Evidence browser

Postinfectious and chronic fatigue syndromes: clinical experience from a tertiary-referral centre in Norway.

Naess, Halvor, Sundal, Endre, Myhr, Kjell-Morten et al.·In vivo (Athens, Greece)·2010

This study looked at 873 ME/CFS patients in Norway to see whether their illness started after an infection. About 77% of patients reported having an infection before their fatigue began. Patients who had an infection at the start were more likely to have a sudden onset of fatigue and to show some improvement by the time they were seen at the clinic, compared to those without an infection.

The Newcastle NHS Chronic Fatigue Syndrome Service: not all fatigue is the same.

Newton, J L, Mabillard, H, Scott, A et al.·The journal of the Royal College of Physicians of Edinburgh·2010

This study looked at patients referred to a specialist fatigue clinic in Newcastle, England to see how many actually had ME/CFS versus other conditions causing tiredness. The researchers found that 60% of referred patients were diagnosed with ME/CFS, while the remaining 40% had other causes of fatigue—most commonly tiredness from other chronic illnesses, sleep problems, or mental health conditions. This suggests many people with fatigue don't fit ME/CFS criteria but still need help managing their symptoms.

Diagnostics

Absence of xenotropic murine leukemia virus-related virus in blood cells of men at risk for and infected with HIV.

Kunstman, Kevin J, Bhattacharya, Tanmoy, Flaherty, John et al.·AIDS (London, England)·2010

Researchers tested nearly 1,000 men for a virus called XMRV that had been found in some ME/CFS patients. They found no evidence of this virus in any of the men tested, even though the virus had been detected in a small percentage of healthy people from similar geographic areas. This suggests that if XMRV is linked to ME/CFS, it may only occur in certain populations.

E2 ModerateBehavioralPEM not requiredCross-Sectional

Detailed analysis of health status of Q fever patients 1 year after the first Dutch outbreak: a case-control study.

Limonard, G J M, Peters, J B, Nabuurs-Franssen, M H et al.·QJM : monthly journal of the Association of Physicians·2010

This study looked at people who had Q fever (a bacterial infection) during an outbreak in the Netherlands and checked how they were doing about a year later. Compared to people who never had Q fever, the infected patients reported significantly more fatigue, symptoms, and problems with daily functioning. About half of the Q fever patients experienced severe fatigue, which is notably higher than in the comparison group.

Interpersonal problems in alexithymia: A study in three primary care groups.

Vanheule, Stijn, Vandenbergen, Jan, Verhaeghe, Paul et al.·Psychology and psychotherapy·2010

This study looked at whether people with ME/CFS have difficulty recognizing and talking about their emotions (a condition called alexithymia), and whether this connects to how they interact with others. Researchers compared 52 ME/CFS patients with two other groups: 52 people with heart or autoimmune diseases, and 51 people with minor health problems. They found that ME/CFS patients and those with chronic diseases struggled more with identifying emotions and tended to have more distant or self-centered relationships compared to those with minor illnesses.

Pain and SensitizationSleep

Interstitial cystitis/painful bladder syndrome and associated medical conditions with an emphasis on irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome.

Nickel, J Curtis, Tripp, Dean A, Pontari, Michel et al.·The Journal of urology·2010

This study looked at how often bladder pain syndrome occurs alongside other conditions like irritable bowel syndrome, fibromyalgia, and ME/CFS. Researchers found that people with bladder pain syndrome were much more likely to have these other conditions compared to healthy controls. Importantly, people who had multiple overlapping conditions experienced worse pain, sleep problems, depression, and lower quality of life than those with just one condition.

E2 ModerateCohortPEM not requiredLongitudinal

[Omaron in the complex treatment of patients with multiple sclerosis].

Popova, N F, Kamchatnov, P R, Riabukhina, O V et al.·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·2010

This study tested a combination medication called omaron in 33 patients with multiple sclerosis to see if it could help with fatigue and thinking problems. After 12 weeks of treatment, patients taking omaron reported feeling less tired (28.6% improvement) and showed better memory and thinking skills compared to a similar group who didn't receive the medication. The drug was well-tolerated with no serious side effects.

Cognitive Impairment

The effects of repeated thermal therapy on quality of life in patients with type II diabetes mellitus.

Beever, Richard·Journal of alternative and complementary medicine (New York, N.Y.)·2010

This study tested whether far-infrared sauna sessions (3 times per week for 3 months) could improve quality of life in people with type II diabetes. Researchers found that participants reported improvements in physical health, general health, stress, and fatigue. The study suggests that saunas might help people with diabetes feel better, and interestingly, more people seemed willing to try saunas compared to other lifestyle changes.

E2 ModerateCohortPEM unclearObservational

Impaired sleep in chronic fatigue syndrome: how is it best measured?

Creti, Laura, Libman, Eva, Baltzan, Marcel et al.·Journal of health psychology·2010

This study compared three different ways of measuring sleep in people with ME/CFS: overnight hospital testing (polysomnography), wrist-worn activity monitors (actigraphy), and patients reporting on their own sleep. Researchers found that while objective measurements matched what patients reported about total sleep time, the objective tests didn't capture daytime symptoms like non-refreshing sleep, fatigue, or sleepiness that patients actually experience.

Antibody to parvovirus B19 nonstructural protein is associated with chronic arthralgia in patients with chronic fatigue syndrome/myalgic encephalomyelitis.

Kerr, Jonathan R, Gough, John, Richards, Selwyn C M et al.·The Journal of general virology·2010

This study looked at whether parvovirus B19 (a common virus) plays a role in ME/CFS, particularly in patients with joint pain. While ME/CFS patients and healthy people had similar rates of past B19 infection, researchers found that ME/CFS patients were much more likely to have specific antibodies suggesting the virus wasn't being cleared properly from their body. Interestingly, patients with these antibodies were more likely to report chronic joint pain.

