Evidence browser

Homebound versus Bedridden Status among Those with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Conroy, Karl, Bhatia, Shaun, Islam, Mohammed et al.·Healthcare (Basel, Switzerland)·2021

This study looked at over 2,100 people with ME/CFS to understand different levels of severity, focusing on those who are homebound (unable to leave home) and bedridden (unable to leave bed). The researchers found that people who are bedridden experience post-exertional malaise (PEM)—a worsening of symptoms after physical or mental activity—differently or more severely than those who are only homebound. This research helps doctors and patients better understand how severe ME/CFS can become.

Complement Component C1q as a Potential Diagnostic Tool for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Subtyping.

Castro-Marrero, Jesús, Zacares, Mario, Almenar-Pérez, Eloy et al.·Journal of clinical medicine·2021

Researchers analyzed blood samples from 250 women with ME/CFS to see if specific blood markers could help identify different types of the disease. They found that about 43% of participants had high levels of a protein called C1q, which was particularly associated with those experiencing more pain symptoms. This discovery suggests that blood tests might one day help doctors identify which ME/CFS patients belong to which subgroup, potentially leading to better tailored treatments.

E2 ModerateCohortPEM not requiredCross-Sectional

Lowered serum cesium levels in schizophrenia: association with immune-inflammatory biomarkers and cognitive impairments.

Almulla, Abbas F, Moustafa, Shatha R, Al-Dujaili, Arafat H et al.·Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)·2021

This study looked at a mineral called cesium in the blood of people with schizophrenia and compared it to healthy people. They found that people with schizophrenia had lower cesium levels, and this was connected to cognitive problems (like memory and thinking difficulties), fatigue symptoms, and signs of immune system activity. The researchers suggest that low cesium might contribute to some of the symptoms seen in schizophrenia.

E2 ModerateCohortPEM not requiredCross-Sectional

The maintained attention assessment in patients affected by Myalgic encephalomyelitis/chronic fatigue syndrome: a reliable biomarker?

Murga, Iñigo, Aranburu, Larraitz, Gargiulo, Pascual A et al.·Journal of translational medicine·2021

This study looked at attention problems in ME/CFS patients by giving them a simple attention test (the Toulouse-Piéron test) and comparing their results to healthy people. Most ME/CFS patients had normal overall thinking skills, but 70% showed very low attention scores and complained of mental fatigue. Women with ME/CFS reported feeling more effort during the test than men did, even though their attention scores were similar.

Biomarkers

E2 ModerateCohortPEM requiredObservational

Markers of Cardiac Autonomic Function During Consecutive Day Peak Exercise Tests in People With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Nelson, Maximillian J, Buckley, Jonathan D, Thomson, Rebecca L et al.·Frontiers in physiology·2021

This study looked at how the hearts of ME/CFS patients respond to exercise on two consecutive days, comparing them to healthy people. Researchers measured heart rate patterns and recovery after exercise, finding that ME/CFS patients had slower heart rate recovery after working out. However, these measurements alone were not reliable enough to diagnose ME/CFS, suggesting that a single heart rate test may not be a useful diagnostic tool on its own.

E2 ModerateCohortPEM requiredCase-Control

Hypothalamic-Pituitary Autoimmunity and Related Impairment of Hormone Secretions in Chronic Fatigue Syndrome.

De Bellis, Annamaria, Bellastella, Giuseppe, Pernice, Vlenia et al.·The Journal of clinical endocrinology and metabolism·2021

This study looked for specific immune system antibodies that attack the pituitary and hypothalamus—two small brain structures that control hormone production—in people with ME/CFS. Researchers found these antibodies in more than half of ME/CFS patients but none in healthy controls. Patients with these antibodies had lower levels of important hormones (like cortisol and growth hormone), and those with the highest antibody levels had the most severe ME/CFS symptoms.

Medical Care Situation of People with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Germany.

