Evidence browser

A Comparison of Patients with Chronic Fatigue Syndrome and Myalgic Encephalomyelitis from the United States and Japan.

Wiedbusch, Elzbieta, Cotler, Joseph, Jason, Leonard A·Journal of preventive medicine & healthcare·2021

This study compared how ME/CFS affects people in the United States and Japan by surveying 124 Japanese patients and 210 U.S. patients. The research found that U.S. patients reported more severe brain fog, stomach problems, and exhaustion after activity compared to Japanese patients. Interestingly, Japanese women experienced similar levels of disability as American patients despite being less likely to receive official disability support.

Post-Exertional Malaise

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

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 requiredCross-Sectional

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

Post-Acute COVID-19 Symptoms, a Potential Link with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A 6-Month Survey in a Mexican Cohort.

González-Hermosillo, J Antonio, Martínez-López, Jhanea Patricia, Carrillo-Lampón, Sofía Antonieta et al.·Brain sciences·2021

This study followed 130 people recovering from COVID-19 for 6 months to see how many developed symptoms similar to ME/CFS. Nearly half the patients experienced ongoing fatigue, and those with fatigue tended to be older and had spent more time in the hospital. Only 13% of the patients met the strict diagnostic criteria for ME/CFS, suggesting that while some people have overlapping symptoms, post-COVID fatigue and ME/CFS may be distinct conditions.

E2 ModerateCohortPEM requiredCase-Control

Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Greatly Improved Fatigue Symptoms When Treated with Oxygen-Ozone Autohemotherapy.

Tirelli, Umberto, Franzini, Marianno, Valdenassi, Luigi et al.·Journal of clinical medicine·2021

This study tested whether a treatment called oxygen-ozone autohemotherapy (a procedure where blood is drawn, treated with ozone gas, and returned to the body) could help ME/CFS patients with fatigue. Among 200 patients treated, most experienced significant improvements in their fatigue levels within 30 days, with nearly half reporting the best possible improvement on a fatigue scale. No serious side effects were reported.

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.

E2 ModerateCohortPEM not requiredObservational

Undetected Jawbone Marrow Defects as Inflammatory and Degenerative Signaling Pathways: Chemokine RANTES/CCL5 as a Possible Link Between the Jawbone and Systemic Interactions?

Lechner, Johann, Schmidt, Marlene, von Baehr, Volker et al.·Journal of inflammation research·2021

This study examined jawbone abnormalities in 301 patients with various chronic illnesses, including ME/CFS. Researchers found that patients with bone loss in the jawbone had elevated levels of a chemical messenger called RANTES/CCL5, which promotes inflammation. These findings were consistent across all disease groups studied, suggesting that jawbone problems may contribute to systemic inflammation in multiple conditions.

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.

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 ModerateCohortPEM not requiredCross-Sectional

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 ModerateCohortPEM not requiredLongitudinal

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

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.

E2 ModerateCohortPEM not requiredCross-Sectional

Medical School Education on Myalgic Encephalomyelitis.

Muirhead, Nina, Muirhead, John, Lavery, Grace et al.·Medicina (Kaunas, Lithuania)·2021

This study looked at how much medical schools in the UK teach doctors-in-training about ME/CFS. Researchers sent questionnaires to all 34 UK medical schools and found that only about half actually teach ME/CFS, and the teaching varies widely between schools. Most schools said they would welcome better teaching materials and resources about ME/CFS, suggesting doctors need more education on how to recognize and diagnose this condition.

Diagnostics

Lowered serum cesium levels in schizophrenia: association with immune-inflammatory biomarkers and cognitive impairments.

Almulla, Abbas F, Moustafa, Shatha R, Al-Dujaili, Arafat H et al.·Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)·2021

This study looked at a mineral called cesium in the blood of people with schizophrenia and compared it to healthy people. They found that people with schizophrenia had lower cesium levels, and this was connected to cognitive problems (like memory and thinking difficulties), fatigue symptoms, and signs of immune system activity. The researchers suggest that low cesium might contribute to some of the symptoms seen in schizophrenia.

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