Evidence browser

E2 ModerateCohortPEM not requiredLongitudinal

A UK based review of recommendations regarding the management of chronic fatigue syndrome.

Mallet, Miriam, King, Eleanor, White, Peter D·Journal of psychosomatic research·2016

This study looked at what different organizations in the UK recommend for treating ME/CFS. Researchers compared advice from patient support groups with advice from medical doctors and textbooks. They found major disagreements: patient groups strongly recommended complementary therapies (74% vs 16% for medical sources) and pacing strategies (91% vs 50%), while doctors more strongly recommended rehabilitation therapies (94% vs 28%). These different messages may confuse patients and affect how well treatments actually work.

Interventions

Workers on transformation of the shelter object of the Chernobyl nuclear power plant into an ecologically-safe system show qEEG abnormalities and cognitive dysfunctions: A follow-up study.

Loganovsky, Konstantyn, Perchuk, Iryna, Marazziti, Donatella·The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry·2016

This study followed 196 workers who helped clean up and secure the damaged Chernobyl nuclear reactor between 2004 and 2008. Researchers tested their brain electrical activity and thinking skills before and after the work. The workers showed changes in brain wave patterns and developed mild memory and concentration problems after exposure to radiation, similar to symptoms seen in chronic fatigue syndrome.

Cognitive Impairment

E2 ModerateCohortPEM unclear

Association of mitochondrial DNA variants with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) symptoms.

Hanson, Maureen R, Gu, Zhenglong, Keinan, Alon et al.·Journal of translational medicine·2016

This study looked at whether variations in mitochondrial DNA (the genetic material in the energy-producing parts of our cells) are linked to ME/CFS. Researchers compared genetic samples from ME/CFS patients and healthy people. While they didn't find that specific DNA variants caused the disease itself, they did discover that certain genetic variations were associated with specific symptoms and how severe those symptoms were.

Energy Metabolism

E2 ModerateMechanismPEM unclearMechanistic

Chronic fatigue syndrome in women assessed with combined cardiac magnetic resonance imaging.

Olimulder, M A G M, Galjee, M A, Wagenaar, L J et al.·Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·2016

This study used advanced heart imaging (MRI scans) to examine the hearts of 12 women with ME/CFS and compared them to 36 healthy women. The researchers found that women with ME/CFS had smaller hearts and mildly weaker heart function than the healthy controls. Some ME/CFS patients also showed signs of scarring in the heart muscle, which was not seen in any of the healthy controls.

ERK1/2, MEK1/2 and p38 downstream signalling molecules impaired in CD56 dim CD16+ and CD56 bright CD16 dim/- natural killer cells in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis patients.

Huth, Teilah Kathryn, Staines, Donald, Marshall-Gradisnik, Sonya·Journal of translational medicine·2016

This study looked at natural killer (NK) cells, which are immune cells that help fight infections and abnormal cells. Researchers found that NK cells in ME/CFS patients have problems with their internal signaling systems—the chemical pathways that tell these cells to attack threats. Specifically, certain types of NK cells showed abnormal activity in proteins called ERK, MEK, and p38 when compared to healthy people. These problems in cell signaling might explain why people with ME/CFS have weaker immune responses.

Regulatory T, natural killer T and γδ T cells in multiple sclerosis and chronic fatigue syndrome/myalgic encephalomyelitis: a comparison.

Ramos, Sandra, Brenu, Ekua, Broadley, Simon et al.·Asian Pacific journal of allergy and immunology·2016

This study compared immune system cells in people with ME/CFS, people with multiple sclerosis (MS), and healthy people. Researchers found that ME/CFS patients had higher levels of certain regulatory immune cells called Tregs, while MS patients had lower levels of gamma delta T cells. The findings suggest that ME/CFS and MS affect the immune system in different ways, rather than through the same mechanisms.

The Health-Related Quality of Life for Patients with Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS).

