Evidence browser

E3 PreliminaryDiagnosticPEM not requiredMethods-Paper

Eradication of persistent coxsackievirus B infection from a pancreatic cell line with clinically used antiviral drugs.

Honkimaa, Anni, Sioofy-Khojine, Amir-Babak, Oikarinen, Sami et al.·Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology·2020

This study tested whether common antiviral medications could eliminate persistent coxsackievirus B infections in laboratory pancreatic cells. Researchers found that four drugs—Enviroxime, Fluoxetine, Hizentra (an immune protein), and Pleconaril—successfully cleared the virus from infected cells. The results suggest these medications might be worth testing in patients with chronic enterovirus infections.

Clinical History Segment Extraction from Chronic Fatigue Syndrome Assessments to Model Disease Trajectories.

Priou, Sonia, Viani, Natalia, Vernugopan, Veshalee et al.·Studies in health technology and informatics·2020

Researchers developed a computer method to automatically read and extract important information from patient medical records about ME/CFS. Since doctors write many patient notes in free text rather than structured data, this tool helps pull out symptom descriptions and track how the illness changes over time for individual patients. This approach could help researchers understand common patterns in how ME/CFS affects different people.

Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Washington, Stuart D, Rayhan, Rakib U, Garner, Richard et al.·Brain communications·2020

This study used brain imaging to compare how the brains of people with ME/CFS and Gulf War Illness respond to exercise during a memory task. Researchers found that exercise affected brain activity differently in the two conditions—specifically in areas related to pain awareness, attention, and threat detection. These differences suggest that ME/CFS and Gulf War Illness may involve distinct biological mechanisms, which could help doctors distinguish between them.

E3 PreliminaryCohortPEM unclearObservational

What ME/CFS caregivers want you to know.

Ausubel, Bobbi·Work (Reading, Mass.)·2020

This study asked ME/CFS caregivers—people who provide care and support to those with the illness—what they wanted others to understand about their experience. The research collected information about the challenges caregivers face, what they wish people knew about ME/CFS, and how caring for someone with this illness affects their own lives. Understanding caregiver perspectives helps improve support systems and raise awareness about ME/CFS.

E3 PreliminaryCohortPEM unclearObservational

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Organic Disease or Psychosomatic Illness? A Re-Examination of the Royal Free Epidemic of 1955.

Underhill, Rosemary, Baillod, Rosemarie·Medicina (Kaunas, Lithuania)·2020

This study examined a major ME/CFS outbreak that occurred at Royal Free Hospital in London in 1955, which forced the hospital to close for three months. Researchers interviewed 27 former staff members who experienced the outbreak and found their descriptions matched an infectious illness affecting the lymph nodes, muscles, and nervous system—not mass hysteria as some had claimed 15 years after the event. The study provides firsthand evidence that the 1955 epidemic was a real physical illness, not a psychological one.

E3 PreliminaryCohortPEM unclearCase-Control

Low-dose naltrexone as a treatment for chronic fatigue syndrome.

Bolton, Monica Jane, Chapman, Bryan Paul, Van Marwijk, Harm·BMJ case reports·2020

This study describes three people with ME/CFS who tried taking low-dose naltrexone (LDN), a medication sometimes used off-label for immune-related conditions. The patients experienced different results—some reported major improvements in their quality of life, while others noticed only modest reductions in specific symptoms like pain or fatigue. The doses used were quite small (4-12 mg), and the authors suggest that larger clinical trials might be worth doing to properly test whether LDN could help ME/CFS patients.

E3 PreliminaryMechanismPEM not requiredCross-Sectional

Antibody-Dependent Cell-mediated Cytotoxicity (ADCC) in Familial Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

Sung, Alexander P, Tang, Jennifer J-J, Guglielmo, Michael J et al.·Fatigue : biomedicine, health & behavior·2020

This study looked at immune cells called NK cells in families where multiple members have ME/CFS. The researchers found that ME/CFS patients and their healthy family members both had fewer of a specific type of NK cell and weaker immune responses compared to unrelated healthy people. This suggests that a genetic weakness in immune cell function might run in families and could increase the risk of developing ME/CFS.

Immune System

Does Motor Cortex Engagement During Movement Preparation Differentially Inhibit Nociceptive Processing in Patients with Chronic Whiplash Associated Disorders, Chronic Fatigue Syndrome and Healthy Controls? An Experimental Study.

Goudman, Lisa, Mouraux, André, Daenen, Liesbeth et al.·Journal of clinical medicine·2020

This study looked at whether the brain's pain-blocking system works differently in ME/CFS patients compared to healthy people when preparing to move. Researchers measured brain activity using brain wave recordings while participants received painful laser stimuli under different conditions. They found that preparing to move actually reduced pain signals in the brain similarly in ME/CFS patients, chronic whiplash patients, and healthy controls—suggesting the motor system's pain-blocking ability may not be the problem researchers expected.

E3 PreliminaryReviewPEM unclearEvidence-Map

[What scientific evidence do the current classifications have in order to assess occupational disability in patients with central sensitisation syndrome?].

