Evidence browser

NeuroinflammationImmune System

Nutritional modulation of the intestinal microbiota; future opportunities for the prevention and treatment of neuroimmune and neuroinflammatory disease.

Lombardi, Vincent C, De Meirleir, Kenny L, Subramanian, Krishnamurthy et al.·The Journal of nutritional biochemistry·2018

Your gut bacteria and brain communicate constantly with each other in ways that affect your immune system and inflammation levels. This review looks at how diet and nutrition can change your gut bacteria in ways that might help prevent or treat brain-related diseases that involve immune problems. The authors suggest that maintaining healthy gut bacteria through food choices could be an important treatment strategy.

E0 ConsensusReviewPEM unclearEditorial

Cognitive behaviour therapy and objective assessments in chronic fatigue syndrome.

McPhee, Graham·Journal of health psychology·2017

This review looked at studies testing whether cognitive behavioral therapy (CBT)—a talking treatment—helps people with ME/CFS. Most studies only asked patients if they felt better, but didn't measure whether they could actually do more physical activities. The review found little evidence that CBT improves what patients can actually do or helps them return to work.

E0 ConsensusReviewPEM not requiredEditorial

Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review.

Campagnolo, N, Johnston, S, Collatz, A et al.·Journal of human nutrition and dietetics : the official journal of the British Dietetic Association·2017

Researchers reviewed 17 studies looking at whether diet changes and supplements could help ME/CFS symptoms like fatigue and quality of life. While a few interventions—including NADH, probiotics, and high-cocoa chocolate—showed promise for reducing fatigue, most studies did not find clear benefits. Overall, there isn't enough strong evidence yet to recommend specific diets or supplements as reliable treatments for ME/CFS.

[Chronic Fatigue Syndrome: A Critical Review].

Rollnik, Jens D·Fortschritte der Neurologie-Psychiatrie·2017

This review examines whether ME/CFS is a distinct disease or if its symptoms overlap significantly with depression and other conditions. The authors found that while ME/CFS affects less than 1% of the population, there is no clear biological explanation for what causes it, and there are no universally agreed-upon diagnostic criteria. They recommend trying exercise, antidepressants, and talk therapy, but caution against using aggressive immune therapies without stronger evidence.

Diagnostics

E0 ConsensusReviewPEM not requiredSystematic-Review

Exercise therapy for chronic fatigue syndrome.

Larun, Lillebeth, Brurberg, Kjetil G, Odgaard-Jensen, Jan et al.·The Cochrane database of systematic reviews·2017

This review looked at eight research studies testing whether exercise therapy helps people with ME/CFS feel less fatigued and improve their daily functioning. Overall, patients who did exercise therapy felt less tired and reported better sleep and physical function compared to those who received standard care or relaxation therapy. Exercise therapy appeared to work about as well as cognitive-behavioral therapy (talking therapy), though more research is needed to figure out the best type, intensity, and duration of exercise for each patient.

Sleep

Chronic fatigue syndrome and the immune system: Where are we now?

Mensah, Fane Kojo Fosu, Bansal, Amolak Singh, Ford, Brian et al.·Neurophysiologie clinique = Clinical neurophysiology·2017

ME/CFS is a complex illness that causes exhaustion, headaches, and thinking problems, and gets worse with activity. Researchers have suspected for years that the immune system plays a role in ME/CFS, but studies have produced confusing and sometimes contradictory results. This review examines what we currently know about immune system changes in ME/CFS and discusses promising new research directions, including the possibility that certain immune-targeting treatments might help patients improve.

Pediatric chronic fatigue syndrome: current perspectives.

Crawley, Esther·Pediatric health, medicine and therapeutics·2017

This review examines ME/CFS in children, showing it is a common condition that significantly affects children and their families. The good news is that most children improve when they receive specialized treatment from doctors who understand this illness. The review summarizes what we know about how many children get ME/CFS, what factors may be involved, and what treatments have evidence supporting them.

Interventions

E0 ConsensusReviewPEM not requiredSystematic-Review

Treatment and management of chronic fatigue syndrome/myalgic encephalomyelitis: all roads lead to Rome.

Castro-Marrero, Jesus, Sáez-Francàs, Naia, Santillo, Dafna et al.·British journal of pharmacology·2017

This review looked at all available research on treatments for ME/CFS to see what actually helps patients. The researchers found that while some treatments like behavioral therapy, pacing strategies, and nutritional supplements show promise, the evidence is still limited because most studies were small and used different methods. The authors conclude that personalized pacing and treating nutritional deficiencies are reasonable approaches, but much larger and better-designed studies are urgently needed to know what really works.

Do evidence based interventions for chronic fatigue syndrome improve sleep? A systematic review and narrative synthesis.

Russell, Charlotte, Kyle, Simon D, Wearden, Alison J·Sleep medicine reviews·2017

This review looked at whether two common treatments for ME/CFS—cognitive behavioural therapy (CBT) and graded exercise therapy (GET)—actually help people sleep better. The researchers found only 8 studies that measured sleep as an outcome. GET showed some promise for improving sleep, but results were inconsistent across different studies. CBT had very limited evidence, with only one study out of two showing sleep improvements. Overall, we know very little about whether adding specific sleep management techniques to these treatments makes a difference.

Sleep

E0 ConsensusReviewPEM not requiredEditorial

Evidence Refuting the Existence of Autoimmune/Autoinflammatory Syndrome Induced by Adjuvants (ASIA).