Falk Hvidberg, Michael, Brinth, Louise Schouborg, Olesen, Anne V et al.·PloS one·2015

This study measured how ME/CFS affects quality of life using a standard health questionnaire given to Danish ME/CFS patients. The results show that people with ME/CFS report significantly lower quality of life (a score of 0.47 out of 1.0) compared to the general population (0.85), and this impact is worse than 20 other health conditions studied. Even after accounting for other illnesses patients might have, ME/CFS itself was shown to cause substantial harm to daily life and wellbeing.

Serum Immune Proteins in Moderate and Severe Chronic Fatigue Syndrome/Myalgic Encephalomyelitis Patients.

Hardcastle, Sharni Lee, Brenu, Ekua Weba, Johnston, Samantha et al.·International journal of medical sciences·2015

This study looked at immune system proteins in the blood of people with ME/CFS, comparing those with moderate and severe illness to healthy people. Researchers found that different immune markers were present at different levels depending on how severe someone's illness was. This suggests that ME/CFS may actually involve different immune patterns in different people, which could help researchers better understand why treatments don't work the same way for everyone.

E2 ModerateCohortPEM unclearLongitudinal

Longitudinal analysis of immune abnormalities in varying severities of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis patients.

Hardcastle, Sharni Lee, Brenu, Ekua Weba, Johnston, Samantha et al.·Journal of translational medicine·2015

This study tracked immune system changes in 42 ME/CFS patients (divided into moderate and severe groups) and 18 healthy controls over 6 months. Researchers used blood tests to count different types of immune cells. They found that people with severe ME/CFS had noticeably different immune cell patterns than those with moderate ME/CFS or healthy controls, suggesting the immune system may work differently depending on how severe the illness is.

BiomarkersImmune System

E2 ModerateCohortPEM requiredCross-Sectional

Cytokine expression provides clues to the pathophysiology of Gulf War illness and myalgic encephalomyelitis.

Khaiboullina, Svetlana F, DeMeirleir, Kenny L, Rawat, Shanti et al.·Cytokine·2015

This study looked at chemical messengers in the blood called cytokines to understand Gulf War illness (GWI) and ME/CFS better. Researchers found that certain cytokines could identify ME/CFS patients very well, but were less reliable for GWI patients. The findings suggest that while GWI and ME/CFS share many similar symptoms, they may have different underlying immune system problems.

BiomarkersImmune System

Chronic fatigue syndrome versus sudden onset myalgic encephalomyelitis.

Jason, Leonard A, Evans, Meredyth, Brown, Abigail et al.·Journal of prevention & intervention in the community·2015

This study looked at whether using a specific definition of ME (sudden onset myalgic encephalomyelitis) identifies a sicker group of patients compared to the broader CFS (chronic fatigue syndrome) definition. Researchers found that people who met the ME criteria had more severe symptoms, greater disability, and worse post-exertional malaise (feeling much worse after physical activity) than those meeting only the CFS criteria. The findings suggest that the ME definition may identify patients with more serious illness.

Post-Exertional Malaise

E2 ModerateBehavioralPEM not requiredCross-Sectional

Slow wave sleep in the chronically fatigued: Power spectra distribution patterns in chronic fatigue syndrome and primary insomnia.

Neu, Daniel, Mairesse, Olivier, Verbanck, Paul et al.·Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology·2015

This study looked at the deepest, most restorative type of sleep in people with ME/CFS and primary insomnia to understand why both groups feel tired and don't feel rested despite sleeping. Researchers used special brain wave measurements during sleep and found that both groups had unusual patterns of very slow brain waves during deep sleep, even though they were getting normal or sometimes even extra amounts of deep sleep. The findings suggest that the problem may not be getting enough deep sleep, but rather that the quality or type of brain activity during that sleep is different.

Sleep

A comparison of patients with Q fever fatigue syndrome and patients with chronic fatigue syndrome with a focus on inflammatory markers and possible fatigue perpetuating cognitions and behaviour.

