Evidence browser

Immune network analysis of cerebrospinal fluid in myalgic encephalomyelitis/chronic fatigue syndrome with atypical and classical presentations.

Hornig, M, Gottschalk, C G, Eddy, M L et al.·Translational psychiatry·2017

This study examined fluid from around the brain and spinal cord in people with ME/CFS to look for immune system differences. Researchers found that people whose ME/CFS started differently (without a clear infection trigger) had different patterns of immune molecules compared to those with typical ME/CFS that started after a viral-like illness. The atypical group had lower levels of certain inflammatory markers and less coordinated immune activity in their central nervous system.

Immune System

E2 ModerateBehavioralPEM not requiredCross-Sectional

Unperturbed Cytotoxic Lymphocyte Phenotype and Function in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients.

Theorell, Jakob, Bileviciute-Ljungar, Indre, Tesi, Bianca et al.·Frontiers in immunology·2017

Researchers tested whether immune cells called cytotoxic lymphocytes—which normally fight infections and respond to stress—work differently in ME/CFS patients compared to healthy people. They studied 48 ME/CFS patients and found that these immune cells looked and functioned normally, suggesting they are not responsible for ME/CFS symptoms. This means cytotoxic lymphocytes alone cannot be used as a simple blood test to diagnose the condition.

Immune System

Fatigue in an adult attention deficit hyperactivity disorder population: A trans-diagnostic approach.

Rogers, Denise C, Dittner, Antonia J, Rimes, Katharine A et al.·The British journal of clinical psychology·2017

This study looked at fatigue in adults with ADHD and compared it to fatigue in people with ME/CFS and healthy people. Researchers found that adults with ADHD experience significantly more fatigue than healthy controls, with about 62% meeting criteria for clinically significant fatigue. Importantly, they discovered that people with ME/CFS and people with ADHD share many similar challenges, including low mood, anxiety, and reduced confidence in their abilities.

E2 ModerateMechanismPEM unclearMechanistic

Comorbidity in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Nationwide Population-Based Cohort Study.

Castro-Marrero, Jesús, Faro, Mónica, Aliste, Luisa et al.·Psychosomatics·2017

This study looked at 1,757 people with ME/CFS in Spain to understand what other health conditions they commonly experience alongside their ME/CFS. Researchers found that more than 80% of patients had at least one additional condition, such as fibromyalgia, thyroid problems, vitamin D deficiency, or ligament issues. The study identified five different groups of ME/CFS patients based on their comorbidities, with some groups experiencing significantly worse fatigue and quality of life than others.

Evidence of mitochondrial dysfunction and impaired redox signalling in a subgroup of patients with myalgic encephalomyelitis/chronic fatigue syndrome

Cara Tomas, Jessica Newton, Stuart Watson·The EPMA Journal·2017·n=25

This UK study analyzed mitochondrial function in immune cells from ME/CFS patients using the Seahorse assay. They found reduced ATP production capacity, impaired electron transport chain function, and altered redox signaling in a subgroup of ME/CFS patients compared to healthy controls.

Energy Metabolism

Persistent neuropsychiatric impairment in HCV patients despite clearance of the virus?!

Dirks, M, Pflugrad, H, Haag, K et al.·Journal of viral hepatitis·2017

This study looked at whether people who had hepatitis C virus (HCV) infection experience long-lasting fatigue, mood problems, and memory difficulties even after the virus is cleared from their body. Researchers found that 85% of HCV patients reported chronic fatigue and about half experienced depression or anxiety, regardless of whether they still had active virus or had been treated. The findings suggest HCV may cause lasting brain-related effects that persist even after successful treatment.

Brain 18F-FDG PET Metabolic Abnormalities in Patients with Long-Lasting Macrophagic Myofascitis.

Van Der Gucht, Axel, Aoun Sebaiti, Mehdi, Guedj, Eric et al.·Journal of nuclear medicine : official publication, Society of Nuclear Medicine·2017

This study used a special type of brain scan (PET imaging) to look for energy metabolism problems in the brains of people with macrophagic myofascitis, a condition involving immune cell buildup in muscles. Researchers found that MMF patients had lower energy use in multiple brain regions compared to healthy people, and this pattern was especially pronounced in patients who also had thinking and memory problems.

E2 ModerateCohortPEM not requiredLongitudinal

Differentiating Multiple Sclerosis from Myalgic Encephalomyelitis and Chronic Fatigue Syndrome.

Jason, L A, Ohanian, D, Brown, A et al.·Insights in biomedicine·2017

This study compared how people with MS, ME, and chronic fatigue syndrome experience their illnesses. Researchers surveyed 120 people with MS and 269 people with ME/CFS about their symptoms using a standardized questionnaire. They found that people with ME/CFS reported more severe symptoms and greater functional limitations than people with MS, suggesting these conditions have different disability profiles.

Diagnostics

A Prospective Study of Infectious Mononucleosis in College Students.

Jason, Leonard A, Katz, Ben, Gleason, Kristen et al.·International journal of psychiatry (Overland Park)·2017

This study followed healthy college students over time to see what happens when they catch infectious mononucleosis (IM) and whether some develop ME/CFS afterward. Researchers collected information about students' physical health and emotional well-being before they got sick, while they had IM, and about 6 months later. By tracking students this way, the study aimed to identify which factors might put someone at higher risk of developing ME/CFS after a mono infection.

