Evidence browser

Deconstructing post-exertional malaise: An exploratory factor analysis.

McManimen, Stephanie L, Sunnquist, Madison L, Jason, Leonard A·Journal of health psychology·2019

This study looked at post-exertional malaise (PEM)—the worsening of symptoms that happens after physical activity in ME/CFS—to understand whether it is one unified experience or two different types. The researchers found that PEM actually consists of two separate experiences: a whole-body fatigue and a muscle-specific fatigue. This suggests that PEM is more complex than previously thought and may need to be understood as having distinct components.

E2 ModerateCohortPEM unclearObservational

Open Trial of Vitamin B12 Nasal Drops in Adults With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Comparison of Responders and Non-Responders.

van Campen, C Linda Mc, Riepma, Klaas, Visser, Frans C·Frontiers in pharmacology·2019

This study tested whether vitamin B12 nasal drops could help people with ME/CFS. Fifty-one patients used the nasal drops for 3 months, and about two-thirds reported feeling better. Those who improved showed increases in their activity levels, better fatigue scores, and significantly higher vitamin B12 levels in their blood. The nasal drops appear to be a practical alternative to vitamin B12 injections for some patients.

E2 ModerateCohortPEM unclearObservational

A logistic regression analysis of risk factors in ME/CFS pathogenesis.

Lacerda, Eliana M, Geraghty, Keith, Kingdon, Caroline C et al.·BMC neurology·2019

This study looked at what factors might increase someone's risk of developing ME/CFS by comparing 269 people with ME/CFS to people with multiple sclerosis and healthy controls. Researchers found that having frequent colds or infections before illness onset, being single, having lower income, and having a family history of anxiety or neurological illness were linked to higher ME/CFS risk. The study suggests that infections may play an important role in how ME/CFS develops, which differs from multiple sclerosis.

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

E2 ModerateBehavioralPEM not requiredLongitudinal

Prediction of long-term outcome after cognitive behavioral therapy for chronic fatigue syndrome.

Janse, Anthonie, Bleijenberg, Gijs, Knoop, Hans·Journal of psychosomatic research·2019

This study followed 511 ME/CFS patients for up to 10 years after they completed cognitive behavioral therapy (CBT) to see which factors predicted who would recover better long-term. Researchers found that patients who started with less severe fatigue, had symptoms for a shorter time before treatment, and felt more in control of their fatigue tended to have better outcomes years later. The study suggests that maximizing improvements during treatment and addressing pain may be important for lasting recovery.

Interventions

E2 ModerateCohortPEM not requiredCross-Sectional

Onset Patterns and Course of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Chu, Lily, Valencia, Ian J, Garvert, Donn W et al.·Frontiers in pediatrics·2019

This study surveyed 150 people with ME/CFS about how their illness started and changed over time. Most people reported their ME/CFS began after an infection, stress, or chemical exposure. While some symptoms like fatigue and flu-like feelings improved slightly over time, others like brain fog stayed about the same or got worse, and nearly half of participants couldn't work by the time of the study.

E2 ModerateCohortPEM not requiredObservational

Epidemiology of paediatric chronic fatigue syndrome in Australia.

Knight, Sarah, Elders, Shane, Rodda, Jill et al.·Archives of disease in childhood·2019

This study looked at how many Australian children develop ME/CFS and what their experiences are like. Researchers tracked newly diagnosed cases over one year and found that the condition is quite rare in children under 10, but becomes more common in teenagers. Interestingly, the rates were very different depending on where children lived in Australia, suggesting some areas may be better at recognizing and diagnosing the condition than others.

Diagnostics

Cellular Immune Function in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

Cliff, Jacqueline M, King, Elizabeth C, Lee, Ji-Sook et al.·Frontiers in immunology·2019

This study examined the immune system of ME/CFS patients by testing their blood for signs of infection and measuring different types of immune cells. Researchers compared 251 ME/CFS patients (including 54 with severe ME/CFS) to healthy people and multiple sclerosis patients. They found that ME/CFS patients had unusual patterns in their T cells—a type of immune cell—but not in natural killer cells, contrary to what some earlier studies suggested.

E2 ModerateCohortPEM not requiredObservational

Decreased Expression of the CD57 Molecule in T Lymphocytes of Patients with Chronic Fatigue Syndrome.

Espinosa, P, Urra, J M·Molecular neurobiology·2019

Researchers measured levels of a protein called CD57 on immune cells in ME/CFS patients and compared them to healthy people. They found that ME/CFS patients had significantly lower amounts of CD57 on their T cells (a type of white blood cell). This difference was large enough that measuring CD57 levels could potentially help doctors diagnose ME/CFS.

BiomarkersImmune System

E2 ModerateDiagnosticPEM requiredMechanistic

A nanoelectronics-blood-based diagnostic biomarker for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

Rahim Esfandyarpour, Aref Kashi, Maya Nemat-Gorgani et al.·Proceedings of the National Academy of Sciences (PNAS)·2019·n=40

Stanford researchers developed a nanoelectronics device that detects immune cell changes using a tiny electrical sensor. When salt stress was applied to blood samples, ME/CFS patient samples showed a distinctly different electrical response compared to healthy controls. This 'nano-needle' assay could potentially serve as an objective diagnostic test.

