Evidence browser

Decreased Connectivity and Increased Blood Oxygenation Level Dependent Complexity in the Default Mode Network in Individuals with Chronic Fatigue Syndrome.

Shan, Zack Y, Finegan, Kevin, Bhuta, Sandeep et al.·Brain connectivity·2018

This study used brain imaging to look at how a specific network in the brain (called the default mode network) works differently in people with ME/CFS compared to healthy people. Researchers found that in ME/CFS patients, this brain network shows more chaotic activity and weaker communication between different regions. These differences might one day help doctors diagnose ME/CFS using brain scans.

Rheumatism and chronic fatigue, the two facets of post-chikungunya disease: the TELECHIK cohort study on Reunion island.

Duvignaud, A, Fianu, A, Bertolotti, A et al.·Epidemiology and infection·2018

This study followed over 1,000 people on Reunion Island to understand why some patients infected with chikungunya virus develop long-lasting fatigue and joint pain. Researchers found that people who had chikungunya were much more likely to experience chronic fatigue and a condition resembling ME/CFS compared to those who were never infected. About 24% of people with chikungunya developed CFS-like illness, compared to only 7% of those without the virus.

Functional Status and Well-Being in People with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Compared with People with Multiple Sclerosis and Healthy Controls.

Kingdon, Caroline C, Bowman, Erinna W, Curran, Hayley et al.·PharmacoEconomics - open·2018

This study compared how much ME/CFS affects people's daily lives compared to people with multiple sclerosis and healthy people. Researchers found that people with ME/CFS reported significantly worse physical function, ability to work, and social activities than the other two groups. People with ME/CFS also worked fewer hours and earned less money, showing the real-world impact of the illness on their lives.

Lower regulatory frequency for postural control in patients with fibromyalgia and chronic fatigue syndrome.

Rasouli, Omid, Vasseljen, Ottar, Fors, Egil A et al.·PloS one·2018

This study tested how well people with ME/CFS and fibromyalgia control their balance while standing still. Researchers found that both patient groups swayed more than healthy people and their bodies made slower, weaker adjustments to maintain balance. The two patient groups showed similar problems, suggesting they may share some underlying balance control difficulties.

E2 ModerateCohortPEM not requiredLongitudinal

Endometriosis increased the risk of bladder pain syndrome/interstitial cystitis: A population-based study.

Wu, Chia-Chang, Chung, Shiu-Dong, Lin, Herng-Ching·Neurourology and urodynamics·2018

This study found that women with endometriosis (a condition where tissue similar to the uterine lining grows outside the uterus) have a significantly higher risk of developing bladder pain syndrome/interstitial cystitis (BPS/IC), a chronic bladder pain condition. Over a 3-year period, about 4 times as many women with endometriosis developed BPS/IC compared to women without endometriosis. This suggests these two painful conditions may share common underlying mechanisms.

Pain and Sensitization

Frailty and pre-frailty in middle-aged and older adults and its association with multimorbidity and mortality: a prospective analysis of 493 737 UK Biobank participants.

Hanlon, Peter, Nicholl, Barbara I, Jani, Bhautesh Dinesh et al.·The Lancet. Public health·2018

This large study looked at nearly 500,000 people aged 37-73 to understand 'frailty'—a condition where people become weak and tired more easily. The researchers found that frailty is associated with having multiple health conditions and an increased risk of death over 7 years. Importantly, they discovered that chronic fatigue syndrome was one of the top five conditions linked to frailty, suggesting that frailty affects not just elderly people but also middle-aged adults with long-term illnesses.

E2 ModeratePEM not requiredRegistry-Resource

A Survey on Human T-cell Lymphotropic Virus Type 1 (HTLV-1) and Xenotropic Murine Leukemia Virus-Related Virus (XMRV) Coinfection in Tehran, Iran.

Keshavarz, Mohsen, Karbalaie Niya, Mohammad Hadi, Tameshkel, Fahimeh Safarnezhad et al.·Journal of pharmacy & bioallied sciences·2018

Researchers in Iran tested 291 patients suspected of having HTLV-1 (a virus that affects the immune system) to see if they also had XMRV, another virus that has been studied in connection with chronic fatigue syndrome. They found that 32% of patients had HTLV-1, but only 1 out of 93 HTLV-1-positive patients also had XMRV. This suggests that having both viruses together is very rare in this population.

The International Collaborative on Fatigue Following Infection (COFFI).

Katz, Ben Z, Collin, Simon M, Murphy, Gabrielle et al.·Fatigue : biomedicine, health & behavior·2018

COFFI is an international research project that combines data from thousands of patients across six countries who developed severe fatigue after different infections, such as mononucleosis, Q fever, and others. Researchers followed patients for up to 10 years to identify what factors predict who will recover and who will develop long-lasting fatigue syndromes. Early findings suggest that being female, having low physical fitness before infection, and experiencing problems with the autonomic nervous system increase the risk of prolonged fatigue.

E2 ModeratePEM not requiredRegistry-Resource

Robuvit®: improvement of fatigue in medical convalescence.