Ameratunga, Rohan, Gillis, David, Gold, Michael et al.·The journal of allergy and clinical immunology. In practice·2017

This study examined whether a theory called ASIA (a proposed condition blamed on vaccine adjuvants like aluminum) is supported by scientific evidence. Researchers looked at data from people who received allergen immunotherapy, which contains much more aluminum than vaccines, and found they actually had fewer autoimmune diseases, not more. The study concludes that current evidence does not support the idea that aluminum in vaccines causes autoimmune problems.

Hypothalamic-Pituitary-Adrenal Hypofunction in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) as a Consequence of Activated Immune-Inflammatory and Oxidative and Nitrosative Pathways.

Morris, Gerwyn, Anderson, George, Maes, Michael·Molecular neurobiology·2017

This review examines why people with ME/CFS often have low cortisol levels (a stress hormone). The researchers found that the problem likely starts with an overactive immune system producing excessive inflammatory markers, which then damages the body's stress-hormone system. This is important because it suggests the low cortisol is a consequence of the disease, not its cause.

Practical management of chronic fatigue syndrome or myalgic encephalomyelitis in childhood.

Brigden, Amberly, Loades, Maria, Abbott, Anna et al.·Archives of disease in childhood·2017

This article provides practical guidance on how doctors should diagnose and treat ME/CFS in children and teenagers. ME/CFS is a serious condition that affects at least 1 in 100 secondary school students in the UK, causing severe fatigue and limiting daily activities. Although effective treatments exist, many young people with ME/CFS don't get diagnosed or receive help they need.

Diagnostics

Children's experiences of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review and meta-ethnography of qualitative studies.

Parslow, Roxanne M, Harris, Sarah, Broughton, Jessica et al.·BMJ open·2017

This study reviewed 10 research papers about how children with ME/CFS experience their illness. The researchers found that ME/CFS causes major disruption to children's lives, affecting their ability to go to school, see friends, and plan their futures. Children struggle when doctors don't recognize or understand their condition, but they cope better when they have support from family, friends, and healthcare providers who believe their illness is real.

A systematic review of the association between fatigue and genetic polymorphisms.

Wang, Tengteng, Yin, Jie, Miller, Andrew H et al.·Brain, behavior, and immunity·2017

Researchers reviewed 50 studies to understand whether differences in our genes (called genetic polymorphisms) might make some people more likely to experience severe fatigue. They found that certain genetic variations in immune system and brain chemistry genes were linked to fatigue across different diseases, including ME/CFS. This suggests that our genes may play a role in determining how tired we become.

E0 ConsensusReviewPEM not requiredSystematic-Review

The treatment of fatigue by non-invasive brain stimulation.

Lefaucheur, Jean-Pascal, Chalah, Moussa A, Mhalla, Alaa et al.·Neurophysiologie clinique = Clinical neurophysiology·2017

Researchers reviewed 15 studies examining whether non-invasive brain stimulation techniques—specifically transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS)—can reduce fatigue in various conditions including ME/CFS. While most studies showed promising results, especially in multiple sclerosis and fibromyalgia, the evidence remains limited and inconsistent because different studies used different methods and measured fatigue in different ways.

Role of dietary modification in alleviating chronic fatigue syndrome symptoms: a systematic review.

Jones, Kathryn, Probst, Yasmine·Australian and New Zealand journal of public health·2017

Researchers reviewed 22 studies looking at whether changing what you eat could help ME/CFS symptoms. They found some promise with certain supplements like omega-3 fatty acids and D-ribose, as well as foods high in polyphenols (like berries and green tea). However, the evidence overall was limited and inconsistent—meaning we don't yet have clear dietary recommendations that work reliably for most ME/CFS patients.

Interventions

E0 ConsensusReviewPEM not requiredSystematic-Review

Vitamin and mineral status in chronic fatigue syndrome and fibromyalgia syndrome: A systematic review and meta-analysis.

Joustra, Monica L, Minovic, Isidor, Janssens, Karin A M et al.·PloS one·2017

This review looked at whether people with ME/CFS and fibromyalgia have low levels of vitamins and minerals, and whether taking supplements helps. Researchers found very little evidence that vitamin or mineral deficiencies cause these illnesses or that supplements improve symptoms. While some studies showed lower vitamin E levels in patients, this finding disappeared when looking only at higher-quality research.

E0 ConsensusReviewPEM unclearEvidence-Map

The European ME/CFS Biomarker Landscape project: an initiative of the European network EUROMENE.

Scheibenbogen, Carmen, Freitag, Helma, Blanco, Julià et al.·Journal of translational medicine·2017

Researchers across Europe are working together to find biological markers (signs in blood or body tests) that could help diagnose ME/CFS and track how treatments work. This study reviewed all the biomarker research happening in Europe and created a database of what scientists are studying. The goal is to develop reliable tests that doctors could use in the future to diagnose ME/CFS and improve clinical trials.

Biomarkers

Serious adverse events after HPV vaccination: a critical review of randomized trials and post-marketing case series.

Martínez-Lavín, Manuel, Amezcua-Guerra, Luis·Clinical rheumatology·2017

This review examined safety reports from HPV vaccine studies and medical databases. The authors found that some large vaccine trials reported more serious side effects in vaccinated groups than in control groups, though researchers did not conclude these were caused by the vaccine. The study raises questions about how thoroughly vaccine safety is monitored and reported.