Evidence browser

Restricted Spatial Windows of Visibility in Myalgic Encephalomyelitis (ME).

Ahmed, Nadia S, Gottlob, Irene, Proudlock, Frank A et al.·Vision (Basel, Switzerland)·2018

This study looked at how ME affects vision by testing how well people can see contrast (the difference between light and dark areas). Researchers tested 19 people with ME and 19 healthy people by asking them to identify faint striped patterns. People with ME had more difficulty seeing these patterns, especially at lower levels of detail, suggesting that ME may affect how the eyes and brain process visual information.

Weighting of orthostatic intolerance time measurements with standing difficulty score stratifies ME/CFS symptom severity and analyte detection.

Richardson, Alice M, Lewis, Don P, Kita, Badia et al.·Journal of translational medicine·2018

This study tested a new way to measure ME/CFS severity by combining how long patients can stand with how difficult standing feels to them. Researchers found that this combined measurement (called weighted standing time) was significantly different between ME/CFS patients and healthy people, and it also related to differences in certain inflammation markers in the blood. This suggests that a simple standing test could help doctors diagnose ME/CFS and track how severe a patient's symptoms are.

Insights into myalgic encephalomyelitis/chronic fatigue syndrome phenotypes through comprehensive metabolomics.

Nagy-Szakal, Dorottya, Barupal, Dinesh K, Lee, Bohyun et al.·Scientific reports·2018

Researchers studied blood and gut bacteria samples from 50 people with ME/CFS and 50 healthy people to find biological markers of the disease. They found that people with ME/CFS have abnormal levels of certain substances in their blood called metabolites, particularly a fatty molecule called ceramide in those who also have irritable bowel syndrome. When scientists combined information about both blood metabolites and gut bacteria, they could identify ME/CFS patients more accurately than using either test alone.

Hand Grip Strength as a Clinical Biomarker for ME/CFS and Disease Severity.

Nacul, Luis Carlos, Mudie, Kathleen, Kingdon, Caroline C et al.·Frontiers in neurology·2018

Researchers tested whether hand grip strength could be a useful tool for diagnosing ME/CFS and measuring how severe the condition is. They found that people with ME/CFS—especially those with severe disease—have noticeably weaker grip strength compared to healthy people, and their grip strength drops more across repeated tests. This simple, objective test may help doctors better diagnose ME/CFS and track how patients are doing over time.

E2 ModeratePEM unclearBiobank-Resource

The UK ME/CFS Biobank: A Disease-Specific Biobank for Advancing Clinical Research Into Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Lacerda, Eliana M, Mudie, Kathleen, Kingdon, Caroline C et al.·Frontiers in neurology·2018

Researchers in the UK created a special collection of biological samples (like blood) and health information from 600 people—including those with ME/CFS, people with multiple sclerosis, and healthy volunteers. This resource, called the UK ME/CFS Biobank, was designed to help scientists study ME/CFS more effectively and find reliable ways to diagnose the disease. The biobank is being shared with researchers around the world to speed up discovery.

E2 ModerateCohortPEM not requiredCross-Sectional

Structural brain changes versus self-report: machine-learning classification of chronic fatigue syndrome patients.

Sevel, Landrew S, Boissoneault, Jeff, Letzen, Janelle E et al.·Experimental brain research·2018

Researchers compared two methods for identifying ME/CFS patients: looking at structural brain changes on MRI scans versus asking patients to rate their symptoms like fatigue, pain, and sleep quality. While brain imaging showed some useful differences between ME/CFS patients and healthy people, patients' own descriptions of their symptoms were actually better at identifying who had ME/CFS.

Prospective Biomarkers from Plasma Metabolomics of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Implicate Redox Imbalance in Disease Symptomatology.

Germain, Arnaud, Ruppert, David, Levine, Susan M et al.·Metabolites·2018

Researchers studied blood samples from 32 women with ME/CFS and 19 healthy women to look for chemical differences. They found 14 metabolites (small molecules in the blood) that were different in ME/CFS patients, suggesting their bodies may have trouble managing oxidative stress—a chemical imbalance that could contribute to their symptoms. This discovery could eventually help doctors identify ME/CFS through a blood test.

