Evidence browser

Test effort in persons with Chronic Fatigue Syndrome when assessed using the Validity Indicator Profile.

Cockshell, Susan J, Mathias, Jane L·Journal of clinical and experimental neuropsychology·2012

This study tested whether people with ME/CFS perform poorly on thinking tests because they aren't trying hard enough, or because of the illness itself. Researchers gave 54 people with ME/CFS and 54 healthy people a special test designed to measure effort and intention during testing. The results showed that most people in both groups were trying their best, and very few showed signs of not putting in effort—suggesting that low effort is not the reason people with ME/CFS struggle with cognitive tasks.

E2 ModerateCohortPEM not requiredCase-Control

Immunophenotyping in post-giardiasis functional gastrointestinal disease and chronic fatigue syndrome.

Hanevik, Kurt, Kristoffersen, Einar K, Sørnes, Steinar et al.·BMC infectious diseases·2012

This study looked at immune system changes in people who developed chronic fatigue and gut problems after a Giardia infection. Researchers found that people with post-infectious chronic fatigue had lower levels of natural killer (NK) cells, which are important for fighting infections. The more severe someone's fatigue and stomach symptoms were, the lower their NK cells tended to be.

E2 ModerateCohortPEM not requiredObservational

[Effects of tuina on the mechanical properties of skeletal muscles of four limbs in patients with chronic fatigue syndrome].

Liu, Kun-Peng, Fang, Min, Jiang, Shu-Yun·Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine·2012

This study tested whether tuina (a traditional Chinese massage therapy) could help ME/CFS patients regain muscle strength and reduce fatigue. Sixty people participated—30 with ME/CFS and 30 healthy controls. After 10 sessions of tuina therapy, ME/CFS patients showed improvements in muscle strength measurements and reported feeling less fatigued, though their muscles remained weaker than those of healthy people.

E2 ModerateBehavioralPEM not requiredCross-Sectional

Confidence judgment in depression and dysphoria: the depressive realism vs. negativity hypotheses.

Szu-Ting Fu, Tiffany, Koutstaal, Wilma, Poon, Lucia et al.·Journal of behavior therapy and experimental psychiatry·2012

This study looked at how accurately people judge their own knowledge and abilities. Researchers compared three groups: healthy people, those with clinical depression, and people with chronic fatigue syndrome who felt sad or low. They found that people with depression were overly critical of themselves, while people with chronic fatigue syndrome were more realistic about their abilities—similar to healthy controls.

E2 ModerateCohortPEM unclearCross-Sectional

Differences in metabolite-detecting, adrenergic, and immune gene expression after moderate exercise in patients with chronic fatigue syndrome, patients with multiple sclerosis, and healthy controls.

White, Andrea T, Light, Alan R, Hughen, Ronald W et al.·Psychosomatic medicine·2012

This study compared how the bodies of ME/CFS patients, multiple sclerosis (MS) patients, and healthy people respond to moderate exercise by measuring changes in specific genes in blood cells. ME/CFS patients experienced much larger increases in fatigue and pain after exercise, and showed distinctive patterns of gene activity related to pain sensing and stress hormones that were different from MS patients and healthy controls.

Immune SystemPost-Exertional Malaise

E2 ModerateCohortPEM unclearCase-Control

Lyme disease in a British referral clinic.

Cottle, L E, Mekonnen, E, Beadsworth, M B J et al.·QJM : monthly journal of the Association of Physicians·2012

This UK study looked at 115 patients who were referred to a specialist clinic because doctors suspected they had Lyme disease. The researchers found that only 23% actually had Lyme disease, while about one-third had ME/CFS instead. Importantly, some ME/CFS patients had been incorrectly told they had Lyme disease by non-specialist doctors, leading them to take unnecessary antibiotics.

Responses to exercise differ for chronic fatigue syndrome patients with fibromyalgia.

Cook, Dane B, Stegner, Aaron J, Nagelkirk, Paul R et al.·Medicine and science in sports and exercise·2012

This study compared how the bodies of ME/CFS patients respond to moderate exercise on a stationary bike. Researchers found that patients who have both ME/CFS and fibromyalgia (a condition causing widespread pain) showed different heart and breathing responses during exercise compared to healthy people, including higher perceived effort and different blood pressure patterns.

