Evidence browser

Awareness and Perception of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Among Pain Specialists: A Questionnaire-Based Study.

Uygun, Gürsan Güneş, Gözükızıl, Salim Taner, Bilen, Ayşegül·Cureus·2025

This study asked pain doctors in Turkey about their knowledge of ME/CFS and how they evaluate and treat patients with the condition. The results show that many pain specialists aren't familiar with ME/CFS, and some hold misconceptions—like thinking it's a type of depression or that intense exercise will help. This matters because pain doctors could potentially help ME/CFS patients, but they need better education about the condition first.

Autonomic Nervous System

An In-Depth Exploration of the Autoantibody Immune Profile in ME/CFS Using Novel Antigen Profiling Techniques.

Germain, Arnaud, Jaycox, Jillian R, Emig, Christopher J et al.·International journal of molecular sciences·2025

This study looked for specific immune proteins called autoantibodies in the blood of ME/CFS patients to see if they might be causing the illness. Researchers tested over 7,500 different immune markers using advanced laboratory techniques in 172 people. Surprisingly, they did not find significant differences in autoantibodies between ME/CFS patients and healthy controls, though they did notice some subtle patterns between men and women with ME/CFS that warrant further investigation.

Immune System

Medication use and symptomology in North American women with myalgic encephalomyelitis/chronic fatigue syndrome.

Pochakom, Angela, MacNevin, Gillian, Madden, Robyn F et al.·Frontiers in medicine·2025

This study surveyed 135 women with ME/CFS in North America to understand what medications they use and how these relate to their symptoms and daily functioning. Most participants were taking an average of 3 medications for ME/CFS-related symptoms, with pain medications being the most common, followed by psychiatric and immune-related medications. Interestingly, the study found a U-shaped pattern: both people using very few medications and those using many medications reported lower physical functioning, while moderate medication use was associated with better functioning.

Interventions

E2 ModerateCohortPEM requiredCross-Sectional

Abnormal T-Cell activation and cytotoxic T-Cell frequency discriminate symptom severity in myalgic encephalomyelitis/chronic fatigue syndrome.

Lee, Ji-Sook, Lacerda, Eliana, Kingdon, Caroline et al.·Journal of translational medicine·2025

This study compared immune system profiles in 96 ME/CFS patients with either mild/moderate or severe disease. Researchers found that people with severe ME/CFS had more activated immune cells and higher levels of inflammatory chemicals, while those with milder disease showed different patterns suggesting their bodies were responding to chronic viral infection. These findings suggest that mild and severe ME/CFS may involve different underlying immune problems, which could eventually help doctors predict disease severity and develop targeted treatments.

Immune System

Patient-reported treatment outcomes in ME/CFS and long COVID.

Eckey, Martha, Li, Peng, Morrison, Braxton et al.·Proceedings of the National Academy of Sciences of the United States of America·2025

This study asked nearly 4,000 ME/CFS and long COVID patients about their experiences with over 150 different treatments to see which ones helped them feel better. The researchers found that ME/CFS and long COVID are very similar illnesses with overlapping symptoms and that patients with each condition responded similarly to treatments. The study also discovered that different patient subgroups—like those with heart rate and blood pressure problems, or those with thinking and memory problems—benefited most from specific types of treatments.

E2 ModerateCohortPEM unclearRegistry-Resource

Unequal access to diagnosis of myalgic encephalomyelitis in England.

Samms, Gemma Louise, Ponting, Chris P·BMC public health·2025

This study examined NHS records from England to understand how many people have ME/CFS and whether diagnosis is fair across different groups. Researchers found that about 100,000 people in England have been officially diagnosed with ME/CFS, but the actual number may be much higher—around 404,000 in the UK. The diagnosis rates varied significantly depending on gender, age, ethnicity, and where people live, suggesting some patients are being missed.

Diagnostics

E2 ModerateBehavioralPEM unclearCross-Sectional

Psychosocial Nursing Diagnoses of Individuals With Myalgic Encephalomyelitis-Chronic Fatigue Syndrome: A Descriptive Study.

Oter-Quintana, Cristina, Alameda-Cuesta, Almudena, Brito-Brito, Pedro Ruymán et al.·Nursing open·2025

This study looked at the emotional and psychological challenges that people with ME/CFS commonly experience. Researchers surveyed 48 adults with ME/CFS and found that most experienced feelings of powerlessness, difficulty coping, and fear. The study identified three different groups of patients: one group with more severe symptoms and greater emotional distress, and two other groups with milder symptoms who were still working or retired.

Abnormal breathing patterns and hyperventilation are common in patients with chronic fatigue syndrome during exercise.

Mancini, Donna M, Brunjes, Danielle L, Cook, Dane et al.·Frontiers in medicine·2025

Researchers studied how patients with ME/CFS breathe during exercise and found that many breathe abnormally in ways that healthy people do not. Specifically, 42% of ME/CFS patients showed irregular breathing patterns, and 32% were breathing too fast and too deeply (hyperventilation). These breathing problems were much more common in ME/CFS patients than in the healthy control group, suggesting that abnormal breathing may be contributing to the fatigue and breathlessness patients experience.

BiomarkersEnergy Metabolism

Circulating Levels of SMPDL3B Define Metabolic Endophenotypes and Subclinical Kidney Alterations in Myalgic Encephalomyelitis.

Rostami-Afshari, Bita, Elremaly, Wesam, McGregor, Neil R et al.·International journal of molecular sciences·2025

Researchers found that people with ME have lower levels of a kidney protein called SMPDL3B in their blood and urine compared to healthy people. This protein is important for keeping the kidney's filtering system working properly. The study also identified several metabolic imbalances in ME patients' blood that are linked to kidney problems. These findings suggest that kidney function may be affected in ME, and this protein could potentially be used as a simple blood test to help understand the disease.

