Evidence browser

E2 ModerateCohortPEM unclearCase-Control

The presence of overlapping quality of life symptoms in primary antibody deficiency (PAD) and chronic fatigue syndrome (CFS).

Bansal, Rhea A, Tadros, Susan, Bansal, Amolak S·Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology·2020

This study looked at whether people with primary antibody deficiency (PAD)—a condition where the immune system doesn't make enough protective proteins—also experience ME/CFS-like symptoms. Researchers sent questionnaires to over 680 PAD patients and found that about 16% of those who responded had symptoms matching ME/CFS criteria, which is much higher than the general population. The study also found that sleep problems, fatigue, anxiety, and low mood were very common in PAD patients.

Sleep

Accurate and objective determination of myalgic encephalomyelitis/chronic fatigue syndrome disease severity with a wearable sensor.

Palombo, Turner, Campos, Andrea, Vernon, Suzanne D et al.·Journal of translational medicine·2020

Researchers developed a wearable sensor that measures how much time ME/CFS patients spend standing or walking each day (called UpTime). In a small study of 15 people, they found that severely ill ME/CFS patients spend less than 20% of their day upright, moderately ill patients spend 20-30%, while healthy people spend more than 30%. This sensor measurement was more accurate than asking patients to estimate their activity themselves, suggesting it could be a reliable way to track disease severity and test new treatments.

E2 ModerateCohortPEM unclearCase-Control

Cytomegalovirus, Epstein-Barr virus, and human herpesvirus-6 infections in patients with myalgic еncephalomyelitis/chronic fatigue syndrome.

Shikova, Evelina, Reshkova, Valentina, Kumanova, Аntoniya et al.·Journal of medical virology·2020

Researchers tested 58 ME/CFS patients and 50 healthy people for three common viruses (EBV, CMV, and HHV-6) that have been suspected of triggering ME/CFS. They found that ME/CFS patients had significantly higher rates of active EBV infection in their bloodstream compared to healthy people, though most people in both groups carried these viruses in a dormant state. This suggests that for some patients, active EBV infection may play a role in ME/CFS development.

Immune System

E2 ModerateCohortPEM unclearCross-Sectional

Patients with ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) and chronic pain report similar level of sickness behavior as individuals injected with bacterial endotoxin at peak inflammation.

Jonsjö, Martin A, Åström, Jenny, Jones, Michael P et al.·Brain, behavior, & immunity - health·2020

This study compared how 'sick' people with ME/CFS and chronic pain feel compared to other groups. Researchers found that ME/CFS and chronic pain patients reported feeling as sick as healthy people who were given a bacterial toxin to trigger temporary inflammation. These high levels of sickness feelings were similar across both conditions and higher than what primary care patients reported, suggesting that the persistent sickness sensation in ME/CFS and chronic pain may involve similar biological mechanisms related to inflammation and how the brain processes illness signals.

Immune System

E2 ModerateCohortPEM unclearObservational

Intravenous Cyclophosphamide in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. An Open-Label Phase II Study.

Rekeland, Ingrid G, Fosså, Alexander, Lande, Asgeir et al.·Frontiers in medicine·2020

Researchers tested whether cyclophosphamide, a chemotherapy drug, could help people with ME/CFS based on observations that some patients improved after cancer treatment. Forty patients received six infusions of this drug over six months, with check-ins lasting up to four years. More than half the patients reported meaningful improvements in fatigue and physical activity, with many staying better even years later.

Interventions

Prediction of Discontinuation of Structured Exercise Programme in Chronic Fatigue Syndrome Patients.

Kujawski, Sławomir, Cossington, Jo, Słomko, Joanna et al.·Journal of clinical medicine·2020

This study looked at why some people with ME/CFS could complete a gradual exercise programme while others had to stop. Researchers measured several body functions—like nervous system activity, reaction time, and heart rate—before the programme started. They found that people whose bodies showed higher stress responses and slower reaction times were more likely to drop out of the exercise programme.

E2 ModerateCohortPEM requiredCross-Sectional

Two-Day Cardiopulmonary Exercise Testing in Females with a Severe Grade of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Comparison with Patients with Mild and Moderate Disease.

van Campen, C Linda Mc, Rowe, Peter C, Visser, Frans C·Healthcare (Basel, Switzerland)·2020

This study tested how exercise affects female ME/CFS patients with different disease severity levels. Researchers had 82 women complete exercise tests on two consecutive days and measured how much oxygen their bodies could use and how much work they could do. Patients with severe ME/CFS showed the biggest drop in exercise capacity between day one and day two, suggesting their bodies recover more poorly from physical activity.

Post-Exertional Malaise

E2 ModerateCohortPEM unclearCase-Control

Changes in DNA methylation profiles of myalgic encephalomyelitis/chronic fatigue syndrome patients reflect systemic dysfunctions.