BiomarkersDiagnostics

Rethinking ME/CFS Diagnostic Reference Intervals via Machine Learning, and the Utility of Activin B for Defining Symptom Severity.

Lidbury, Brett A, Kita, Badia, Richardson, Alice M et al.·Diagnostics (Basel, Switzerland)·2019

This study looked for blood test markers that could help diagnose ME/CFS and measure how severe someone's illness is. Researchers tested a protein called activin B along with routine blood work from pathology labs in people with ME/CFS and healthy controls. They used a computer learning method to see which combinations of blood markers worked best for identifying ME/CFS and predicting symptom severity.

Biomarkers

Antibodies to Human Herpesviruses in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients.

Blomberg, Jonas, Rizwan, Muhammad, Böhlin-Wiener, Agnes et al.·Frontiers in immunology·2019

This study looked for evidence that common viruses called herpesviruses might be reactivated or causing problems in ME/CFS patients. Researchers tested blood samples from ME/CFS patients and healthy people to measure immune responses (antibodies) against several herpesviruses. While the overall antibody levels were similar between the two groups, the study found subtle differences in how ME/CFS patients' immune systems reacted to a few specific herpesvirus proteins.

E2 ModerateCohortPEM not requiredCase-Control

MicroRNAs as Biomarkers of Pain Intensity in Patients With Chronic Fatigue Syndrome.

Al-Rawaf, Hadeel A, Alghadir, Ahmad H, Gabr, Sami A·Pain practice : the official journal of World Institute of Pain·2019

This study looked at tiny molecules called microRNAs in the blood of adolescents with ME/CFS to see if they could help explain why these patients experience pain. Researchers found that five specific microRNAs were lower in ME/CFS patients compared to healthy teens, and these changes were linked to higher levels of inflammatory chemicals that are known to cause pain. Interestingly, girls with ME/CFS had even lower microRNA levels and higher inflammation markers than boys with the condition.

BiomarkersImmune System

Diagnostic sensitivity of 2-day cardiopulmonary exercise testing in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Nelson, Maximillian J, Buckley, Jonathan D, Thomson, Rebecca L et al.·Journal of translational medicine·2019

Researchers tested whether a simple exercise test could help diagnose ME/CFS. They had patients and healthy people exercise on a stationary bike on two consecutive days and measured how their performance changed. ME/CFS patients showed a larger drop in exercise capacity on the second day compared to healthy people, suggesting this difference might be a useful diagnostic tool.

E2 ModerateCohortPEM not requiredCross-Sectional

The proportion of women with central sensitivity syndrome in gynecology outpatient clinics (GOPDs).

Vij, Monika, Davies, Anthony, Dua, Anu et al.·International urogynecology journal·2019

This study looked at women visiting gynecology clinics whose symptoms didn't match what doctors could see on physical exams or tests. Researchers gave these women a questionnaire about pain sensitivity and related symptoms. They found that 37% of the women screened positive for central sensitization—a condition where the nervous system becomes more sensitive to pain and other sensations. Many of these women also had other conditions like migraine, depression, anxiety, IBS, and ME/CFS.

Pain and Sensitization

Impaired Health-Related Quality of Life in Adolescent Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: The Impact of Core Symptoms.

Roma, Maria, Marden, Colleen L, Flaherty, Marissa A K et al.·Frontiers in pediatrics·2019

This study looked at how ME/CFS affects the daily lives and well-being of teenagers and young adults compared to healthy peers. Young people with ME/CFS reported much worse quality of life across all areas tested, and the study found that post-exertional malaise (feeling much worse after activity) was the strongest predictor of this reduced quality of life. The findings confirm that ME/CFS in young people is as serious as or more serious than other chronic childhood illnesses like asthma, diabetes, and cystic fibrosis.

E2 ModerateCohortPEM not requiredCross-Sectional

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.

Changes in the transcriptome of circulating immune cells of a New Zealand cohort with myalgic encephalomyelitis/chronic fatigue syndrome.

Sweetman, Eiren, Ryan, Margaret, Edgar, Christina et al.·International journal of immunopathology and pharmacology·2019

Researchers studied blood immune cells from 10 ME/CFS patients and 10 healthy people to understand what's different at the genetic level. They found that several genes related to inflammation were more active in ME/CFS patients, and genes related to energy production and circadian rhythms (your body's internal clock) showed abnormal patterns. These findings suggest ME/CFS involves multiple biological systems working incorrectly at the same time.

E2 ModerateBehavioralPEM not requiredCross-Sectional

Could disease labelling have positive effects? An experimental study exploring the effect of the chronic fatigue syndrome label on intended social support.

Noble, Samara, Bonner, Carissa, Hersch, Jolyn et al.·Patient education and counseling·2019

This study asked university students how they would respond to a close friend who has ME/CFS, comparing situations where the condition was labeled as 'chronic fatigue syndrome' versus unlabeled. When the CFS label was used, students reported they would be more sympathetic, less rejecting, and more supportive of medical treatment for their friend. This suggests that having a recognized disease name might actually help people with ME/CFS receive better social support from their friends.