Evidence browser

E3 PreliminaryReviewPEM not requiredReview-Narrative

[Fatigue in neuromuscular disease].

Van Engelen, B G M, Kalkman, J S, Schillings, M L et al.·Nederlands tijdschrift voor geneeskunde·2004

Fatigue is a common symptom in many diseases, including neuromuscular disorders like post-polio syndrome and myasthenia gravis. This review found that about 64% of neuromuscular patients experience severe fatigue—a rate similar to multiple sclerosis patients. The authors suggest that using reliable measurement tools and combining different medical specialties could help researchers understand why fatigue happens and develop better treatments.

Unloading the trunk: neurasthenia, CFS and race.

Luthra, A, Wessely, S·Social science & medicine (1982)·2004

This study examines how ME/CFS and its historical predecessor neurasthenia have been discussed in terms of race and ethnicity over the past century. The authors found that there is a pattern of thinking that associates fatigue illnesses with technological 'development' in white countries, and they explore why far fewer non-white patients appear in specialist ME/CFS clinics compared to what you might expect from the general population.

E3 PreliminaryCommentaryPEM not requiredEditorial

New insights into culture driven disorders.

Aceves-Avila, Francisco Javier, Ferrari, Robert, Ramos-Remus, Cesar·Best practice & research. Clinical rheumatology·2004

This editorial examines why conditions like ME/CFS, fibromyalgia, and similar illnesses are often difficult for doctors to diagnose using standard tests. The authors suggest that social and cultural factors—including how society views these diseases and how disability systems work—play a major role in how these illnesses show up in patients. They argue that understanding these broader influences could help doctors offer better support to patients.

E3 PreliminaryReviewPEM not requiredReview-Narrative

In vivo MR spectroscopy in diagnosis and research of neuropsychiatric disorders.

Cox, I J, Puri, B K·Prostaglandins, leukotrienes, and essential fatty acids·2004

This study reviewed how a specialized brain imaging technique called magnetic resonance spectroscopy can be used to detect chemical changes in the brains of people with chronic fatigue syndrome and other neuropsychiatric conditions. The technique is non-invasive and allows doctors to measure things like energy production, brain cell function, and neurotransmitter activity without surgery. The authors summarized findings from previous research showing what these brain chemistry changes look like in ME/CFS patients.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Fibromyalgia: a stress disorder? Piecing the biopsychosocial puzzle together.

Van Houdenhove, Boudewijn, Egle, Ulrich T·Psychotherapy and psychosomatics·2004

This review article explores whether stress might be a root cause of fibromyalgia, a condition with widespread pain and fatigue that overlaps significantly with chronic fatigue syndrome. The authors examine how the body's stress response system works and how stress-related changes might lead to abnormal pain sensitivity and other fibromyalgia symptoms. They propose that fibromyalgia could be understood as a stress-related disorder involving both physical and psychological factors.

Sleep

E3 PreliminaryReviewPEM not requiredReview-Narrative

In vivo magnetic resonance spectroscopy in chronic fatigue syndrome.

Chaudhuri, A, Behan, P O·Prostaglandins, leukotrienes, and essential fatty acids·2004

This study used a special type of MRI scan called magnetic resonance spectroscopy (MRS) to look at how cells work in ME/CFS patients. The scans showed that muscle cells may become too acidic during exercise, and brain cells may have signs of stress. These findings suggest that ME/CFS involves problems with how cells produce and use energy.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Carnitines and its congeners: a metabolic pathway to the regulation of immune response and inflammation.

Famularo, Giuseppe, De Simone, Claudio, Trinchieri, Vito et al.·Annals of the New York Academy of Sciences·2004

This review discusses carnitine, a natural substance in the body that helps cells produce energy from fats. Carnitine levels are low in several conditions involving immune problems, including ME/CFS. The authors suggest that low carnitine may contribute to immune dysfunction and excessive inflammation, and that carnitine treatment might help restore normal immune function.

Energy MetabolismImmune System

E3 PreliminaryReviewPEM not requiredReview-Narrative

Immunologic aspects of chronic fatigue syndrome. Report on a Research Symposium convened by The CFIDS Association of America and co-sponsored by the US Centers for Disease Control and Prevention and the National Institutes of Health.

Gerrity, Timothy R, Papanicolaou, Dimitris A, Amsterdam, Jay D et al.·Neuroimmunomodulation·2004

This report summarizes what experts learned at a major research meeting about how immune system problems might be connected to ME/CFS. The experts found that people with ME/CFS do have immune system changes that look different from healthy people, but they couldn't determine whether these immune problems cause the illness or result from it. The researchers emphasized that understanding ME/CFS requires looking at multiple body systems working together, not just one system in isolation.

E3 PreliminaryMechanismPEM not requiredMechanistic

Effect of Hochu-ekki-to (TJ-41), a Japanese Herbal Medicine, on Daily Activity in a Murine Model of Chronic Fatigue Syndrome.

Wang, Xin Q, Takahashi, Takashi, Zhu, Shi-Jie et al.·Evidence-based complementary and alternative medicine : eCAM·2004

Researchers tested a Japanese herbal medicine called Hochu-ekki-to (TJ-41) in mice with an experimentally induced condition similar to ME/CFS. Mice treated with the herb showed better activity levels and survived longer than untreated mice, suggesting the herb may help reduce activity loss associated with chronic fatigue-like conditions.

E3 PreliminaryReviewPEM not requiredReview-Narrative

The HPA axis and the genesis of chronic fatigue syndrome.

