Evidence browser

An exploratory study of discrepancies between objective and subjective measurement of the physical activity level in female patients with chronic fatigue syndrome.

Vergauwen, Kuni, Huijnen, Ivan P J, Smeets, Rob J E M et al.·Journal of psychosomatic research·2021

This study compared two ways of measuring physical activity in women with ME/CFS: a written activity diary (where patients recorded what they did) and an accelerometer (a device that objectively tracks movement). The researchers found that the diary method was much less accurate in ME/CFS patients compared to healthy people. Interestingly, factors like symptom severity or quality of life didn't explain why the diary was unreliable—suggesting ME/CFS itself may affect how accurately patients can report their own activity levels.

E2 ModerateBehavioralPEM not requiredCross-Sectional

Chronotropic Incompetence in Non-Hospitalized Patients with Post-COVID-19 Syndrome.

Jimeno-Almazán, Amaya, Pallarés, Jesús G, Buendía-Romero, Ángel et al.·Journal of clinical medicine·2021

Some people who recover from COVID-19 experience persistent fatigue and difficulty exercising for months afterward. This study tested 32 people with long-lasting COVID symptoms and found that about 12% had a specific heart problem called chronotropic incompetence—their heart rate doesn't increase normally during exercise. This heart rhythm problem may explain why some patients struggle with exercise intolerance after COVID-19.

Autonomic Nervous System

Prevalence and correlates of chronic fatigue syndrome and post-traumatic stress disorder after the outbreak of the COVID-19.

Simani, Leila, Ramezani, Mahtab, Darazam, Ilad Alavi et al.·Journal of neurovirology·2021

This study looked at whether people who survived COVID-19 developed chronic fatigue syndrome (ME/CFS) or PTSD within 6 months of infection. Among 120 COVID-19 survivors in Iran, about 2.5% met the criteria for ME/CFS and 5.8% showed signs of PTSD. Interestingly, the researchers found that having PTSD was not linked to developing ME/CFS in these patients.

Long COVID Overlap

E2 ModerateCohortPEM unclearCase-Control

Saliva Fatigue Biomarker Index As a Marker for Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in a Community Based Sample.

Jason, Leonard A, Kalns, John, Richarte, Alicia et al.·Fatigue : biomedicine, health & behavior·2021

Researchers tested whether a simple saliva test could help diagnose severe ME/CFS in children and teens. They measured two protein fragments in saliva from young people with ME/CFS and compared them to healthy controls. The study found that this 'Fatigue Biomarker Index' showed significant differences between those with severe ME/CFS and healthy youth, suggesting it might one day be a useful objective test to help doctors diagnose the condition.

Diagnostics

E2 ModerateCohortPEM not requiredLongitudinal

How peptic ulcer disease could potentially lead to the lifelong, debilitating effects of chronic fatigue syndrome: an insight.

Kuo, Chien-Feng, Shi, Leiyu, Lin, Cheng-Li et al.·Scientific reports·2021

This study looked at whether people who have had peptic ulcers (stomach ulcers often caused by H. pylori bacteria) are at higher risk of developing ME/CFS. Researchers compared hospital records from Taiwan for people with and without peptic ulcers over many years. They found that people with a history of peptic ulcers were about twice as likely to develop ME/CFS, with higher risk in women and older adults.

Immune System

Oral Minocycline Therapy Improves Symptoms of Myalgic Encephalomyelitis, Especially in the Initial Disease Stage.

Miwa, Kunihisa·Internal medicine (Tokyo, Japan)·2021

Researchers tested whether minocycline, an antibiotic that may reduce brain inflammation, could help ME/CFS patients. About 27% of 100 patients taking minocycline for 6 weeks experienced meaningful symptom improvement, particularly those who had been sick for less than 3 years. However, 38% of patients had to stop taking it early due to side effects like nausea and dizziness.

Neuroinflammation

E2 ModerateCohortPEM unclearLongitudinal

Cerebral blood flow remains reduced after tilt testing in myalgic encephalomyelitis/chronic fatigue syndrome patients.

van Campen, C Linda M C, Rowe, Peter C, Visser, Frans C·Clinical neurophysiology practice·2021

This study looked at blood flow to the brain in ME/CFS patients during and after a tilt test (where people are tilted upright). Researchers found that when ME/CFS patients were tilted, blood flow to their brain decreased abnormally, and importantly, it did not fully recover even after returning to lying down—unlike their heart's ability to recover. The severity of this delayed blood flow recovery was directly related to how sick the patient was, with the most severely ill patients showing the slowest recovery.

Autonomic Nervous System

Risks for Developing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in College Students Following Infectious Mononucleosis: A Prospective Cohort Study.

Jason, Leonard A, Cotler, Joseph, Islam, Mohammed F et al.·Clinical infectious diseases : an official publication of the Infectious Diseases Society of America·2021

This study followed college students to see who developed ME/CFS after getting infectious mononucleosis (mono). Researchers found that about 23% of students who got mono later met criteria for ME/CFS within 6 months. Before getting mono, students who later developed ME/CFS had more physical symptoms and certain immune markers that were different from those who recovered, but they didn't have more stress, anxiety, or depression.

Immune System

Recursive ensemble feature selection provides a robust mRNA expression signature for myalgic encephalomyelitis/chronic fatigue syndrome.

Metselaar, Paula I, Mendoza-Maldonado, Lucero, Li Yim, Andrew Yung Fong et al.·Scientific reports·2021

Researchers found a set of 23 genes in blood cells that could reliably identify people with ME/CFS. By looking at both gene activity and chemical markers on genes, they developed a test that correctly identified ME/CFS patients about 92-97% of the time. This is important because there's currently no reliable blood test to diagnose ME/CFS.

