Evidence browser

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 unclearCase-Control

Reduced Parasympathetic Reactivation during Recovery from Exercise in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Van Oosterwijck, Jessica, Marusic, Uros, De Wandele, Inge et al.·Journal of clinical medicine·2021

This study examined how the nervous system controls heart rate and other body functions in ME/CFS patients compared to healthy people, both at rest and after exercise. Researchers found that while ME/CFS patients had normal nerve function at rest, their bodies had difficulty recovering after exercise—specifically, their parasympathetic nervous system (the 'rest and digest' system) didn't reactivate properly. This delayed recovery is concerning because similar patterns in other diseases are linked to worse health outcomes.

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.

Pain and SensitizationSleepDiagnostics

Clinical Profile and Aspects of Differential Diagnosis in Patients with ME/CFS from Latvia.

Krumina, Angelika, Vecvagare, Katrine, Svirskis, Simons et al.·Medicina (Kaunas, Lithuania)·2021

This study looked at 65 people with ME/CFS in Latvia to understand their main symptoms and how the condition differs from simple tiredness. Researchers found that people with ME/CFS commonly experience fatigue, muscle pain, joint pain, and sleep problems—more often than people without ME/CFS. When patients had other health conditions alongside ME/CFS, their symptoms tended to be more severe.

E2 ModerateCohortPEM unclearLongitudinal

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Major Impact on Lives of Both Patients and Family Members.

Brittain, Esme, Muirhead, Nina, Finlay, Andrew Y et al.·Medicina (Kaunas, Lithuania)·2021

This study looked at how ME/CFS affects the quality of life of patients and their family members using two surveys. The researchers found that ME/CFS seriously damages patients' quality of life, particularly in physical health, and also significantly impacts the wellbeing of partners and family members who care for them. The study shows that family members experience worry, sadness, and difficulty maintaining normal family activities because of their loved one's illness.

Salivary DNA Loads for Human Herpesviruses 6 and 7 Are Correlated With Disease Phenotype in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Lee, Ji-Sook, Lacerda, Eliana M, Nacul, Luis et al.·Frontiers in medicine·2021

This study tested saliva samples from people with ME/CFS and healthy people to measure levels of common viruses that stay dormant in the body. Researchers found that two viruses (HHV-6B and HHV-7) were present at higher levels in people with ME/CFS, especially in those whose viral levels went up and down over time. Importantly, when these viral levels were higher, patients reported worse symptoms like pain, brain fog, and heart/blood pressure problems.

Immune System

Cortical autonomic network connectivity predicts symptoms in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Zinn, Mark A, Jason, Leonard A·International journal of psychophysiology : official journal of the International Organization of Psychophysiology·2021

This study looked at how the brain controls the autonomic nervous system (the part that manages heart rate, breathing, and other automatic functions) in people with ME/CFS. Researchers used special brain recordings to measure electrical activity in 34 ME/CFS patients and 34 healthy people at rest, then looked for differences in how different brain regions communicate with each other. They found that people with ME/CFS had different patterns of brain communication, and these differences were connected to specific symptoms like fatigue, thinking problems, and pain.

Autonomic Nervous System

Perceptions of European ME/CFS Experts Concerning Knowledge and Understanding of ME/CFS among Primary Care Physicians in Europe: A Report from the European ME/CFS Research Network (EUROMENE).

Cullinan, John, Pheby, Derek F H, Araja, Diana et al.·Medicina (Kaunas, Lithuania)·2021

ME/CFS experts across Europe were asked what they think family doctors know about ME/CFS and how to help them understand it better. The experts reported serious concerns: about 60% of ME/CFS patients go undiagnosed because family doctors lack knowledge about the condition, don't believe it's real, or don't know how to manage it. Most experts agreed that better training for doctors at all levels would help.

Diagnostics

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 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.

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.

Immune System

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

Tryptophan Metabolites, Cytokines, and Fatty Acid Binding Protein 2 in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Simonato, Manuela, Dall'Acqua, Stefano, Zilli, Caterina et al.·Biomedicines·2021

This study compared blood samples from 40 people with ME/CFS to 40 healthy people to look for biological differences. Researchers found that ME/CFS patients had different levels of certain molecules related to immune function, gut health, and how the body uses the amino acid tryptophan. These differences were independent of each other, suggesting multiple biological pathways may be disrupted in ME/CFS.

Immune System

Are Circulating Fibroblast Growth Factor 21 and N-Terminal Prohormone of Brain Natriuretic Peptide Promising Novel Biomarkers in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?