Keijmel, Stephan P, Saxe, Johanna, van der Meer, Jos W M et al.·Journal of psychosomatic research·2015

This study compared people with Q fever fatigue syndrome (a fatigue illness that develops after a specific infection) with people with ME/CFS to see if they were similar. Researchers found that both groups experienced similar levels of fatigue and emotional distress, but had some differences in their backgrounds and how they thought about their symptoms. The study suggests that physical activity might play a role in fatigue for both conditions, and that treatments focusing on behavior changes could potentially help people with Q fever fatigue syndrome.

E2 ModerateCohortPEM requiredObservational

Fatigue in adults with post-infectious fatigue syndrome: a qualitative content analysis.

Stormorken, Eva, Jason, Leonard A, Kirkevold, Marit·BMC nursing·2015

This study interviewed 26 adults with ME/CFS about their fatigue to better understand what they experience. The researchers found that fatigue in ME/CFS is not just tiredness—it's a complex, all-consuming symptom that gets much worse with even small activities and is accompanied by other symptoms like brain fog and pain. The fatigue also changes throughout the day and is triggered by physical activity, emotions, stress, and sometimes things patients don't even realize are triggering it.

Post-Exertional Malaise

Timed loaded standing in female chronic fatigue syndrome compared with other populations.

Eyskens, Jan B, Nijs, Jo, D'Août, Kristiaan et al.·Journal of rehabilitation research and development·2015

Researchers tested how long women with ME/CFS could hold small weights with their arms extended straight out—a test that measures muscle endurance in the arms and trunk. Women with ME/CFS performed significantly worse than healthy women and even worse than older women with osteoporosis, suggesting a specific weakness pattern in ME/CFS. This finding could help guide rehabilitation programs that focus on movement quality rather than just building strength.

Post-Exertional Malaise

Cardiac dysfunction and orthostatic intolerance in patients with myalgic encephalomyelitis and a small left ventricle.

Miwa, Kunihisa·Heart and vessels·2015

This study looked at heart function in 40 ME/CFS patients compared to 40 healthy people. Researchers found that ME/CFS patients frequently had smaller hearts and difficulty standing up without dizziness or other symptoms (orthostatic intolerance). The smaller heart size appeared to pump less blood with each beat, which may explain why patients struggle with upright posture and fatigue.

Autonomic Nervous System

E2 ModerateCohortPEM not requiredCase-Control

Functional level of patients with chronic fatigue syndrome reporting use of alternative vs. traditional treatments.

Wise, Shelby, Jantke, Rachel, Brown, Abigail et al.·Fatigue : biomedicine, health & behavior·2015

This study looked at 97 ME/CFS patients to compare how well they were functioning based on the treatments they used. Patients were divided into three groups: those using only complementary/alternative medicine (CAM), those using only traditional medicine, and those using both. The study found that patients using CAM alone had better social functioning and fewer psychiatric diagnoses compared to the other groups.

Interventions

Reduced gait automaticity in female patients with chronic fatigue syndrome: Case-control study.

Eyskens, Jan B, Nijs, Jo, Wouters, Kristien et al.·Journal of rehabilitation research and development·2015

This study tested how automatically women with ME/CFS can walk while doing other things at the same time. Researchers asked women with ME/CFS and healthy women to walk, close their eyes, and solve a math problem. Most women with ME/CFS stopped walking when they had to do the math problem with their eyes closed, while most healthy women kept walking. This suggests that walking requires more conscious effort and attention in ME/CFS patients than in healthy people.

Cytokines in the cerebrospinal fluids of patients with chronic fatigue syndrome/myalgic encephalomyelitis.

Peterson, D, Brenu, E W, Gottschalk, G et al.·Mediators of inflammation·2015

Researchers tested cerebrospinal fluid (the fluid around the brain and spinal cord) from ME/CFS patients and healthy controls to see if immune chemicals called cytokines were different. Out of 27 different immune chemicals tested, they found that only one—called IL-10—was lower in ME/CFS patients. This suggests that immune system problems in the brain and nervous system may play a role in ME/CFS symptoms.