BiomarkersImmune System

Off label use of Aripiprazole shows promise as a treatment for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a retrospective study of 101 patients treated with a low dose of Aripiprazole.

Crosby, L D, Kalanidhi, S, Bonilla, A et al.·Journal of translational medicine·2021

This study looked back at medical records of 101 ME/CFS patients who were prescribed a low dose of aripiprazole, a medication typically used for other conditions. The researchers found that some patients reported improvements in their symptoms. While these results are encouraging, the study design means we need to be cautious about how much weight to give these findings.

Interventions

BiomarkersEnergy MetabolismImmune System

Sex-specific plasma lipid profiles of ME/CFS patients and their association with pain, fatigue, and cognitive symptoms.

Nkiliza, Aurore, Parks, Megan, Cseresznye, Adam et al.·Journal of translational medicine·2021

This study analyzed fatty substances in the blood of ME/CFS patients and healthy controls to see if they differ in ways that might explain symptoms. Researchers found that men and women with ME/CFS had different patterns of these blood fats compared to healthy people. Importantly, certain blood fats were connected to the severity of fatigue, headaches, and thinking difficulties, suggesting that problems with how the body processes fats may play a role in ME/CFS symptoms.

E2 ModeratePEM not requiredRegistry-Resource

Sarcoidosis among US Hispanics in a Nationwide Registry.

Innabi, Ayoub, Alzghoul, Bashar N, Kalra, Saminder et al.·Respiratory medicine·2021

This study looked at how sarcoidosis (a disease that causes inflammation in the body) affects Hispanic patients in the United States compared to non-Hispanic patients. Researchers surveyed nearly 3,835 people and found that Hispanic patients with sarcoidosis experience more depression, chronic pain, sleep problems, and job loss than non-Hispanic patients. The findings suggest that doctors may need to approach treatment differently for Hispanic patients with this condition.

Pain and SensitizationSleep

E2 ModerateCohortPEM requiredCase-Control

Fine mapping of the major histocompatibility complex (MHC) in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) suggests involvement of both HLA class I and class II loci.

Hajdarevic, Riad, Lande, Asgeir, Rekeland, Ingrid et al.·Brain, behavior, and immunity·2021

This study looked at genes related to the immune system in people with ME/CFS to understand why some people develop the condition. Researchers compared genetic markers in 427 Norwegian ME/CFS patients with 480 healthy controls and found two specific genetic regions associated with ME/CFS—one involving immune system genes that present antigens to cells, and another in a different immune region. These findings suggest the immune system's ability to recognize and respond to threats may play a role in ME/CFS.

Immune System

Characterizing long COVID in an international cohort: 7 months of symptoms and their impact.

Davis, Hannah E, Assaf, Gina S, McCorkell, Lisa et al.·EClinicalMedicine·2021

This study surveyed nearly 3,800 people from around the world who had long-lasting COVID-19 symptoms lasting more than 28 days. By seven months after illness onset, most participants had not fully recovered and experienced an average of 56 symptoms affecting multiple body systems. The three most persistent symptoms were fatigue, post-exertional malaise (feeling worse after activity), and cognitive problems, with nearly 86% experiencing relapses triggered by exercise, physical activity, mental stress, or other exertion.

Post-Exertional Malaise

Subcortical brain segment volumes in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Addiego, Florencia Martinez, Zajur, Kristina, Knack, Sarah et al.·Life sciences·2021

Researchers used brain imaging to measure the size of deep brain structures in people with ME/CFS, Gulf War Illness, and healthy controls. They found that men and women with these conditions had different patterns of brain volume changes, suggesting that sex differences play an important role in how these illnesses affect the brain. The findings suggest that previous brain imaging studies may need to be reconsidered to account for whether participants were male or female.

Potential of Activin B as a Clinical Biomarker in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

Gravelsina, Sabine, Nora-Krukle, Zaiga, Vilmane, Anda et al.·Biomolecules·2021

Researchers tested whether a protein called activin B could be used as a simple blood test to diagnose ME/CFS. They compared activin B levels in 134 people with ME/CFS and 54 healthy people, but found no meaningful difference between the two groups. Based on these results, activin B does not appear to be a useful diagnostic tool for ME/CFS.

Biomarkers

Virtual Consultations: Young People and Their Parents' Experience.

Proulx-Cabana, Stephanie, Segal, Terry Yvonne, Gregorowski, Anna et al.·Adolescent health, medicine and therapeutics·2021

This study asked 50 young people (ages 10-18) and their families in the UK about their experience with doctor visits done online instead of in person. Most felt prepared for the visits, found them helpful, and felt private. Many liked that they didn't have to travel and could continue seeing the same doctor, but only about one-third got to speak privately with their doctor without a parent present.

Nationwide epidemiological characteristics of chronic fatigue syndrome in South Korea.

Lim, Eun-Jin, Lee, Jin-Seok, Lee, Eun-Jung et al.·Journal of translational medicine·2021

This study looked at medical records from South Korea between 2010 and 2020 to understand how many people have ME/CFS and who gets diagnosed with it. Researchers found that about 45 out of every 100,000 people are newly diagnosed each year, and roughly 58 out of every 100,000 people have the condition overall. The number of diagnoses roughly doubled over the 10-year period, with women being about 1.5 times more likely to be diagnosed than men, and cases increasing with age.