E2 ModerateCohortPEM requiredObservational

Novel characterisation of mast cell phenotypes from peripheral blood mononuclear cells in chronic fatigue syndrome/myalgic encephalomyelitis patients.

Nguyen, Thao, Johnston, Samantha, Chacko, Anu et al.·Asian Pacific journal of allergy and immunology·2017

This study looked at immune cells called mast cells in the blood of people with ME/CFS and compared them to healthy people. Researchers found that ME/CFS patients—especially those with severe illness—had more mast cells and these cells showed different activation patterns. Mast cells are known to release chemicals that cause inflammation, so understanding them better could help explain some ME/CFS symptoms.

Immune System

Altered right anterior insular connectivity and loss of associated functions in adolescent chronic fatigue syndrome.

Wortinger, Laura Anne, Glenne Øie, Merete, Endestad, Tor et al.·PloS one·2017

This study looked at how the brains of adolescents with ME/CFS work differently compared to healthy teenagers. Researchers used brain imaging to examine a region called the anterior insula, which helps coordinate motivation and responses to pain. They found that this brain region had weaker connections to areas involved in thinking and decision-making in ME/CFS patients, which may help explain why patients struggle with concentration, pain sensitivity, and physical activity.

E2 ModerateCohortPEM requiredCross-Sectional

Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia.

Jason, Leonard A, McManimen, Stephanie, Sunnquist, Madison et al.·Neurology (E-Cronicon)·2017

This study compared two groups of people with ME/CFS: those who met the official Institute of Medicine diagnostic criteria, and those who met those same criteria plus also had fibromyalgia (a condition involving widespread pain and tender points). The researchers found that patients with both ME/CFS and fibromyalgia experienced more severe symptoms and greater functional impairment across many areas than those with ME/CFS alone.

Diagnostics

Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME).

Josev, Elisha K, Jackson, Melinda L, Bei, Bei et al.·Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine·2017

This study examined sleep problems in teenagers with ME/CFS compared to healthy teenagers. Researchers found that teens with ME/CFS took longer to fall asleep, spent more total time in bed, slept longer overall, woke up later, and reported feeling their sleep was of poorer quality. Anxiety levels were also higher in the ME/CFS group and were connected to worse sleep quality in both groups.

Sleep

Elevations of Ventricular Lactate Levels Occur in Both Chronic Fatigue Syndrome and Fibromyalgia.

Natelson, Benjamin H, Vu, Diana, Coplan, Jeremy D et al.·Fatigue : biomedicine, health & behavior·2017

Researchers used brain imaging to measure a substance called lactate in the fluid around the brain in people with ME/CFS, fibromyalgia, both conditions together, and healthy people. They found that lactate levels were higher in all three patient groups compared to healthy controls, but the levels were similar among the three patient groups. This means lactate alone cannot be used to distinguish ME/CFS from fibromyalgia.

Immune SystemPost-Exertional Malaise

Transforming growth factor beta (TGF-β) in adolescent chronic fatigue syndrome.

Wyller, Vegard Bruun, Nguyen, Chinh Bkrong, Ludviksen, Judith Anita et al.·Journal of translational medicine·2017

This study tested whether a protein called TGF-β, which helps regulate immune and stress responses, was elevated in adolescents with ME/CFS. Researchers compared blood levels of TGF-β in 120 young ME/CFS patients to 68 healthy controls and found the protein levels were actually the same in both groups. However, they discovered that in ME/CFS patients, TGF-β levels were connected to stress hormones and fatigue severity, suggesting it may play a role in how the illness affects the body even if it's not simply 'too high.'

E2 ModerateCohortPEM not requiredObservational

Endogenous Pain Facilitation Rather Than Inhibition Differs Between People with Chronic Fatigue Syndrome, Multiple Sclerosis, and Controls: An Observational Study.

Collin, Simon M, Nijs, Jo, Meeus, Mira et al.·Pain physician·2017

This study tested how people with ME/CFS, people with multiple sclerosis (MS), and healthy people respond to pain. Researchers found that people with ME/CFS have lower pain thresholds and more pain amplification than people with MS, suggesting their nervous systems may process pain differently. These findings suggest that ME/CFS pain may involve a different biological mechanism than MS pain.

Pain and Sensitization

E2 ModerateCohortPEM requiredCross-Sectional

Post-Exertional Malaise in Patients with ME and CFS with Comorbid Fibromyalgia.

McManimen, Stephanie L, Jason, Leonard A·SRL neurology & neurosurgery·2017

This study looked at how having fibromyalgia (FM) alongside ME/CFS affects post-exertional malaise (PEM)—the worsening of symptoms after physical or mental activity. Researchers surveyed people online about their PEM symptoms and found that those with both conditions experienced more severe and frequent PEM symptoms than those with ME/CFS alone, particularly affecting muscle pain and overall fatigue. The findings suggest that having fibromyalgia as an additional diagnosis makes ME/CFS symptoms significantly worse.

Post-Exertional Malaise