Evidence browser

Comprehensive Circulatory Metabolomics in ME/CFS Reveals Disrupted Metabolism of Acyl Lipids and Steroids.

Germain, Arnaud, Barupal, Dinesh K, Levine, Susan M et al.·Metabolites·2020

Researchers studied the chemicals in blood samples from 26 ME/CFS patients and 26 healthy controls to understand what might be different in ME/CFS. They found that ME/CFS patients have lower levels of certain fats (especially acyl cholines) and hormones (including some involved in stress response and reproduction) compared to healthy people. These chemical differences might help explain why ME/CFS causes such widespread symptoms affecting many body systems.

Energy Metabolism

The Prevalence of Pediatric Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in a Community‑Based Sample.

Jason, Leonard A, Katz, Ben Z, Sunnquist, Madison et al.·Child & youth care forum·2020

Researchers studied over 10,000 children and teenagers in the Chicago area to find out how many have ME/CFS. They found that about 0.75% (roughly 1 in 133) young people have the condition, with higher rates among African American and Latino youth. Importantly, less than 5% of these children had been diagnosed before the study, meaning many young people with ME/CFS are going unrecognized by doctors.

Diagnostics

Energy MetabolismImmune System

Multi-omics examination of Q fever fatigue syndrome identifies similarities with chronic fatigue syndrome.

Raijmakers, Ruud P H, Roerink, Megan E, Jansen, Anne F M et al.·Journal of translational medicine·2020

This study compared people with Q fever fatigue syndrome (a prolonged tiredness that develops after a Q fever infection) to people with ME/CFS and healthy controls. Researchers examined three types of biological markers: gut bacteria, blood chemicals, and inflammatory proteins. They found that people with Q fever fatigue syndrome have very similar patterns to ME/CFS patients, suggesting these two conditions may share similar underlying biological mechanisms.

E2 ModerateCohortPEM requiredCase-Control

The prevalence of papilledema in patients with migraine: a crucial cooccurrence of migraine and idiopathic intracranial hypertension.

Onder, Halil, Ulusoy, Ersin Kasim, Aslanyavrusu, Memet et al.·Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·2020

This study looked at 158 people with migraines to see how many had a condition called idiopathic intracranial hypertension (IIH), which causes increased pressure inside the skull. The researchers found that 6% of migraine patients had signs of IIH, and that this condition was more common in people with chronic migraines (ongoing frequent headaches) rather than occasional migraines. Obesity was the strongest risk factor for having IIH in this group.

Human Leukocyte Antigen alleles associated with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

Lande, Asgeir, Fluge, Øystein, Strand, Elin B et al.·Scientific reports·2020

Researchers studied immune system markers called HLA alleles in 426 Norwegian ME/CFS patients and compared them to healthy controls. They found that two specific immune markers (HLA-C*07:04 and HLA-DQB1*03:03) were more common in ME/CFS patients than in healthy people, suggesting the immune system may play a role in developing ME/CFS. About 1 in 5 ME/CFS patients carried one or both of these markers, compared to 1 in 8 healthy people.

E2 ModerateBehavioralPEM not requiredCross-Sectional

Associations of occupational stress, workplace violence, and organizational support on chronic fatigue syndrome among nurses.

Li, Mengyao, Shu, Qianyi, Huang, Hao et al.·Journal of advanced nursing·2020

This study examined whether workplace stress, violence, and lack of organizational support increase the risk of ME/CFS in nurses. Researchers surveyed 1,080 Chinese nurses and found that those experiencing high levels of overcommitment, workplace violence, and little support from their employers were significantly more likely to have ME/CFS. The findings suggest that improving workplace safety, support, and reducing internal stress could help prevent ME/CFS in this high-risk group.

SleepCognitive Impairment

E2 ModerateCohortPEM not requiredCase-Control

Metabolic Dysfunction in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Not Due to Anti-mitochondrial Antibodies.