Helliwell, A M, Sweetman, E C, Stockwell, P A et al.·Clinical epigenetics·2020

This study looked at chemical tags on DNA called methylation patterns in people with ME/CFS compared to healthy people. These tags can turn genes on or off without changing the DNA itself. Researchers found that people with ME/CFS have different methylation patterns, particularly in genes related to energy production, immune function, and brain chemistry, which may help explain why they experience the symptoms they do.

Energy MetabolismImmune System

Autonomic Phenotypes in Chronic Fatigue Syndrome (CFS) Are Associated with Illness Severity: A Cluster Analysis.

Słomko, Joanna, Estévez-López, Fernando, Kujawski, Sławomir et al.·Journal of clinical medicine·2020

This study looked at 131 ME/CFS patients to see if different types of autonomic nervous system problems (the system that controls heart rate, blood pressure, and digestion) exist. Researchers found four distinct patterns: some patients had sympathetic overactivity with dysfunction, some had sympathetic symptoms alone, some had parasympathetic issues, and some had an imbalance between the two systems. Patients with sympathetic overactivity had the most severe symptoms and worst quality of life, while those with balanced autonomic function were younger, less fatigued, and reported better quality of life.

Association between quadrivalent human papillomavirus vaccination and selected syndromes with autonomic dysfunction in Danish females: population based, self-controlled, case series analysis.

Hviid, Anders, Thorsen, Nicklas M, Valentiner-Branth, Palle et al.·BMJ (Clinical research ed.)·2020

This study examined whether the HPV vaccine (used to prevent cervical cancer) was linked to ME/CFS, complex regional pain syndrome, or POTS in over 1.3 million Danish girls and women. Researchers found no evidence that the vaccine caused these conditions—the rates of these illnesses were similar whether or not girls received the vaccine.

Metabolic Dysfunction in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Not Due to Anti-mitochondrial Antibodies.

Nilsson, Isabell, Palmer, Jeremy, Apostolou, Eirini et al.·Frontiers in medicine·2020

Researchers tested whether ME/CFS patients have immune system antibodies that attack their mitochondria (the energy-producing parts of cells), similar to what happens in a different disease called primary biliary cholangitis. They found that ME/CFS patients almost never have these specific antibodies, while patients with the other disease have them consistently. This suggests that the energy problems seen in ME/CFS are caused by something other than the immune system attacking mitochondria.

Energy Metabolism

Parasympathetic activity is reduced during slow-wave sleep, but not resting wakefulness, in patients with chronic fatigue syndrome.

Fatt, Scott J, Beilharz, Jessica E, Joubert, Michael et al.·Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine·2020

This study found that people with ME/CFS have reduced calming nervous system activity during deep sleep, compared to healthy people. This overactive state during sleep—even when the brain should be resting—is linked to poor sleep quality and feeling unwell. The findings suggest that the body's inability to fully relax during sleep may be a key problem in ME/CFS.

E2 ModerateCohortPEM requiredObservational

Characterization of Post-exertional Malaise in Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Stussman, Barbara, Williams, Ashley, Snow, Joseph et al.·Frontiers in neurology·2020

This study asked 43 ME/CFS patients about post-exertional malaise (PEM)—the worsening of symptoms that happens after physical or mental activity. Patients described three main types of symptoms that get worse after exertion: exhaustion, trouble thinking clearly, and muscle/nerve problems. Most patients said their symptoms started within 24 hours after activity and felt worst around 3 days later, and they needed complete rest to recover.

Post-Exertional Malaise

E2 ModeratePEM not requiredRegistry-Resource

Exploring the concept of vigor and dys-vigor in men of 50-65 years: effects of Robuvit®.

Ledda, Andrea, Hosoi, Morio, Cesarone, Maria R et al.·Panminerva medica·2020

This small study tested whether a supplement called Robuvit® (made from oak wood extract) could help middle-aged men feel more energetic and less tired. Forty men aged 50-65 who felt exhausted took either standard lifestyle advice alone or the same advice plus the supplement for 4 weeks. Both groups improved, but the men taking Robuvit® reported significantly better energy levels and had lower markers of cellular stress in their blood.

Pain in adolescent chronic fatigue following Epstein-Barr virus infection.

Brodwall, Elias Myrstad, Pedersen, Maria, Asprusten, Tarjei Tørre et al.·Scandinavian journal of pain·2020

This study looked at pain symptoms in teenagers who developed chronic fatigue after a common virus infection (Epstein-Barr virus). Researchers compared teenagers who had the virus and became fatigued, those who had the virus but did not become fatigued, and healthy teenagers without the virus. They found that the fatigued group reported significantly more pain symptoms and that the amount of pain they experienced was strongly linked to their quality of life.

Pain and Sensitization