Evidence browser

Equity of access to specialist chronic fatigue syndrome (CFS/ME) services in England (2008-2010): a national survey and cross-sectional study.

Collin, Simon M, Sterne, Jonathan A C, Hollingworth, William et al.·BMJ open·2012

This study examined how fairly ME/CFS specialist services were distributed across England between 2008-2010. Researchers found that some areas had no specialist services at all, while others had very different numbers of patients being seen and diagnosed. In some regions, people living in poorer neighborhoods were less likely to access services than those in wealthier areas, even when services existed.

E2 ModerateCohortPEM unclearLongitudinal

No evidence for xenotropic murine leukemia-related virus infection in Sweden using internally controlled multiepitope suspension array serology.

Blomberg, Jonas, Blomberg, Fredrik, Sjösten, Anna et al.·Clinical and vaccine immunology : CVI·2012

Researchers tested blood samples from ME/CFS patients and healthy blood donors to see if they had been infected with a mouse virus called XMRV, which had been proposed as a possible cause of ME/CFS. Using a sensitive new testing method that looked for multiple signs of XMRV infection, they found no difference in viral markers between the two groups, suggesting XMRV is not associated with ME/CFS.

Longitudinal investigation of natural killer cells and cytokines in chronic fatigue syndrome/myalgic encephalomyelitis.

Brenu, Ekua W, van Driel, Mieke L, Staines, Donald R et al.·Journal of translational medicine·2012

This study tracked immune system changes in 65 people with ME/CFS over one year, comparing them to 21 healthy controls. Researchers found that people with ME/CFS had consistently lower natural killer (NK) cell activity—immune cells that help fight infections—throughout the year. They also found changes in inflammatory molecules called cytokines that fluctuated at different time points.

E2 ModerateCohortPEM unclearObservational

A multicenter blinded analysis indicates no association between chronic fatigue syndrome/myalgic encephalomyelitis and either xenotropic murine leukemia virus-related virus or polytropic murine leukemia virus.

Alter, Harvey J, Mikovits, Judy A, Switzer, William M et al.·mBio·2012

Earlier studies suggested that two viruses (XMRV and pMLV) might cause ME/CFS, but this finding was controversial. In this study, the same scientists who originally reported finding these viruses carefully re-examined blood samples from 147 ME/CFS patients and 146 healthy people without knowing which samples came from which group. They found no evidence that either virus was present in any of the samples, meaning the original finding could not be confirmed.

E2 ModerateCohortPEM unclearCase-Control

Responses to exercise differ for chronic fatigue syndrome patients with fibromyalgia.

Cook, Dane B, Stegner, Aaron J, Nagelkirk, Paul R et al.·Medicine and science in sports and exercise·2012

This study compared how the bodies of ME/CFS patients respond to moderate exercise on a stationary bike. Researchers found that patients who have both ME/CFS and fibromyalgia (a condition causing widespread pain) showed different heart and breathing responses during exercise compared to healthy people, including higher perceived effort and different blood pressure patterns.

Post-Exertional Malaise

E2 ModerateCohortPEM not requiredObservational

Predictors of Fatigue among Patients with Chronic Fatigue Syndrome.

Jason, Leonard A, Brown, Molly, Evans, Meredyth et al.·Journal Of Human Behavior In The Social Environment·2012

This study asked ME/CFS patients to keep detailed activity logs to understand what triggers their fatigue. Researchers looked at what patients were doing, what they had been doing 30 minutes earlier, and their fatigue levels to find patterns. The study suggests that tracking daily activities can help doctors and patients see which activities are most connected to fatigue flare-ups.

Evidence for inflammation and activation of cell-mediated immunity in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): increased interleukin-1, tumor necrosis factor-α, PMN-elastase, lysozyme and neopterin.

Maes, Michael, Twisk, Frank N M, Kubera, Marta et al.·Journal of affective disorders·2012

This study examined whether people with ME/CFS have higher levels of inflammatory markers—substances in the blood that signal inflammation—compared to healthy people and those with regular fatigue. Researchers found that ME/CFS patients had significantly elevated levels of five different inflammatory markers, and these markers were linked to common ME/CFS symptoms like fatigue, brain fog, and flu-like feelings. The findings suggest that low-grade inflammation in the body may be contributing to ME/CFS symptoms.

Immune SystemPost-Exertional Malaise

Association of active human herpesvirus-6, -7 and parvovirus b19 infection with clinical outcomes in patients with myalgic encephalomyelitis/chronic fatigue syndrome.

Chapenko, Svetlana, Krumina, Angelika, Logina, Inara et al.·Advances in virology·2012

This study tested 108 ME/CFS patients and 90 healthy people for three viruses: HHV-6, HHV-7, and parvovirus B19. The researchers found that about 65% of ME/CFS patients had active viral infections compared to only 13% of healthy people. Patients with active viral infections showed higher levels of inflammatory markers and experienced more severe symptoms, especially when infected with multiple viruses at once.

E2 ModerateCohortPEM not requiredLongitudinal

Understanding long-term outcomes of chronic fatigue syndrome.

Brown, Molly M, Bell, David S, Jason, Leonard A et al.·Journal of clinical psychology·2012

This study followed people who were diagnosed with ME/CFS 25 years earlier and compared them to healthy people. Most participants (20 out of 25) no longer had an ME/CFS diagnosis, but surprisingly, they still experienced significantly more health problems and limitations than healthy controls. This suggests that even when people stop meeting the criteria for ME/CFS, they may not fully recover to their previous level of health.