Froehlich, Laura, Hattesohl, Daniel B R, Jason, Leonard A et al.·Medicina (Kaunas, Lithuania)·2021

This study surveyed nearly 500 people with ME/CFS in Germany to understand how well they can access medical care and how satisfied they are with the care they receive. The researchers found that many patients struggle to get medical help because of cost and distance, and many are unhappy with their doctors' care. The study also created and tested a German language symptom questionnaire that could help doctors diagnose ME/CFS.

Limbic Perfusion Is Reduced in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

Li, Xia, Julin, Per, Li, Tie-Qiang·Tomography (Ann Arbor, Mich.)·2021

Researchers used a specialized brain imaging technique to measure blood flow in the brains of ME/CFS patients and compared it to healthy people. They found that patients with ME/CFS have reduced blood flow in several areas of the limbic system—the part of the brain that helps control emotions, automatic body functions, and memory. The amount of reduced blood flow was also linked to how severe patients' symptoms were.

Autonomic Nervous System

Parent-child discrepancies in health-related quality of life of children and adolescents with myalgic encephalomyelitis/chronic fatigue syndrome.

Ekberg, Krista M, Torres, Chelsea, Jason, Leonard A·Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation·2021

This study looked at whether parents and their children with ME/CFS report symptoms and quality of life differently. Researchers compared 75 families where children had ME/CFS and 72 families without the condition, asking both parents and children to describe the child's health and symptoms. They found that parents and children often gave different answers, suggesting that both perspectives are important for understanding how ME/CFS affects young people.

Orthostatic Symptoms and Reductions in Cerebral Blood Flow in Long-Haul COVID-19 Patients: Similarities with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Campen, C Linda M C van, Rowe, Peter C, Visser, Frans C·Medicina (Kaunas, Lithuania)·2021

This study compared people with long-haul COVID-19 to people with ME/CFS to see if they experience similar problems with dizziness and blood flow when standing up. Researchers found that long-haul COVID patients had very similar symptoms to ME/CFS patients and showed even greater reductions in blood flow to the brain during tilt testing. The findings suggest that COVID-19 infection may trigger ME/CFS-like illness in some people.

Autonomic Nervous System

A preliminary investigation of nutritional intake and supplement use in Australians with myalgic encephalomyelitis/chronic fatigue syndrome and the implications on health-related quality of life.

Weigel, Breanna, Eaton-Fitch, Natalie, Passmore, Rachel et al.·Food & nutrition research·2021

This study looked at what Australian ME/CFS patients eat and what supplements they take, and whether these choices affect their quality of life. Researchers surveyed 24 ME/CFS patients online and compared their diets to the general Australian population. They found that ME/CFS patients use supplements much more often than the general public, but couldn't find a clear link between specific nutrients or supplements and how patients felt.

Medical School Education on Myalgic Encephalomyelitis.

Muirhead, Nina, Muirhead, John, Lavery, Grace et al.·Medicina (Kaunas, Lithuania)·2021

This study looked at how much medical schools in the UK teach doctors-in-training about ME/CFS. Researchers sent questionnaires to all 34 UK medical schools and found that only about half actually teach ME/CFS, and the teaching varies widely between schools. Most schools said they would welcome better teaching materials and resources about ME/CFS, suggesting doctors need more education on how to recognize and diagnose this condition.

Diagnostics

Monitoring treatment harm in myalgic encephalomyelitis/chronic fatigue syndrome: A freedom-of-information study of National Health Service specialist centres in England.

McPhee, Graham, Baldwin, Adrian, Kindlon, Tom et al.·Journal of health psychology·2021

This study looked at how 38 ME/CFS specialist clinics in England monitor and report harms from treatments like graded exercise therapy and cognitive behavioural therapy. Researchers found that clinics were inconsistent in how they handle treatment-related harm, rarely warned patients about potential risks in their written materials, and reported zero cases of harm despite knowing many patients dropped out of treatment. The study suggests clinics need better systems to detect, record, and stop treatments when patients are being harmed.

Diffusion tensor imaging reveals neuronal microstructural changes in myalgic encephalomyelitis/chronic fatigue syndrome.

