Evidence browser

A laboratory approach for characterizing chronic fatigue: what does metabolomics tell us?

Erasmus, Elardus, Mason, Shayne, van Reenen, Mari et al.·Metabolomics : Official journal of the Metabolomic Society·2019

This study looked at whether a simple urine test could help measure fatigue severity in ME/CFS patients. Researchers used a specialized scanning technique (NMR) to analyze urine samples from 578 women with chronic fatigue before and after a detoxification challenge, finding that the fatigue group showed different metabolite patterns compared to controls. While the study didn't identify a single reliable biomarker for fatigue, it suggests that fatigue may be connected to how the body processes toxins.

Biomarkers

E2 ModerateBehavioralPEM not requiredCross-Sectional

Healthcare Utilization in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Analysis of US Ambulatory Healthcare Data, 2000-2009.

Bae, Jaeyong, Lin, Jin-Mann S·Frontiers in pediatrics·2019

This study examined how often people with ME/CFS visited doctors in the United States between 2000 and 2009. Researchers found that about 2.9 million visits were coded as ME/CFS-related during this period, with most patients being women in their 40s and 50s. Many patients with ME/CFS also had other health conditions like depression, high blood pressure, and diabetes, making their care more complicated.

Diagnostics

Adolescent and parent factors related to fatigue in paediatric multiple sclerosis and chronic fatigue syndrome: A comparative study.

Carroll, Susan, Chalder, Trudie, Hemingway, Cheryl et al.·European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society·2019

This study compared teenagers with multiple sclerosis (MS) who experienced fatigue, teenagers with ME/CFS, and healthy teenagers to understand what factors contribute to severe fatigue. Researchers found that teenagers with MS who were fatigued and teenagers with ME/CFS had very similar patterns of fatigue and unhelpful thinking patterns about their symptoms, but teenagers with ME/CFS had normal brain function while those with MS had some cognitive difficulties. The study suggests that psychological approaches used successfully in ME/CFS might also help teenagers with MS who experience fatigue.

Cognitive Impairment

E2 ModerateCohortPEM requiredCross-Sectional

MtDNA population variation in Myalgic encephalomyelitis/Chronic fatigue syndrome in two populations: a study of mildly deleterious variants.

Venter, Marianne, Tomas, Cara, Pienaar, Ilse S et al.·Scientific reports·2019

This study looked at mitochondrial DNA (the genetic material in the energy-producing parts of our cells) in people with ME/CFS to see if differences in this DNA might help explain the condition. Researchers compared DNA samples from ME/CFS patients in the UK and South Africa to look for variations. Interestingly, they found that ME/CFS patients were less likely to have certain common genetic variations that most people carry, but they did not find any confirmed disease-causing mutations.

Energy Metabolism

Chronic Widespread Pain in a tertiary pain clinic: classification overlap and use of a patient generated quality of life instrument.

Tschudi-Madsen, Hedda, Rødevand, Linn N, Bøymo Kaarbø, Mette et al.·Scandinavian journal of pain·2019

This study looked at 33 patients with widespread pain to understand how different diagnostic labels (fibromyalgia, chronic fatigue syndrome, and bodily distress syndrome) overlap and apply to the same people. Researchers also tested whether a patient-created quality-of-life survey could capture things that standard questionnaires miss. They found that most patients had very low quality of life scores, and that the newer diagnostic criteria for fibromyalgia work better together than older versions.

Diagnostics

E2 ModerateDiagnosticPEM unclearCross-Sectional

Searching for Serum Antibodies to Neuronal Proteins in Patients With Myalgic Encephalopathy/Chronic Fatigue Syndrome.

Giannoccaro, Maria Pia, Cossins, Judith, Sørland, Kari et al.·Clinical therapeutics·2019

Researchers tested blood samples from 50 ME/CFS patients and 50 healthy people to see if ME/CFS patients had unusual antibodies (immune proteins) that attack nerve cells. While a small number of both patients and healthy people had some immune activity toward nerve proteins, only one ME/CFS patient had a specific antibody that could be clearly identified. Interestingly, the patients who did have these antibodies tended to have more severe symptoms and had become ill more recently.