E2 ModerateCohortPEM unclearCase-Control

Identification of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome-associated DNA methylation patterns.

Trivedi, Malav S, Oltra, Elisa, Sarria, Leonor et al.·PloS one·2018

Researchers studied chemical tags on DNA (called methylation) in people with ME/CFS compared to healthy people. While the overall amount of these tags was similar between groups, they found specific locations on thousands of genes where the tags differed. Many of these differences were in genes involved in immune system function, which aligns with what doctors already know about ME/CFS affecting immunity.

E2 ModeratePEM unclearBiobank-Resource

The UK ME/CFS Biobank for biomedical research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Multiple Sclerosis.

Lacerda, Eliana M, Bowman, Erinna W, Cliff, Jacqueline M et al.·Open journal of bioresources·2017

The UK ME/CFS Biobank is a collection of blood samples and health information from 284 people with ME/CFS, 60 people with multiple sclerosis, and 135 healthy volunteers. Researchers created this resource to help scientists study what causes ME/CFS and find better ways to diagnose and treat it. The samples and detailed patient information can be used by researchers worldwide to search for biological markers of the disease.

BiomarkersEnergy Metabolism

Fecal metagenomic profiles in subgroups of patients with myalgic encephalomyelitis/chronic fatigue syndrome.

Nagy-Szakal, Dorottya, Williams, Brent L, Mishra, Nischay et al.·Microbiome·2017

This study looked at the bacteria living in the gut of 50 ME/CFS patients and 50 healthy people to see if differences in gut bacteria might explain some ME/CFS symptoms. The researchers found that ME/CFS patients have unusual patterns of gut bacteria, and these patterns are different depending on whether the patient also has irritable bowel syndrome (IBS). Importantly, the type and balance of gut bacteria were linked to how severe patients' fatigue, pain, and other symptoms were.

BiomarkersEnergy Metabolism

Metabolic profiling of a myalgic encephalomyelitis/chronic fatigue syndrome discovery cohort reveals disturbances in fatty acid and lipid metabolism.

Germain, Arnaud, Ruppert, David, Levine, Susan M et al.·Molecular bioSystems·2017

This study examined the chemicals in the blood of 17 ME/CFS patients and compared them to 15 healthy people. Researchers found 74 different chemicals at abnormal levels in ME/CFS patients, with 35 showing significant differences. Many of these chemicals are important for producing energy in the body, which could help explain why ME/CFS patients feel so exhausted.

E2 ModerateCohortPEM unclearCase-Control

Multimodal and simultaneous assessments of brain and spinal fluid abnormalities in chronic fatigue syndrome and the effects of psychiatric comorbidity.

Natelson, Benjamin H, Mao, Xiangling, Stegner, Aaron J et al.·Journal of the neurological sciences·2017

This study compared brain and spinal fluid measurements in people with ME/CFS and healthy controls to understand what physical changes occur in the condition. Researchers found that ME/CFS patients had lower levels of a protective brain chemical (glutathione), reduced blood flow to the brain, higher levels of lactate (a sign of energy problems), and more abnormalities in spinal fluid compared to healthy people. Importantly, these differences were the same whether or not ME/CFS patients also had depression or anxiety, suggesting psychiatric conditions are not making the disease worse.

E2 ModerateCohortPEM not requiredCase-Control

Elevated brain natriuretic peptide levels in chronic fatigue syndrome associate with cardiac dysfunction: a case control study.

Tomas, Cara, Finkelmeyer, Andreas, Hodgson, Tim et al.·Open heart·2017

This study found that people with ME/CFS have higher levels of a hormone called BNP (brain natriuretic peptide) in their blood compared to healthy people without the condition. Interestingly, those with higher BNP levels had smaller heart chambers, which suggests their hearts may be working differently in ME/CFS. The researchers believe this finding is related to the condition itself, not simply from being inactive.

Illness progression in chronic fatigue syndrome: a shifting immune baseline.