Regal Ramos, R J·Semergen·2020

This study looked at whether doctors have good, scientific ways to measure how much ME/CFS and related conditions limit a person's ability to work. The researchers found that while many different rating systems exist, none of them have strong enough evidence to be considered reliable. This is a significant problem because patients need fair, consistent methods to document their disability for work accommodations and benefits.

Diagnostics

E3 PreliminaryCohortPEM unclearCase-Control

Impact of Myalgic Encephalomyelitis on treatment of comorbidities: A lived experience.

Lopez-Majano, Denise·Work (Reading, Mass.)·2020

This study shares the real-life story of two siblings who both have ME and other health conditions. It explains how ME makes it very difficult to treat other illnesses they have, because ME symptoms can get worse with standard medical treatments. The study highlights why doctors need to understand how ME affects daily life so they can help treat other conditions without making ME worse.

E3 PreliminaryDiagnosticPEM unclearMethods-Paper

Substrate utilisation of cultured skeletal muscle cells in patients with CFS.

Tomas, Cara, Elson, Joanna L, Newton, Julia L et al.·Scientific reports·2020

This study examined how muscle cells from ME/CFS patients use different fuels for energy compared to healthy people. Researchers found that ME/CFS muscle cells have trouble using glucose (a key fuel source) for energy, but can still use other fuels normally. This suggests the energy-producing problem in ME/CFS starts very early in the energy-making process, and may be caused by something genetic or chemical that persists even when cells are grown in a laboratory.

Energy Metabolism

Extracting medication information from unstructured public health data: a demonstration on data from population-based and tertiary-based samples.

Chen, Robert, Ho, Joyce C, Lin, Jin-Mann S·BMC medical research methodology·2020

Researchers developed a computer program to automatically read through medical records and extract information about what medications ME/CFS patients are taking and why they're taking them. Instead of having someone manually review thousands of medication entries (which is slow and error-prone), their automated system condensed over 1,200 different medication names into 89 standard categories and organized reasons for use into 65 categories. This tool could help future research studies more quickly analyze medication patterns in ME/CFS patients.

E3 PreliminaryMechanismPEM unclearMechanistic

Activation of Transposable Elements in Immune Cells of Fibromyalgia Patients.

Ovejero, Tamara, Sadones, Océane, Sánchez-Fito, Teresa et al.·International journal of molecular sciences·2020

Researchers discovered that fibromyalgia patients have unusual activity of genetic sequences called transposable elements (pieces of DNA that can move and copy themselves) in their immune cells. This overactivity was linked to higher levels of interferon proteins, which trigger inflammation and flu-like symptoms. This finding may help explain why fibromyalgia patients often feel sick even when they don't have an actual infection.

Immune System

E3 PreliminaryMechanismPEM unclearCross-Sectional

Altered muscle membrane potential and redox status differentiates two subgroups of patients with chronic fatigue syndrome.

Jammes, Yves, Adjriou, Nabil, Kipson, Nathalie et al.·Journal of translational medicine·2020

This study examined muscle function and stress markers in 72 ME/CFS patients during rest, exercise, and recovery. Researchers found that about half the patients showed significant changes in how their muscles respond to electrical signals, combined with higher levels of oxidative stress (cellular damage from chemical imbalance). The other half showed normal muscle responses and lower stress markers. This suggests ME/CFS may include at least two different biological subtypes.

Informatics Inference of Exercise-Induced Modulation of Brain Pathways Based on Cerebrospinal Fluid Micro-RNAs in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Narayan, Vaishnavi, Shivapurkar, Narayan, Baraniuk, James N·Network and systems medicine·2020

This study looked at tiny molecules called microRNAs in spinal fluid to understand why ME/CFS patients feel worse after exercise (post-exertional malaise). Researchers compared spinal fluid from patients who rested overnight with fluid from patients who had exercised, finding that certain microRNAs were lower after exercise. The study suggests this change might affect how cells stick together and communicate in the brain and nervous system.

BiomarkersPost-Exertional Malaise

Profile of circulating microRNAs in myalgic encephalomyelitis and their relation to symptom severity, and disease pathophysiology.

Nepotchatykh, Evguenia, Elremaly, Wesam, Caraus, Iurie et al.·Scientific reports·2020

This study looked at tiny molecules called microRNAs in the blood of severely ill ME/CFS patients before and after a stress challenge designed to trigger post-exertional malaise (the worsening of symptoms after activity). The researchers found that eleven different microRNAs changed in response to this challenge, with patterns that varied depending on symptom severity. These microRNA signatures could potentially be used one day as blood tests to help diagnose ME/CFS.

Exercise alters cerebellar and cortical activity related to working memory in phenotypes of Gulf War Illness.

Washington, Stuart D, Rayhan, Rakib U, Garner, Richard et al.·Brain communications·2020

This study looked at how exercise affects brain activity in Gulf War veterans with illness that causes fatigue, pain, and cognitive problems after physical or mental effort. Researchers used brain imaging to measure how the brain worked during a memory task before and after exercise in three different subgroups of affected veterans. They found that exercise changed how specific brain regions functioned, but only in those with Gulf War Illness—not in healthy controls.