Thapaliya, Kiran, Marshall-Gradisnik, Sonya, Staines, Donald et al.·The European journal of neuroscience·2021

This study used a specialized brain imaging technique called diffusion tensor imaging (DTI) to look for structural changes in the brains of ME/CFS patients compared to healthy people. The researchers found subtle differences in how water moves through certain nerve fiber pathways in the brains of patients who met strict diagnostic criteria for ME/CFS, particularly in areas controlling movement, coordination, and breathing. These brain changes were linked to patient symptoms like difficulty processing information, fatigue, and sleep problems.

Subcortical brain segment volumes in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Addiego, Florencia Martinez, Zajur, Kristina, Knack, Sarah et al.·Life sciences·2021

Researchers used brain imaging to measure the size of deep brain structures in people with ME/CFS, Gulf War Illness, and healthy controls. They found that men and women with these conditions had different patterns of brain volume changes, suggesting that sex differences play an important role in how these illnesses affect the brain. The findings suggest that previous brain imaging studies may need to be reconsidered to account for whether participants were male or female.

Patients with Persistent Polyclonal B-Cell Lymphocytosis Share the Symptomatic Criteria of Systemic Exertion Intolerance Disease.

Morizot, Romain, de Korwin, Jean-Dominique, Feugier, Pierre et al.·Journal of clinical medicine·2021

Researchers studied a rare blood condition called persistent polyclonal B-cell lymphocytosis (PPBL) and found that most patients with PPBL experience symptoms very similar to ME/CFS, including severe fatigue that doesn't improve with rest, worsening after physical activity, sleep problems, and difficulty thinking clearly. Out of 39 patients surveyed, 72% met the official criteria for ME/CFS, and nearly all reported chronic fatigue lasting more than 6 months. This finding suggests these two conditions may share common underlying features, though more research is needed to understand why.

E2 ModerateCohortPEM not requiredCross-Sectional

Clinical Heterogeneity in ME/CFS. A Way to Understand Long-COVID19 Fatigue.

Murga, Iñigo, Aranburu, Larraitz, Gargiulo, Pascual A et al.·Frontiers in psychiatry·2021

This study examined 84 ME/CFS patients and 22 healthy controls using questionnaires to measure fatigue, pain, sleep quality, heart rate problems, thinking difficulties, mood, and other symptoms. Researchers used statistical clustering to group patients into five distinct subtypes based on their symptom patterns. The findings suggest that ME/CFS is not one-size-fits-all—some patients have high anxiety and depression without fibromyalgia, while others have fibromyalgia combined with heart rate regulation problems, hormone imbalances, or immune issues.

Immune SystemPost-Exertional Malaise

E2 ModerateBehavioralPEM not requiredCross-Sectional

Prevalence and correlates of chronic fatigue syndrome and post-traumatic stress disorder after the outbreak of the COVID-19.

Simani, Leila, Ramezani, Mahtab, Darazam, Ilad Alavi et al.·Journal of neurovirology·2021

This study looked at whether people who survived COVID-19 developed chronic fatigue syndrome (ME/CFS) or PTSD within 6 months of infection. Among 120 COVID-19 survivors in Iran, about 2.5% met the criteria for ME/CFS and 5.8% showed signs of PTSD. Interestingly, the researchers found that having PTSD was not linked to developing ME/CFS in these patients.

Long COVID Overlap

E2 ModerateCohortPEM requiredCase-Control

Fine mapping of the major histocompatibility complex (MHC) in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) suggests involvement of both HLA class I and class II loci.

Hajdarevic, Riad, Lande, Asgeir, Rekeland, Ingrid et al.·Brain, behavior, and immunity·2021

This study looked at genes related to the immune system in people with ME/CFS to understand why some people develop the condition. Researchers compared genetic markers in 427 Norwegian ME/CFS patients with 480 healthy controls and found two specific genetic regions associated with ME/CFS—one involving immune system genes that present antigens to cells, and another in a different immune region. These findings suggest the immune system's ability to recognize and respond to threats may play a role in ME/CFS.