Ippolito, Edmondo, Belcaro, Gianni, Luzzi, Roberta et al.·The Journal of sports medicine and physical fitness·2018

This study tested whether an oak wood extract supplement called Robuvit® could help people recover faster after the flu. One group of recovering patients took the supplement (300 mg daily) along with standard care, while another group received standard care alone. After 3 weeks, the supplement group reported less weakness, better sleep, improved focus, and faster recovery after physical activity compared to the control group.

Post-Exertional Malaise

No evidence found for an increased risk of long-term fatigue following human papillomavirus vaccination of adolescent girls.

Schurink-Van't Klooster, T M, Kemmeren, J M, van der Maas, N A T et al.·Vaccine·2018

Researchers in the Netherlands investigated whether the HPV vaccine (given to prevent cervical cancer) could cause long-term fatigue in teenage girls. They compared fatigue rates before and after the vaccine was introduced and found no evidence that the vaccine increased fatigue cases. While some girls did report lasting tiredness, this happened at similar rates whether or not they had received the vaccine.

E2 ModerateCohortPEM unclearObservational

The etiologic relation between disequilibrium and orthostatic intolerance in patients with myalgic encephalomyelitis (chronic fatigue syndrome).

Miwa, Kunihisa, Inoue, Yukichi·Journal of cardiology·2018

This study looked at 44 ME/CFS patients to understand why they struggle to stay upright (orthostatic intolerance). Researchers found that balance problems—difficulty staying steady when standing with eyes closed—were common and seemed to make orthostatic intolerance worse. Patients with balance problems were more likely to have trouble completing a 10-minute standing test than those with only heart rate changes, suggesting balance issues may be just as important as blood pressure and heart rate problems in ME/CFS.

Autonomic Nervous System

Effects of a short-term aquatic exercise intervention on symptoms and exercise capacity in individuals with chronic fatigue syndrome/myalgic encephalomyelitis: a pilot study.

Broadbent, Suzanne, Coetzee, Sonja, Beavers, Rosalind·European journal of applied physiology·2018

This small study looked at whether exercising in water could help women with ME/CFS. Eleven women did gentle water exercise twice a week for 4 weeks, and researchers measured their strength, fitness, and fatigue levels before and after. The women were able to walk farther, felt less tired and had less pain after the program, and nobody reported feeling worse from the exercise.

Post-Exertional Malaise

Static and dynamic functional connectivity in patients with chronic fatigue syndrome: use of arterial spin labelling fMRI.

Boissoneault, Jeff, Letzen, Janelle, Lai, Song et al.·Clinical physiology and functional imaging·2018

Researchers used a brain imaging technique to compare how the brains of people with ME/CFS and healthy people process information during a tiring mental task. They found that people with ME/CFS had different patterns of communication between brain regions, and these patterns were linked to how fatigued they felt. This suggests that the fatigue experienced in ME/CFS may be related to how different parts of the brain work together.

Cognitive Impairment

E2 ModerateCohortPEM requiredCross-Sectional

The effects of warm water immersion on blood pressure, heart rate and heart rate variability in people with chronic fatigue syndrome.

Parker, Romy, Higgins, Zeenath, Mlombile, Zandiswa N P et al.·The South African journal of physiotherapy·2018

This study looked at how warm water bathing affects heart function in people with ME/CFS compared to healthy people. Researchers found that people with ME/CFS had less stable heart rate patterns before entering warm water, but this improved during the water immersion. The heart rate stayed slightly elevated in the ME/CFS group even after leaving the water. Overall, warm water immersion appeared safe and may help with managing ME/CFS symptoms.

Autonomic Nervous System

Association of chronic fatigue syndrome with premature telomere attrition.

Rajeevan, Mangalathu S, Murray, Janna, Oakley, Lisa et al.·Journal of translational medicine·2018

This study compared telomere length—the protective caps at the ends of our DNA—between people with ME/CFS and healthy controls. Researchers found that people with ME/CFS had shorter telomeres, suggesting their cells may be aging faster than expected. The effect was strongest in women under 45 years old with ME/CFS, who showed signs of aging equivalent to 10-20 years beyond their actual age.

Post-Exertional Malaise

E2 ModerateCohortPEM unclearObservational

Low Sensitivity of Abbreviated Tilt Table Testing for Diagnosing Postural Tachycardia Syndrome in Adults With ME/CFS.

van Campen, C Linda M C, Rowe, Peter C, Visser, Frans C·Frontiers in pediatrics·2018

Many people with ME/CFS experience dizziness and rapid heartbeat when standing up, a condition called POTS. This study found that when doctors use shortened tilt table tests (lasting only 2 minutes) to diagnose POTS, they miss more than half of the patients who actually have it. The researchers recommend using the full 10-minute test instead of the abbreviated version to properly identify POTS in ME/CFS patients.

Autonomic Nervous System

Comparison of Fatigue Severity and Quality of Life between Unexplained Fatigue Patients and Explained Fatigue Patients.

Yoo, Eun Hae, Choi, Eun Sil, Cho, Soo Hyun et al.·Korean journal of family medicine·2018

This study compared fatigue and quality of life in 200 Korean adults with fatigue. Researchers divided participants into two groups: those whose fatigue had a clear medical explanation (like anemia or thyroid disease) and those whose fatigue remained unexplained after testing. People with unexplained fatigue reported significantly lower quality of life, especially in physical functioning, compared to those with explained fatigue.

Diagnostics