Nilsson, Isabell, Palmer, Jeremy, Apostolou, Eirini et al.·Frontiers in medicine·2020

Researchers tested whether ME/CFS patients have immune system antibodies that attack their mitochondria (the energy-producing parts of cells), similar to what happens in a different disease called primary biliary cholangitis. They found that ME/CFS patients almost never have these specific antibodies, while patients with the other disease have them consistently. This suggests that the energy problems seen in ME/CFS are caused by something other than the immune system attacking mitochondria.

Energy Metabolism

Cortisol levels in chronic fatigue syndrome and atypical depression measured using hair and saliva specimens.

Herane-Vives, Andres, Papadopoulos, Andrew, de Angel, Valeria et al.·Journal of affective disorders·2020

This study compared stress hormone (cortisol) levels in people with ME/CFS and people with a specific type of depression called atypical depression, both with and without fatigue. Researchers measured cortisol in two ways: through hair samples (showing levels over 3 months) and saliva samples (showing daily patterns). Both ME/CFS and atypical depression groups had lower daily cortisol output than healthy people, but normal cortisol levels when measured over longer periods, suggesting the low levels might be temporary or related to how the body's rhythm changes.

Endocrine Disruption

E2 ModerateCohortPEM requiredCross-Sectional

Cardiac Dimensions and Function Are Not Altered among Females with the Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Iversen, Per Ole, von Lueder, Thomas Gero, Kardel, Kristin Reimers et al.·Healthcare (Basel, Switzerland)·2020

Researchers used heart ultrasounds to check if the hearts of people with ME/CFS were structurally different or working differently than healthy people's hearts. They found no significant differences in heart size or function between the 16 women with ME/CFS and 10 healthy women they studied. This suggests that ME/CFS exercise intolerance and lactate buildup may not be caused by problems with how the heart itself is structured or functioning.

Post-Exertional Malaise

A hierarchical logistic regression predicting rapid respiratory rates from post-exertional malaise.

Cotler, Joseph, Katz, Ben Z, Reurts-Post, Corine et al.·Fatigue : biomedicine, health & behavior·2020

This study looked at whether faster breathing rates could be a sign of post-exertional malaise (PEM)—the worsening of symptoms that many ME/CFS patients experience after activity. Researchers measured breathing rates in 216 ME/CFS patients over two days and compared them to information about PEM and other symptoms. They found that patients with more severe PEM tended to have faster resting breathing rates, while depression, anxiety, and activity level did not explain the faster breathing.

Post-Exertional Malaise

E2 ModerateCohortPEM unclearObservational

Rituximab Serum Concentrations and Anti-Rituximab Antibodies During B-Cell Depletion Therapy for Myalgic Encephalopathy/Chronic Fatigue Syndrome.

Rekeland, Ingrid G, Fluge, Øystein, Alme, Kine et al.·Clinical therapeutics·2019

This study looked at whether the amount of a drug called rituximab in patients' blood predicted whether they would improve from ME/CFS symptoms. The researchers measured rituximab levels in 23 patients and found no clear connection between how much drug was in the blood and who felt better. Interestingly, none of the patients developed antibodies against the drug, which was a potential concern.

E2 ModerateCohortPEM not requiredLongitudinal

Increased risk of chronic fatigue syndrome following psoriasis: a nationwide population-based cohort study.

Tsai, Shin-Yi, Chen, Hsuan-Ju, Chen, Chi et al.·Journal of translational medicine·2019

This study found that people with psoriasis (a skin condition involving immune system dysfunction) have a higher chance of developing ME/CFS compared to people without psoriasis. Researchers followed over 13,000 people in Taiwan for several years and found that those with psoriasis were about 1.5 times more likely to develop ME/CFS. Interestingly, people who received certain psoriasis treatments appeared to have a lower risk of developing ME/CFS.

E2 ModerateBehavioralPEM not requiredLongitudinal

Fatigue in Epstein-Barr virus infected adolescents and healthy controls: A prospective multifactorial association study.

Pedersen, Maria, Asprusten, Tarjei Tørre, Godang, Kristin et al.·Journal of psychosomatic research·2019

This study followed teenagers with acute Epstein-Barr virus (EBV) infection and compared them to healthy teenagers to understand what causes fatigue. Researchers measured 148 different factors including symptoms, quality of life, sleep, emotions, immune markers, and heart rate control at the start of infection and again six months later. They found that fatigue was consistently linked to sleep problems, negative emotions, and poor quality of life, but surprisingly, markers of active infection were not associated with how tired people felt.

