Exertion Intolerance Disease). They found that the new SEID criteria identified about 88% of patients, which is similar to an older diagnostic system but captures a larger group than some other definitions. The study suggests that different diagnostic criteria can identify different sizes and severity levels of patient populations.

Plasma cytokine expression in adolescent chronic fatigue syndrome.

Wyller, Vegard Bruun, Sørensen, Øystein, Sulheim, Dag et al.·Brain, behavior, and immunity·2015

This study measured inflammation markers called cytokines in the blood of 120 adolescents with ME/CFS and compared them to 68 healthy young people. Despite CFS patients reporting significantly more fatigue and symptoms suggesting inflammation, the researchers found no differences in cytokine levels or inflammation patterns between the two groups. This suggests that the fatigue and symptoms in adolescent ME/CFS may not be caused by the type of low-grade inflammation in the blood that researchers had previously suspected.

Immune System

Measuring substantial reductions in activity.

Schafer, Charles, Evans, Meredyth, Jason, Leonard A et al.·Journal of prevention & intervention in the community·2015

ME/CFS diagnosis requires showing a significant drop in daily activities, but doctors have struggled to measure this fairly. This study looked at different ways to measure activity levels—including work, quality of life surveys, and activity trackers—to find which method works best. The researchers found that tracking current work activities was the most useful way to show the substantial reduction in functioning that ME/CFS patients experience.

Altered resting-state functional connectivity in women with chronic fatigue syndrome.

Kim, Byung-Hoon, Namkoong, Kee, Kim, Jae-Jin et al.·Psychiatry research·2015

This study used brain scans to examine how different regions of the brain communicate with each other in women with ME/CFS compared to healthy women. Researchers found that certain brain areas involved in attention and emotion showed increased communication in ME/CFS patients, and this increased activity was linked to symptom severity. Interestingly, the overall efficiency of brain network communication was reduced in people with ME/CFS, suggesting the brain may be working harder to accomplish its tasks.

SleepCognitive Impairment

The association between daytime napping and cognitive functioning in chronic fatigue syndrome.

Gotts, Zoe M, Ellis, Jason G, Deary, Vincent et al.·PloS one·2015

This study looked at how sleep patterns, especially daytime napping, affect fatigue, sleepiness, and thinking ability in people with ME/CFS. Researchers asked 118 patients to keep a sleep diary for two weeks and complete daily assessments of their symptoms. They found that afternoon napping was linked to worse cognitive problems and increased daytime sleepiness, suggesting that when and how much patients nap may influence how well they can think and function.

E2 ModerateBehavioralPEM not requiredCross-Sectional

The Preinterventional Psychiatric History as a Major Predictor for a Reduced Quality of Life After Treatment of Unruptured Intracranial Aneurysms.

Fontana, Johann, Wenz, Ralf, Groden, Christoph et al.·World neurosurgery·2015

This study looked at patients who had surgery for unruptured brain aneurysms (weak blood vessel spots in the brain that hadn't bled yet) and compared them to patients who had surgery for brain tumors. The researchers found that patients with a history of psychiatric conditions before surgery reported worse quality of life and more chronic fatigue symptoms after surgery, but when they removed those patients from the analysis, the differences went away. This suggests that pre-existing mental health conditions, not the aneurysm or surgery itself, may explain poor outcomes.

Sleep

E2 ModerateBehavioralPEM not requiredObservational

The role of the partner and relationship satisfaction on treatment outcome in patients with chronic fatigue syndrome.

Verspaandonk, J, Coenders, M, Bleijenberg, G et al.·Psychological medicine·2015

This study looked at how a patient's partner and their relationship quality affect how well cognitive behavioural therapy (CBT) works for ME/CFS. Researchers found that when partners were overly helpful or protective (called 'solicitous responses'), patients were less likely to improve significantly from their fatigue and disability. The study suggests that addressing how partners respond to the illness during treatment may be important for better outcomes.

Interventions

Attention network test: assessment of cognitive function in chronic fatigue syndrome.