Domingo, Joan Carles, Cordobilla, Begoña, Ferrer, Roser et al.·Antioxidants & redox signaling·2021

This study looked for new blood markers that could help identify ME/CFS by measuring two proteins called FGF21 and NT-proBNP in patients and healthy people. The researchers found that ME/CFS patients had significantly higher levels of both proteins and showed signs of increased inflammation and oxidative stress (cellular damage). These findings suggest these proteins might be useful tools for diagnosing ME/CFS or developing new treatments.

BiomarkersImmune System

E2 ModerateBehavioralPEM unclearCross-Sectional

Comparison of the finger plethysmography derived stroke volumes by Nexfin CO Trek and suprasternal aortic Doppler derived stroke volume measurements in adults with myalgic encephalomyelitis/chronic fatigue syndrome and in healthy controls.

van Campen, C Linda M C, Verheugt, Freek W A, Rowe, Peter C et al.·Technology and health care : official journal of the European Society for Engineering and Medicine·2021

This study compared two different ways of measuring how much blood the heart pumps with each beat during a tilt table test (where patients lie down then are tilted upright). Researchers tested 154 ME/CFS patients and 39 healthy people using finger cuff measurements and ultrasound of the heart. They found that the finger cuff method gave higher readings than ultrasound, but after adjusting the finger cuff numbers to match ultrasound values, the device became reliable enough to track changes during tilt testing.

Autonomic Nervous System

How common are depression and anxiety in adolescents with chronic fatigue syndrome (CFS) and how should we screen for these mental health co-morbidities? A clinical cohort study.

Loades, Maria E, Read, Rebecca, Smith, Lucie et al.·European child & adolescent psychiatry·2021

This study looked at how common depression and anxiety are in teenagers with ME/CFS. Researchers interviewed 164 young people with ME/CFS and their parents using detailed diagnostic interviews and questionnaires. They found that about 1 in 3 teenagers had depression or anxiety, which is higher than expected. However, the questionnaires commonly used to screen for these conditions were not always accurate at detecting problems in this group, so doctors need to be careful and do thorough assessments rather than relying on questionnaires alone.

E2 ModerateCohortPEM not requiredCross-Sectional

Postural orthostatic tachycardia syndrome in patients of orthostatic intolerance symptoms: an ambispective study.

Chouksey, Dinesh, Rathi, Pankaj, Sodani, Ajoy et al.·AIMS neuroscience·2021

This study looked at patients who experience dizziness, fainting, or heart racing when standing up—symptoms of a condition called POTS (Postural Orthostatic Tachycardia Syndrome). Researchers tested 246 patients with these symptoms and confirmed POTS in 40 of them using a special tilt-table test. Most POTS patients experienced fainting, lightheadedness, and heart palpitations, and nearly half also had a related condition causing fainting.

Autonomic Nervous System

E2 ModerateCohortPEM requiredObservational

Epidemiological and clinical factors associated with post-exertional malaise severity in patients with myalgic encephalomyelitis/chronic fatigue syndrome.

Ghali, Alaa, Richa, Paul, Lacout, Carole et al.·Journal of translational medicine·2020

This study looked at 197 ME/CFS patients to understand which people are more likely to experience severe post-exertional malaise (PEM)—the symptom crash that happens after physical or mental activity. Researchers found that patients who developed ME/CFS after age 32, those who had recurring infections during their illness, and those whose ME/CFS started after a stomach infection were more likely to have severe PEM. Understanding these risk factors could help doctors better predict and manage PEM in individual patients.

E2 ModerateDiagnosticPEM not requiredMethods-Paper

Joint Assessment of Equilibrium and Neuromotor Function: A Validation Study in Patients with Fibromyalgia.

Lomas-Vega, Rafael, Rodríguez-Almagro, Daniel, Peinado-Rubia, Ana Belén et al.·Diagnostics (Basel, Switzerland)·2020

Researchers created and tested a new 20-question tool to measure balance problems and nerve-muscle coordination in people with fibromyalgia. The tool was tested on 62 fibromyalgia patients, 22 older adults, and 24 healthy people. The results show the tool works well at identifying balance issues in fibromyalgia patients, especially problems related to head movements.

E2 ModerateCohortPEM unclearObservational

Preliminary ICF core set for patients with myalgic encephalomyelitis/chronic fatigue syndrome in rehabilitation medicine.

Bileviciute-Ljungar, Indre, Schult, Marie-Louise, Borg, Kristian et al.·Journal of rehabilitation medicine·2020

Researchers studied 100 ME/CFS patients to identify which body functions, activities, and life areas are most affected by the illness. They found that nearly all patients experience severe fatigue, poor sleep, and pain, while most struggle with work, household tasks, and socializing. This study created a standardized checklist that doctors can use to understand and measure how ME/CFS impacts different aspects of patients' lives.