Immune System

E2 ModerateCohortPEM requiredObservational

Unravelling the nature of postexertional malaise in myalgic encephalomyelitis/chronic fatigue syndrome: the role of elastase, complement C4a and interleukin-1beta.

Nijs, J, Van Oosterwijck, J, Meeus, M et al.·Journal of internal medicine·2010

This study looked at what happens in the blood after people with ME/CFS exercise. Researchers compared 22 women with ME/CFS to 22 healthy women and measured specific immune markers (elastase, IL-1beta, and complement C4a) before and after two different types of exercise. Both types of exercise triggered postexertional malaise (a worsening of symptoms after activity) in the ME/CFS group, but surprisingly, the immune markers they measured didn't show significant changes in either group.

Immune SystemPost-Exertional Malaise

E2 ModerateCohortPEM unclearCross-Sectional

Absence of evidence of xenotropic murine leukemia virus-related virus infection in persons with chronic fatigue syndrome and healthy controls in the United States.

Switzer, William M, Jia, Hongwei, Hohn, Oliver et al.·Retrovirology·2010

Researchers tested blood samples from 51 ME/CFS patients and 56 healthy people to see if a virus called XMRV was present. Using multiple sensitive tests from different laboratories, they found no evidence of this virus in either group. This study contradicted an earlier claim that XMRV was found in most ME/CFS patients.

Biochemical and vascular aspects of pediatric chronic fatigue syndrome.

Kennedy, Gwen, Khan, Faisel, Hill, Alexander et al.·Archives of pediatrics & adolescent medicine·2010

This study compared 25 children with ME/CFS to 23 healthy children to understand what happens in their bodies at a chemical and blood vessel level. The researchers found that children with ME/CFS had signs of increased oxidative stress (cellular damage from harmful molecules) and more dying white blood cells, similar to what has been seen in adults with ME/CFS. However, unlike adults, the children's blood vessel stiffness appeared normal.

Immune System

Phenotypes of chronic fatigue syndrome in children and young people.

May, Margaret, Emond, Alan, Crawley, Esther·Archives of disease in childhood·2010

Researchers studied 333 children and young people with ME/CFS to see if the illness presents differently in different people. They found three main patterns: one involving muscle and joint pain, another involving migraine-like symptoms with sensitivity to light and sound, and a third involving sore throat and swollen lymph nodes. These different patterns were linked to varying levels of severity, suggesting that ME/CFS affects children in different ways.

Pain and Sensitization

Reduced heart rate variability predicts poor sleep quality in a case-control study of chronic fatigue syndrome.

Burton, A R, Rahman, K, Kadota, Y et al.·Experimental brain research·2010

People with ME/CFS often report poor sleep quality. This study measured heart rate patterns during sleep in 20 patients with ME/CFS and 20 healthy controls, finding that ME/CFS patients had much lower heart rate variability (natural changes in heart rate) during sleep. The researchers concluded that this reduced variability—suggesting the nervous system stays "on high alert" even at night—is closely linked to their sleep problems.

Autonomic Nervous System

E2 ModerateCohortPEM unclearObservational

Exercise tolerance testing in a prospective cohort of adolescents with chronic fatigue syndrome and recovered controls following infectious mononucleosis.

Katz, Ben Z, Boas, Steven, Shiraishi, Yukiko et al.·The Journal of pediatrics·2010

After infectious mononucleosis, some teenagers develop ME/CFS. Researchers compared how well teenagers with ME/CFS could exercise compared to teenagers who recovered normally from mono. Teenagers with ME/CFS showed lower oxygen use and heart efficiency during exercise tests, even though they looked the same as healthy teens in other ways.

Post-Exertional Malaise

A retrospective review of the sleep characteristics in patients with chronic fatigue syndrome and fibromyalgia.

Spitzer, A Robert, Broadman, Melissa·Pain practice : the official journal of World Institute of Pain·2010

Researchers studied sleep patterns in 118 patients with ME/CFS and fibromyalgia using objective sleep tests. They found that most patients had abnormal sleep studies showing excessive daytime sleepiness, and some had sleep features similar to narcolepsy. A genetic marker (HLA DQB1*0602) associated with narcolepsy was found in 43% of patients, much higher than in the general population.

Sleep

Biomarkers in chronic fatigue syndrome: evaluation of natural killer cell function and dipeptidyl peptidase IV/CD26.

Fletcher, Mary A, Zeng, Xiao R, Maher, Kevin et al.·PloS one·2010

This study tested whether two immune system markers could reliably identify ME/CFS patients. Researchers measured natural killer (NK) cell function—a type of immune cell that fights infections—and CD26, a protein found on immune cells. They found that ME/CFS patients had lower NK cell function and different patterns of CD26 compared to healthy people, suggesting these markers could potentially help diagnose the condition.

Immune System

Postinfectious fatigue in adolescents and physical activity.

Huang, Yue, Katz, Ben Z, Mears, Cynthia et al.·Archives of pediatrics & adolescent medicine·2010

This study followed 301 teenagers with infectious mononucleosis (mono) for 2 years, comparing those who developed chronic fatigue syndrome (CFS) with those who recovered normally. Adolescents with post-infection CFS reported much more severe fatigue and needed more daytime sleep than their peers, even though their overall activity levels looked similar on paper. The key finding suggests that teenagers with CFS after mono may be forcing themselves to stay active like their friends, but at a significant physical cost in terms of exhaustion and sleep needs.

Post-Exertional Malaise