Post-Exertional Malaise

E2 ModerateBehavioralPEM not requiredCross-Sectional

Attention-deficit hyperactivity disorder in chronic fatigue syndrome patients.

Sáez-Francàs, Naia, Alegre, José, Calvo, Natalia et al.·Psychiatry research·2012

This study looked at whether people with ME/CFS also have ADHD (attention-deficit hyperactivity disorder), a condition that affects focus and attention. Researchers found that about 30% of ME/CFS patients had ADHD as children, and about 21% still had it as adults. People with ME/CFS who also had ADHD experienced worse depression and anxiety, more severe fatigue, and higher suicide risk than those without ADHD.

E2 ModerateCohortPEM not requiredCase-Control

Loss of capacity to recover from acidosis on repeat exercise in chronic fatigue syndrome: a case-control study.

Jones, David E J, Hollingsworth, Kieren G, Jakovljevic, Djordje G et al.·European journal of clinical investigation·2012

This study looked at how muscles produce and use energy during exercise in ME/CFS patients compared to healthy people. Researchers found that ME/CFS patients' muscles became more acidic (like buildup of lactic acid) during exercise and took much longer to recover back to normal levels, even after repeated exercise sessions. This abnormal response to exercise may explain why some ME/CFS patients feel worse after exertion rather than better.

Post-Exertional Malaise

E2 ModerateCohortPEM unclearCase-Control

IgM-mediated autoimmune responses directed against anchorage epitopes are greater in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) than in major depression.

Maes, Michael, Mihaylova, Ivana, Kubera, Marta et al.·Metabolic brain disease·2012

This study examined immune system markers in people with ME/CFS, depression, and healthy controls. Researchers found that people with ME/CFS had higher levels of specific immune antibodies (IgM) attacking certain body molecules compared to people with depression. These antibodies were especially high against fatty acid anchors and oxidatively damaged proteins, suggesting ME/CFS may involve distinct immune processes that differ from depression.

E2 ModerateCohortPEM unclearCross-Sectional

Functional somatic syndromes: sensitivities and specificities of self-reports of physician diagnosis.

Warren, John W, Clauw, Daniel J·Psychosomatic medicine·2012

This study found that when doctors ask patients "Have you been diagnosed with ME/CFS or fibromyalgia?" they miss many people who actually have these conditions based on their symptoms. For example, doctors missed 90% of people who truly had ME/CFS by symptom criteria, and 77% of those with fibromyalgia. The researchers showed that asking about symptoms directly, rather than relying on patients to report a doctor's diagnosis, is much more accurate for identifying these conditions.

Diagnostics

Antinuclear antibody detection by automated multiplex immunoassay in untreated patients at the time of diagnosis.

Op De Beéck, Katrijn, Vermeersch, Pieter, Verschueren, Patrick et al.·Autoimmunity reviews·2012

This study compared two different blood tests for detecting autoantibodies (proteins the immune system makes that attack the body's own cells) in patients with various autoimmune diseases and in people with ME/CFS. The researchers found that one newer automated test missed some antibodies that an older, more traditional test detected, and that having multiple antibodies together was much more common in autoimmune disease patients than in ME/CFS patients.

What to do about attention and memory problems in children with CFS/ME: a neuropsychological approach.

Tucker, Peter, Haig-Ferguson, Andrew, Eaton, Nicola et al.·Clinical child psychology and psychiatry·2011

Children with ME/CFS often experience problems with concentration, attention, and memory—difficulties that go beyond normal tiredness. This study tested children's attention and memory abilities and found they scored lower than expected on tasks involving sustained focus, switching between tasks, and remembering new information. The researchers suggest practical strategies that could help children manage these cognitive challenges in daily life.

E2 ModerateDiagnosticPEM not requiredCross-Sectional

Is the International Physical Activity Questionnaire-short form (IPAQ-SF) valid for assessing physical activity in Chronic Fatigue Syndrome?