Autonomic Nervous SystemCognitive Impairment

Characterization of Postural Orthostatic Tachycardia Syndrome in Long COVID: Self-reported Data From the LISTEN Study.

Al Mouslmani, Mohammad, Sawano, Mitsuaki, Arun, Adith S et al.·JACC. Advances·2025

This study looked at people with long COVID who also developed POTS (a condition where the heart rate spikes when standing up). Among nearly 600 long COVID patients, about 29% reported having POTS. People with both conditions reported significantly more symptoms—including dizziness, chest pain, extreme fatigue, difficulty exercising, and brain fog—and experienced worse overall health and quality of life compared to those with long COVID alone.

E2 ModerateCohortPEM requiredObservational

Low-dose rapamycin alleviates clinical symptoms of fatigue and PEM in ME/CFS patients via improvement of autophagy: a pilot study.

Ruan, Brian T, Bulbule, Sarojini, Gile, Brooke et al.·Journal of translational medicine·2025

Researchers tested a low-dose drug called rapamycin in 86 ME/CFS patients to see if it could reduce fatigue and post-exertional malaise (PEM). About 74% of patients who completed the first month showed improvements in fatigue, PEM, and other symptoms, and the drug appeared safe with no serious side effects. The study suggests that rapamycin may work by fixing a cellular process called autophagy, which appears to be broken in ME/CFS patients.

Circulating FGF-21 as a Disease-Modifying Factor Associated with Distinct Symptoms and Cognitive Profiles in Myalgic Encephalomyelitis and Fibromyalgia.

Azimi, Ghazaleh, Elremaly, Wesam, Elbakry, Mohamed et al.·International journal of molecular sciences·2025

This study measured a protein called FGF-21 in the blood of people with ME/CFS, fibromyalgia, and both conditions combined, then compared how their symptoms and thinking abilities differed based on their FGF-21 levels. The researchers found that FGF-21 levels—not just the diagnosis alone—were better at predicting which symptoms and cognitive problems each person would experience. This suggests FGF-21 could become a useful blood test to help doctors understand and treat these conditions more precisely.

Post-COVID-19 Condition Risk Factors and Symptom Clusters and Associations With Return to Pre-COVID-19 Health-Results From a 2021 Multistate Survey.

Konkle, Stacey L, Magleby, Reed, Bonacci, Robert A et al.·Clinical infectious diseases : an official publication of the Infectious Diseases Society of America·2025

This study looked at nearly 30% of people who had COVID-19 in 2020 and developed long-term symptoms afterward (post-COVID condition). Among those with ongoing symptoms, about 77% had not fully recovered to their pre-COVID health 2-15 months later. The researchers found that certain symptom patterns—especially fatigue similar to ME/CFS, upper respiratory problems, and digestive issues—were most strongly linked to prolonged recovery.

E2 ModerateCohortPEM unclearObservational

Absence of BOLD adaptation in chronic fatigue syndrome revealed by task functional MRI.

Schönberg, Laura, Mohamed, Abdalla Z, Yu, Qiang et al.·Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism·2025

This study looked at how the brain responds when people with ME/CFS do mental tasks, using brain imaging to measure blood flow. Researchers found that while healthy people's brains become more efficient with repeated effort (showing less activation over time), people with ME/CFS showed the opposite pattern—their brains actually increased activity with each repetition. This suggests that ME/CFS may involve a fundamental difference in how the brain adapts to mental work, potentially explaining why cognitive tasks feel so exhausting.

Cognitive Impairment

E2 ModerateCohortPEM unclearCase-Control

People with Long Covid and ME/CFS Exhibit Similarly Impaired Balance and Physical Capacity: A Case-Case-Control Study.

Hayes, Lawrence D, Sanal-Hayes, Nilihan E M, Mclaughlin, Marie et al.·The American journal of medicine·2025

This study compared balance and physical strength in people with long COVID, people with ME/CFS, and healthy volunteers. Both long COVID and ME/CFS patients showed significantly worse balance during standing and took longer to perform simple physical tasks like standing up from a chair compared to healthy people. Importantly, the balance and strength problems were equally severe in both groups, despite long COVID being a much newer illness.

E2 ModerateCohortPEM requiredLongitudinal

Autonomic Dysfunction in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Findings from the Multi-Site Clinical Assessment of ME/CFS (MCAM) Study in the USA.

Issa, Anindita, Lin, Jin-Mann S, Chen, Yang et al.·Journal of clinical medicine·2025

This study found that people with ME/CFS experience much higher levels of autonomic nervous system problems—which control things like heart rate, blood pressure, and digestion—compared to healthy people. Nearly all ME/CFS patients (97%) had at least one autonomic symptom, with common complaints including dizziness, cold hands and feet, and difficulty standing up. The more autonomic symptoms someone had, especially in certain areas like blood pressure regulation and stomach problems, the more severe their overall illness tended to be.

Autonomic Nervous System

Temporal Dynamics of the Plasma Proteomic Landscape Reveals Maladaptation in ME/CFS Following Exertion.

Germain, Arnaud, Glass, Katherine A, Eckert, Melissa A et al.·Molecular & cellular proteomics : MCP·2025

Researchers studied what happens in the blood of ME/CFS patients during and after exercise to understand post-exertional malaise (PEM)—the worsening of symptoms that occurs after physical activity. They measured over 6,000 different proteins in 79 ME/CFS patients and 53 healthy controls before exercise, immediately after, and during recovery. They found that ME/CFS patients have abnormal protein changes during recovery that suggest their immune system and energy-producing cells are not working properly after exertion.

Immune SystemPost-Exertional Malaise