SleepAutonomic Nervous System

Clinical symptoms and markers of disease mechanisms in adolescent chronic fatigue following Epstein-Barr virus infection: An exploratory cross-sectional study.

Kristiansen, Miriam Skjerven, Stabursvik, Julie, O'Leary, Elise Catriona et al.·Brain, behavior, and immunity·2019

This study looked at adolescents who had Epstein-Barr virus (EBV) infection and tracked whether they developed chronic fatigue 6 months later. Researchers found that those with ongoing fatigue had more symptoms overall, but blood tests and heart-monitoring showed only small differences compared to those who recovered—mainly slightly higher inflammation markers and changes in nervous system activity. The study suggests that post-EBV fatigue in teenagers involves subtle changes in the body's stress and immune systems, even though the virus itself had cleared.

Patients with Fibromyalgia and Chronic Fatigue Syndrome show increased hsCRP compared to healthy controls.

Groven, Nina, Fors, Egil A, Reitan, Solveig Klæbo·Brain, behavior, and immunity·2019

This study measured inflammation markers in the blood of people with ME/CFS and fibromyalgia, compared to healthy people. Both patient groups had higher levels of a marker called hsCRP (a sign of inflammation) than healthy controls. The two conditions showed similar inflammation levels, suggesting they may share some biological similarities.

BiomarkersImmune System

Cerebral blood flow and heart rate variability predict fatigue severity in patients with chronic fatigue syndrome.

Boissoneault, Jeff, Letzen, Janelle, Robinson, Michael et al.·Brain imaging and behavior·2019

This study looked at blood flow in the brain and heart rate patterns in women with ME/CFS compared to healthy women. The researchers found that women with ME/CFS who had better blood flow to the brain and more variable heart rates tended to have less severe fatigue. These findings suggest that how well the body's circulatory and nervous systems are working may be connected to how tired people with ME/CFS feel.

E2 ModerateCohortPEM not requiredObservational

A new approach to find biomarkers in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) by single-cell Raman micro-spectroscopy.

Xu, Jiabao, Potter, Michelle, Tomas, Cara et al.·The Analyst·2019

Researchers used a new scanning technology called Raman spectroscopy to look at individual cells from ME/CFS patients and healthy people. They found that cells from ME/CFS patients had higher levels of a protein building block called phenylalanine, similar to cells with broken energy-producing structures (mitochondria). Using computer learning, they could identify ME/CFS patient cells with 98% accuracy based on this signature.

Biomarkers

Can a Chronic BPPV With a History of Trauma be the Trigger of Symptoms in Vestibular Migraine, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), and Whiplash Associated Disorders (WAD)? A Retrospective Cohort Study.

Tjell, Carsten, Iglebekk, Wenche, Borenstein, Peter·Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·2019

This study looked at patients with a condition called chronic BPPV (a type of inner ear problem that causes dizziness), many of whom had experienced head or neck trauma. The researchers found that treating this inner ear condition improved symptoms in about 90% of patients. Interestingly, the patients' symptoms overlapped with ME/CFS, migraine, and whiplash-related disorders, raising the question of whether the inner ear problem might be triggering or contributing to these conditions.

E2 ModerateCohortPEM requiredCross-Sectional

Elevated blood lactate in resting conditions correlate with post-exertional malaise severity in patients with Myalgic encephalomyelitis/Chronic fatigue syndrome.

Ghali, Alaa, Lacout, Carole, Ghali, Maria et al.·Scientific reports·2019

This study looked at lactate levels (a substance produced by muscles) in the blood of ME/CFS patients who were at rest. Researchers found that about 45% of patients had higher-than-normal lactate levels even when not exercising. Importantly, patients with elevated resting lactate tended to experience more severe post-exertional malaise (the symptom flare-ups that follow physical activity).

Energy MetabolismPost-Exertional Malaise