Immune System

Myalgic encephalomyelitis and chronic fatigue syndrome case definitions: effects of requiring a substantial reduction in functioning.

Scartozzi, Samantha, Sunnquist, Madison, Jason, Leonard A·Fatigue : biomedicine, health & behavior·2019

ME/CFS diagnoses require doctors to confirm that patients have a significant drop in their ability to function compared to before they got sick. However, there's no clear agreement on how much of a drop counts as 'significant.' This study looked at over 1,000 people with ME/CFS to see whether this requirement actually helps doctors identify who has the illness. The researchers found that when diagnostic criteria clearly describe which symptoms to look for and how severe they should be, the 'significant drop in functioning' requirement may not be necessary.

Diagnostics

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.

Immune System

Psychometric properties of the PROMIS® Fatigue Short Form 7a among adults with myalgic encephalomyelitis/chronic fatigue syndrome.

Yang, Manshu, Keller, San, Lin, Jin-Mann S·Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation·2019

Researchers tested whether a short questionnaire called PROMIS Fatigue (7 questions) accurately measures fatigue in people with ME/CFS. They found that the questionnaire reliably captures how tired ME/CFS patients feel, works the same way for different ages and genders, and can detect when fatigue changes over time. This tool may help doctors and researchers measure whether new treatments for ME/CFS actually work.

Factors associated with work status in chronic fatigue syndrome.

Stevelink, S A M, Fear, N T, Hotopf, M et al.·Occupational medicine (Oxford, England)·2019

This study looked at how ME/CFS affects people's ability to work. Researchers surveyed 507 patients and found that about half were still working, while nearly one-third had stopped working completely. People who were older, had more severe symptoms, or felt depressed were more likely to have left work, while those with higher education or strong relationships were more likely to still be employed.

E2 ModerateBehavioralPEM not requiredCross-Sectional

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.

Hematological and Psychophysiological Correlates of Anomalous Information Reception in Mediums: A Preliminary Exploration.

Beischel, Julie, Tassone, Shawn, Boccuzzi, Mark·Explore (New York, N.Y.)·2019

This study looked at whether people who identify as mediums (those who report communicating with deceased individuals) experience more health problems than people who don't. Researchers found that mediums reported significantly more autoimmune diseases, sleep problems, gastrointestinal issues, and other symptoms compared to non-mediums. However, blood tests and heart rate measurements taken during mediumship sessions showed no unusual changes.

Sleep

EBV-requisitioning physicians' guess on fatigue state 6 months after acute EBV infection.

Asprusten, Tarjei Tørre, Pedersen, Maria, Skovlund, Eva et al.·BMJ paediatrics open·2019

This study looked at whether doctors could predict which teenagers with mono (infectious mononucleosis caused by EBV) would develop long-lasting fatigue 6 months later. The researchers found that when doctors initially thought a patient would be 'likely fatigued' or 'unsurely fatigued,' those patients were more likely to actually develop fatigue compared to those predicted as 'not fatigued.' However, the doctors' predictions were only correct about two-thirds of the time.

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

Brain abnormalities in myalgic encephalomyelitis/chronic fatigue syndrome: Evaluation by diffusional kurtosis imaging and neurite orientation dispersion and density imaging.

Kimura, Yukio, Sato, Noriko, Ota, Miho et al.·Journal of magnetic resonance imaging : JMRI·2019

Researchers used advanced brain imaging to examine 20 ME/CFS patients and 23 healthy people. The imaging revealed that people with ME/CFS had subtle structural differences in specific brain regions involved in communication, thinking, and sensation. These differences were not visible on standard brain scans but were detected using newer, more detailed imaging techniques.

E2 ModerateCohortPEM not requiredLongitudinal

Energy envelope maintenance among patients with myalgic encephalomyelitis and chronic fatigue syndrome: Implications of limited energy reserves.

O'connor, Kelly, Sunnquist, Madison, Nicholson, Laura et al.·Chronic illness·2019

This study tested whether staying within your personal energy limits helps people with ME/CFS feel better. Researchers compared six groups of patients based on how much energy they had available and whether they stayed within those limits. The results showed that people with more available energy generally functioned better, but pushing beyond their limits was particularly harmful for those with higher energy reserves.

Post-Exertional Malaise

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.

Immune System