Cleare, Anthony J·Trends in endocrinology and metabolism: TEM·2004

This review examines whether ME/CFS involves problems with the body's stress hormone system (the HPA axis). While people with long-standing ME/CFS show some changes in this system, early studies suggest these changes may not be present when the illness first develops. Interestingly, lifestyle factors like inactivity and poor sleep may cause these changes, and they can sometimes improve when these factors are addressed.

Endocrine Disruption

E3 PreliminaryDiagnosticPEM not requiredMethods-Paper

Developing and evaluating community-based services through participatory action research: two case examples.

Taylor, Renée R, Braveman, Brent, Hammel, Joy·The American journal of occupational therapy : official publication of the American Occupational Therapy Association·2004

This study shows how occupational therapists can work together with ME/CFS patients and their communities to design better support services. Instead of experts telling people what they need, this approach lets patients and community members have a real voice in deciding what services should be created and how they should work. The researchers used two real-world examples—one with ME/CFS patients and one with AIDS patients—to show how this partnership approach can lead to more helpful and empowering services.

E3 PreliminaryCohortPEM not requiredCase-Control

Q fever (coxiellosis): epidemiology and pathogenesis.

Woldehiwet, Zerai·Research in veterinary science·2004

Q fever is an infection caused by bacteria that spread from animals to humans, usually through contact with infected livestock. In some people, Q fever causes a long-lasting illness with fatigue, similar to ME/CFS symptoms. This review summarizes what we know about how Q fever spreads and why it makes people sick.

[Polyneuritis cranialis HHV-6 infection associated].

Brustia, Diego, Uglietti, Alessia, Garavelli, Pietro Luigi·Recenti progressi in medicina·2004

This case study describes one patient with a rare condition called polyneuritis cranialis (weakness affecting multiple nerves in the head and face) that was linked to a human herpesvirus-6 (HHV-6) infection. The patient was treated with an antiviral medication called ganciclovir, and her symptoms improved only after the virus was completely cleared from her body.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Subjective health complaints, sensitization, and sustained cognitive activation (stress).

Eriksen, H R, Ursin, H·Journal of psychosomatic research·2004

This review suggests that common symptoms like pain, tiredness, sleep problems, and digestive issues in conditions like ME/CFS may occur when the body's normal sensing system becomes overly sensitive. Rather than being caused by hidden disease, these symptoms may develop when people experience sustained stress and feel helpless, causing the nervous system to amplify normal bodily signals until they become unbearable.

Pain and SensitizationCognitive Impairment

E3 PreliminaryPEM not required

[Appraisal of Lyme borreliosis].

Hausotter, W·Versicherungsmedizin·2004

Lyme disease is an infection spread by tick bites that can cause many different symptoms affecting multiple body systems. This article discusses how doctors can better identify and diagnose Lyme disease, especially since its symptoms overlap with conditions like fibromyalgia and chronic fatigue syndrome. People who work outdoors in areas where Lyme disease is common face higher infection risks and may qualify for financial compensation if diagnosed.

Evaluation and management of medically unexplained physical symptoms.

Richardson, Ralph D, Engel, Charles C·The neurologist·2004

This article reviews research on medically unexplained physical symptoms (MUPS)—symptoms that persist without clear diagnosis. The authors note that conditions like ME/CFS, fibromyalgia, and others may be more similar than different, and suggest that helpful treatment involves working closely with doctors to gradually increase activity and develop healthy coping strategies rather than relying only on medications.

E3 PreliminaryMechanismPEM not requiredCross-Sectional

High levels of type 2 cytokine-producing cells in chronic fatigue syndrome.

Skowera, A, Cleare, A, Blair, D et al.·Clinical and experimental immunology·2004

This study looked at immune cells in the blood of ME/CFS patients to see if they respond differently than in healthy people. Researchers found that ME/CFS patients had higher levels of immune cells that produce type 2 cytokines—signaling molecules associated with a particular type of immune response. This suggests the immune system in ME/CFS may be stuck in an unusual activation pattern.

E3 PreliminaryMechanismPEM not requiredMechanistic

Muscle metabolism with blood flow restriction in chronic fatigue syndrome.

McCully, Kevin K, Smith, Sinclair, Rajaei, Sheeva et al.·Journal of applied physiology (Bethesda, Md. : 1985)·2004

This study looked at whether ME/CFS patients have problems with blood flow and how their muscles use oxygen during recovery from exercise. Researchers compared 19 ME/CFS patients to 11 healthy people and found that ME/CFS patients had reduced blood flow to muscles during recovery, but this did not actually impair how well their muscles worked or used oxygen.

Chronic fatigue syndrome (cfs).

Adler, Rolf H·Swiss medical weekly·2004

This review examines whether ME/CFS is a single illness or actually several different conditions. The authors found that ME/CFS involves multiple body systems—including the immune system, nervous system, hormones, and muscles—and that psychological factors also play a role. Rather than one disease, they suggest ME/CFS represents the body's emergency stress responses (fight-or-flight and shutdown) being inappropriately activated, and treatment should address the whole person, not just symptoms.

E3 PreliminaryMechanismPEM not requiredMechanistic

Differential-display PCR of peripheral blood for biomarker discovery in chronic fatigue syndrome.

Steinau, Martin, Unger, Elizabeth R, Vernon, Suzanne D et al.·Journal of molecular medicine (Berlin, Germany)·2004

Researchers looked at immune cells from one ME/CFS patient and one healthy person to find differences in which genes were turned on or off. They found about 10 genes that behaved differently between the two people, with most differences present even before exercise. Many of these genes are involved in immune function, suggesting that ME/CFS may involve problems with how the immune system works.