Russell, Lindsey, Broderick, Gordon, Taylor, Renee et al.·BMC immunology·2016

This study looked at three inflammatory proteins (IL-1α, IL-6, and IL-8) in the blood of people with ME/CFS at different stages of illness—newly diagnosed teenagers, people in the middle of their illness, and those who had been sick for over a decade. The researchers found that the pattern of these proteins changes as the illness progresses, suggesting that the body's immune response shifts over time. By adjusting for how long someone has been ill, doctors might be able to use these three proteins together to identify ME/CFS with 75-88% accuracy.

E2 ModerateCohortPEM not requiredCross-Sectional

Index markers of chronic fatigue syndrome with dysfunction of TCA and urea cycles.

Yamano, Emi, Sugimoto, Masahiro, Hirayama, Akiyoshi et al.·Scientific reports·2016

Researchers analyzed blood samples from ME/CFS patients and healthy people to look for chemical markers that could help diagnose the disease. They found that certain metabolites—molecules involved in energy production and waste removal—were abnormal in ME/CFS patients. Two specific chemical ratios in the blood showed promise as potential diagnostic tools, correctly identifying CFS patients about 75-80% of the time.

BiomarkersEnergy Metabolism

E2 ModerateCohortPEM not requiredLongitudinal

Tracking post-infectious fatigue in clinic using routine Lab tests.

Harvey, Jeanna M, Broderick, Gordon, Bowie, Alanna et al.·BMC pediatrics·2016

Researchers followed 301 teenagers who had infectious mononucleosis to see who would develop chronic fatigue syndrome (ME/CFS). They found that measuring common blood tests over 2 years—including stress hormones, sex hormones, and immune cell counts—might help doctors identify which patients are at risk and confirm the diagnosis. Only 4% of the teens developed CFS, but specific blood markers showed different patterns in those who did compared to those who recovered normally.

Gene Expression Factor Analysis to Differentiate Pathways Linked to Fibromyalgia, Chronic Fatigue Syndrome, and Depression in a Diverse Patient Sample.

Iacob, Eli, Light, Alan R, Donaldson, Gary W et al.·Arthritis care & research·2016

Researchers studied blood cell genes from 261 people—including those with ME/CFS, fibromyalgia, depression, and healthy controls—to see if certain genes work together in patterns tied to these conditions. They found four distinct gene clusters, and two of these clusters showed opposite patterns in ME/CFS patients compared to those with depression, suggesting these conditions may involve different biological pathways even when they overlap.

E2 ModerateMechanismPEM unclearMechanistic

Antibodies to β adrenergic and muscarinic cholinergic receptors in patients with Chronic Fatigue Syndrome.

Loebel, Madlen, Grabowski, Patricia, Heidecke, Harald et al.·Brain, behavior, and immunity·2016

Researchers tested whether ME/CFS patients have unusually high levels of antibodies (immune proteins) that attack nerve signaling receptors in the body. They found that about 30% of ME/CFS patients had elevated antibodies against certain receptors involved in adrenaline and acetylcholine signaling—chemicals that control heart rate, breathing, and other automatic body functions. Importantly, patients who received rituximab (a treatment that depletes B cells) and improved showed decreases in these antibody levels, suggesting a possible link between these antibodies and disease activity.

Reductions in circulating levels of IL-16, IL-7 and VEGF-A in myalgic encephalomyelitis/chronic fatigue syndrome.

Landi, Abdolamir, Broadhurst, David, Vernon, Suzanne D et al.·Cytokine·2016

Researchers measured 34 different immune system proteins in blood samples from 100 ME/CFS patients and 79 healthy controls. They found that three specific immune proteins—IL-16, IL-7, and VEGF-A—were significantly lower in ME/CFS patients. This pattern was different from what is seen in other chronic diseases with similar fatigue symptoms, suggesting it may be unique to ME/CFS.

E2 ModerateCohortPEM not requiredCase-Control

A potential biomarker for fatigue: Oxidative stress and anti-oxidative activity.

Fukuda, Sanae, Nojima, Junzo, Motoki, Yukari et al.·Biological psychology·2016

This study looked at whether certain markers of cellular damage from harmful molecules (oxidative stress) and the body's ability to repair that damage (antioxidant capacity) could be used to identify ME/CFS patients and measure their fatigue levels. Researchers compared these markers in ME/CFS patients at rest versus healthy people during and after exercise, finding that ME/CFS patients had a different pattern of these markers compared to healthy controls.