Meeus, Mira, Van Eupen, Inge, Willems, Joke et al.·Disability and rehabilitation·2011

Researchers tested whether a common activity questionnaire (IPAQ-SF) could accurately measure physical activity in people with ME/CFS. Fifty-six patients filled out the questionnaire, wore activity monitors for a week, and kept activity diaries. The questionnaire's measurements didn't match what the activity monitors and diaries showed, and it wasn't good at capturing the low activity levels typical of ME/CFS patients.

E2 ModeratePEM not requiredRegistry-Resource

Lower whole blood glutathione peroxidase (GPX) activity in depression, but not in myalgic encephalomyelitis / chronic fatigue syndrome: another pathway that may be associated with coronary artery disease and neuroprogression in depression.

Maes, Michael, Mihaylova, Ivanka, Kubera, Marta et al.·Neuro endocrinology letters·2011

This study looked at a protective enzyme called GPX that helps defend cells from damage in people with depression and ME/CFS. The researchers found that people with depression had lower levels of this enzyme compared to healthy people, but people with ME/CFS had normal levels. Both groups showed connections between low enzyme levels and symptoms like mood problems and autonomic nervous system dysfunction.

Biomarkers

A Disease Register for ME/CFS: Report of a Pilot Study.

Pheby, Derek, Lacerda, Eliana, Nacul, Luis et al.·BMC research notes·2011

Researchers created a disease register (a database) to identify and track people with ME/CFS in a fair and systematic way. They searched GP records in three regions of England and found 510 patients with unexplained chronic fatigue, of which 160 agreed to join the register. By following these patients over time, researchers can better understand how ME/CFS progresses and use this group for future studies.

Diagnostics

E2 ModerateBehavioralPEM not requiredObservational

Does the heterogeneity of chronic fatigue syndrome moderate the response to cognitive behaviour therapy? An exploratory study.

Cella, Matteo, Chalder, Trudie, White, Peter D·Psychotherapy and psychosomatics·2011

This study looked at whether ME/CFS patients are different from each other in ways that predict how well they respond to cognitive behaviour therapy (CBT), a type of talking therapy. Researchers analyzed data from 236 patients and found that most patients improved with CBT regardless of their characteristics, but they identified a smaller group with certain traits—including weight changes, tremors, anxiety, and pain—who were less likely to benefit. The findings suggest CBT can help most people with ME/CFS, though a minority may need different approaches.

Interventions

Characteristics of chronic fatigue syndrome in a Japanese community population : chronic fatigue syndrome in Japan.

Hamaguchi, Masahide, Kawahito, Yutaka, Takeda, Noriyuki et al.·Clinical rheumatology·2011

This Japanese study looked at how many people have ME/CFS in the general population and what their daily habits are like. Researchers found that about 1 in 100 people in Japan have ME/CFS, and people with the condition slept significantly less (about 5.5 hours per night) compared to people without it (about 6.3 hours). The symptom of unrefreshing sleep was particularly useful for identifying who has ME/CFS.

Sleep

E2 ModerateCohortPEM not requiredObservational

Failure to Detect XMRV-Specific Antibodies in the Plasma of CFS Patients Using Highly Sensitive Chemiluminescence Immunoassays.

Oakes, Brendan, Qiu, Xiaoxing, Levine, Susan et al.·Advances in virology·2011

In 2009, researchers claimed they found a virus called XMRV in most ME/CFS patients' blood. This study tested whether that finding was real by looking for antibodies (immune system markers) to XMRV in blood samples from ME/CFS patients and healthy people. The researchers found no evidence of XMRV antibodies in any of the samples, suggesting the original finding may not have been accurate.

Biomarkers

Peripheral blood gene expression in postinfective fatigue syndrome following from three different triggering infections.

Galbraith, Sally, Cameron, Barbara, Li, Hui et al.·The Journal of infectious diseases·2011

Researchers studied blood samples from 18 people who developed long-lasting fatigue after three different infections (Epstein-Barr virus, Ross River virus, and Q fever) and compared them to 18 healthy people who recovered normally. They looked for patterns in which genes were turned on or off that might explain the fatigue syndrome. While they found some differences in gene activity, these patterns were not consistent across the different infection groups, suggesting there may not be a single blood-based marker that identifies post-infectious fatigue.