E2 ModerateCohortPEM unclearCase-Control

Do you think it's a disease? a survey of medical students.

Erueti, Chrissy, Glasziou, Paul, Mar, Chris Del et al.·BMC medical education·2012

This study asked medical students whether various health conditions should be classified as a 'disease' or not. Interestingly, when the same condition was given a more medical-sounding name (like 'myalgic encephalomyelitis') versus a simpler name (like 'chronic fatigue syndrome'), students were more likely to call it a disease. This suggests that the words doctors use to describe an illness can influence how seriously it is viewed, even when describing the exact same condition.

Regional grey and white matter volumetric changes in myalgic encephalomyelitis (chronic fatigue syndrome): a voxel-based morphometry 3 T MRI study.

Puri, B K, Jakeman, P M, Agour, M et al.·The British journal of radiology·2012

Researchers used a specialized MRI brain scan to compare 26 ME/CFS patients with 26 healthy volunteers. They found that patients had smaller volumes of brain tissue in specific areas related to vision, memory, and movement coordination. These structural changes in the brain may help explain why ME/CFS patients often experience memory problems and other cognitive difficulties.

Cognitive Impairment

E2 ModerateCohortPEM unclearCase-Control

Inflammatory and cell-mediated immune biomarkers in myalgic encephalomyelitis/chronic fatigue syndrome and depression: inflammatory markers are higher in myalgic encephalomyelitis/chronic fatigue syndrome than in depression.

Maes, Michael, Twisk, Frank N M, Ringel, Karl·Psychotherapy and psychosomatics·2012

This study found that people with ME/CFS have higher levels of inflammatory markers (immune chemicals) in their blood compared to people with depression, even though both conditions can cause fatigue and other similar symptoms. The researchers measured specific immune proteins and found that while both ME/CFS and depression involve some immune system changes, ME/CFS shows a distinctly different immune profile that helps distinguish it from depression.

Temporal ordering of interstitial cystitis/bladder pain syndrome and non-bladder conditions.

Clemens, J Quentin, Elliott, Marc N, Suttorp, Marika et al.·Urology·2012

This study looked at nearly 3,400 women with bladder pain syndrome (IC/BPS) to see how often they also had other long-term conditions like fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, migraines, panic attacks, and depression. The researchers found that most of these conditions commonly occur together, but the symptoms don't follow a predictable order—sometimes the bladder symptoms came first, sometimes the other conditions came first, and sometimes they started around the same time.

Seroprevalence of xenotropic murine leukemia virus-related virus in normal and retrovirus-infected blood donors.

Qiu, Xiaoxing, Swanson, Priscilla, Tang, Ning et al.·Transfusion·2012

Researchers tested blood samples from over 2,000 donors worldwide to see if they carried XMRV, a virus that had been suggested as a possible cause of ME/CFS. They found very little evidence that XMRV was present in most people's blood. The small amount of positive results they found were likely false positives caused by confusion with a different virus (HTLV-I) that shares similar genetic sequences.

Test effort in persons with Chronic Fatigue Syndrome when assessed using the Validity Indicator Profile.

Cockshell, Susan J, Mathias, Jane L·Journal of clinical and experimental neuropsychology·2012

This study tested whether people with ME/CFS perform poorly on thinking tests because they aren't trying hard enough, or because of the illness itself. Researchers gave 54 people with ME/CFS and 54 healthy people a special test designed to measure effort and intention during testing. The results showed that most people in both groups were trying their best, and very few showed signs of not putting in effort—suggesting that low effort is not the reason people with ME/CFS struggle with cognitive tasks.

Cognitive Impairment

E2 ModerateCohortPEM not requiredCase-Control

Absence of xenotropic murine leukemia virus-related virus in blood donors in China.

Mi, Zhiqiang, Lu, Ying, Zhang, Shana et al.·Transfusion·2012

Researchers tested 391 healthy blood donors in China to see if they carried a virus called XMRV, which had been found in some people with chronic fatigue syndrome. Using sensitive laboratory tests, they found no evidence of this virus in any of the blood donors. This suggests that XMRV may not be present in the Chinese blood donor population.

Increased IgA and IgM responses against gut commensals in chronic depression: further evidence for increased bacterial translocation or leaky gut.

Maes, Michael, Kubera, Marta, Leunis, Jean-Claude et al.·Journal of affective disorders·2012

This study looked at whether depression might be linked to bacteria leaking from the gut into the bloodstream. Researchers measured immune proteins (IgA and IgM antibodies) in the blood of depressed patients that target common gut bacteria, and found these antibodies were higher in depressed people than in healthy controls. The findings suggest that if gut bacteria do leak into the blood, the body's immune system reacts to them, which could contribute to depression—particularly long-lasting depression.

E2 ModerateBehavioralPEM not requiredObservational

Therapist effects and the dissemination of cognitive behavior therapy for chronic fatigue syndrome in community-based mental health care.

Wiborg, Jan F, Knoop, Hans, Wensing, Michel et al.·Behaviour research and therapy·2012

This study looked at how well cognitive behavior therapy (CBT) for ME/CFS works when delivered by different therapists in regular mental health clinics rather than specialized centers. Researchers found that the individual therapist made a big difference in patient outcomes—accounting for 21% of the improvement variation. The therapist's beliefs about using treatment manuals and the specific clinic where treatment happened both influenced how well patients did.