Togo, Fumiharu, Lange, Gudrun, Natelson, Benjamin H et al.·Journal of neuropsychology·2015

This study tested whether a computer-based attention test called the Attention Network Task (ANT) could measure thinking and processing speed problems in ME/CFS patients. Researchers compared 41 ME/CFS patients (some with depression, some without) to 29 healthy controls and found that ME/CFS patients took longer to respond to tasks, especially when the tasks were complex, even though they made the same number of mistakes as controls. This suggests that slowed thinking speed, rather than errors, may be the main cognitive problem in ME/CFS.

Cognitive Impairment

Cytokine expression provides clues to the pathophysiology of Gulf War illness and myalgic encephalomyelitis.

Khaiboullina, Svetlana F, DeMeirleir, Kenny L, Rawat, Shanti et al.·Cytokine·2015

This study looked at chemical messengers in the blood called cytokines to understand Gulf War illness (GWI) and ME/CFS better. Researchers found that certain cytokines could identify ME/CFS patients very well, but were less reliable for GWI patients. The findings suggest that while GWI and ME/CFS share many similar symptoms, they may have different underlying immune system problems.

BiomarkersImmune System

Perceived fatigue is highly prevalent and debilitating in patients with mitochondrial disease.

Gorman, Gráinne S, Elson, Joanna L, Newman, Jane et al.·Neuromuscular disorders : NMD·2015

This study found that fatigue is very common and severely disabling in people with mitochondrial disease. About 62% of patients reported excessive fatigue, and 32% experienced severe fatigue that significantly limited their daily activities—levels comparable to fatigue in ME/CFS patients. The researchers surveyed 132 patients and compared their fatigue levels to healthy people and ME/CFS patients to understand how widespread and serious this problem is.

Response to vitamin B12 and folic acid in myalgic encephalomyelitis and fibromyalgia.

Regland, Björn, Forsmark, Sara, Halaouate, Lena et al.·PloS one·2015

This study looked at 38 ME/CFS patients who were receiving vitamin B12 injections and oral folic acid to see how well this treatment worked for them. Patients who improved the most received more frequent injections at higher doses, took more folic acid, and were less likely to use strong pain medications like opioids. The researchers found that this treatment combination showed real benefits for some patients, particularly when carefully matched to individual needs.

Interventions

Painful temporomandibular disorders are common in patients with postural orthostatic tachycardia syndrome and impact significantly upon quality of life.

Durham, Justin, McDonald, Claire, Hutchinson, Luke et al.·Journal of oral & facial pain and headache·2015

This study found that people with PoTS (a condition causing rapid heart rate when standing) often also have painful jaw disorders (TMD). Nearly half of the patients studied screened positive for TMD, and those with TMD reported that it significantly worsened their quality of life. The researchers suggest that doctors should routinely check for jaw pain in PoTS patients.

Autonomic Nervous System

Cardiac dysfunction and orthostatic intolerance in patients with myalgic encephalomyelitis and a small left ventricle.

Miwa, Kunihisa·Heart and vessels·2015

This study looked at heart function in 40 ME/CFS patients compared to 40 healthy people. Researchers found that ME/CFS patients frequently had smaller hearts and difficulty standing up without dizziness or other symptoms (orthostatic intolerance). The smaller heart size appeared to pump less blood with each beat, which may explain why patients struggle with upright posture and fatigue.

Autonomic Nervous System

Factor Analysis of the DePaul Symptom Questionnaire: Identifying Core Domains.

Jason, Leonard A, Sunnquist, Madison, Brown, Abigail et al.·Journal of neurology and neurobiology·2015

Researchers analyzed symptom patterns in people with ME/CFS from three countries to better understand what makes this illness unique. Using statistical analysis, they found that ME/CFS symptoms naturally organize into four main groups: exhaustion that gets worse after activity, brain fog and memory problems, sleep issues, and a combination of hormone, nervous system, and immune problems. This organized way of thinking about symptoms could help doctors recognize and study the disease more effectively.

Post-Exertional Malaise