ME/CFS Evidence Browser — Classified Studies on Myalgic Encephalomyelitis

441–460 of 737 studies

E3 PreliminaryGuidelinePEM requiredGuideline

[Transdisciplinary Expert Statement: care guide for people severely affected by ME/CFS in home-based care].

Hermisson, Joachim, Schreiner, Claudia, Weichselbaumer, Stefanie et al.·Wiener medizinische Wochenschrift (1946)·2026

This guide describes practical home-care approaches for people severely affected by ME/CFS, developed by combining advice from patients and family caregivers with input from nursing, physiotherapy, and medical professionals. The guide addresses how to adjust daily care activities—such as nutrition, hygiene, and communication—to avoid overexertion and post-exertional malaise (PEM). However, because this is a compiled expert consensus rather than a systematic trial, the strength of evidence for each recommendation remains unclear.

Severe MEInterventionsPost-Exertional Malaise

E3 PreliminaryReviewPEM unclearReview-Narrative

Physiotherapy management of long COVID in adults.

Nygren-Bonnier, Malin, Holland, Anne E·Journal of physiotherapy·2026

This study examines how physical therapy and rehabilitation approaches can help adults with long COVID manage their symptoms and improve function. The review looks at different physiotherapy strategies that healthcare providers use to treat long COVID patients. Understanding which approaches work best can help patients and doctors make better decisions about treatment options.

Post-Exertional Malaise

E3 PreliminaryMechanismPEM required

From fatigue to physiology: Submaximal 2-day cardiopulmonary exercise test and emerging standards in long COVID.

Risbano, Michael G·Experimental physiology·2026

This study examines how a special two-day exercise test can help doctors understand the physical changes that happen in long COVID and ME/CFS patients. Instead of pushing patients to their maximum effort, researchers used a gentler approach to measure heart and lung function, which may be safer and more revealing for people with these conditions. The study aims to create new standard ways of testing that better capture what's happening in patients' bodies.

Post-Exertional Malaise

E3 PreliminaryReviewPEM unclearReview-Narrative

Molecular hydrogen as a treatment for ME/CFS: a mini-review of clinical evidence and mechanistic rationale.

Friedberg, Fred, LeBaron, Tyler W·Frontiers in medicine·2026

This review examines whether hydrogen-rich water might help ME/CFS patients. Hydrogen is a simple molecule that may reduce inflammation and improve energy production in cells—two problems linked to ME/CFS. Early studies show it may help reduce fatigue and improve daily functioning with few side effects, though the research is still very limited.

Post-Exertional Malaise

E3 PreliminaryMechanismPEM requiredMechanistic

Genetic depletion of the early autophagy protein ATG13 impairs mitochondrial energy metabolism, augments oxidative stress, induces the polarization of macrophages to the M1 inflammatory mode, and compromises myelin integrity in skeletal muscle.

Toriola, Mubaraq A, Timlin, Emma, Bulbule, Sarojini et al.·Inflammation research : official journal of the European Histamine Research Society ... [et al.]·2026

This study examined a protein called ATG13 that helps cells clean up damaged parts, particularly in immune cells called macrophages. When ATG13 was reduced, these immune cells couldn't work properly, their energy-producing structures (mitochondria) became dysfunctional, and they created too much harmful oxidative stress. This triggered the immune cells to switch into an inflammatory state and caused muscle weakness and nerve damage in a mouse model.

Immune SystemPost-Exertional Malaise

E3 PreliminaryReviewPEM requiredReview-Narrative

Virus-induced endothelial senescence as a cause and driving factor for ME/CFS and long COVID: mediated by a dysfunctional immune system.

Nunes, Massimo, Kell, Loren, Slaghekke, Anouk et al.·Cell death & disease·2026

This study proposes that ME/CFS and long COVID may be caused by damage to the blood vessels (endothelial cells) that occurs after a viral infection. When these cells become damaged and 'senescent' (aged), they release harmful substances that cause inflammation, blood clots, and reduced blood flow to the brain and other organs. The study suggests that a faulty immune system keeps these damaged blood vessels from healing, which is why symptoms persist for months or years after the initial infection.

Immune SystemPost-Exertional Malaise

E3 PreliminaryCommentaryPEM requiredEditorial

Expert perspectives on Myalgic encephalomyelitis/chronic fatigue syndrome - Insights from the 3rd International Conference of the Charité Fatigue Center.

Fehrer, Annick, Windzio, Lara, Schoening, Simon et al.·Autoimmunity reviews·2026

Nearly 4,000 ME/CFS researchers and experts gathered at an international conference in May 2025 to share the latest discoveries about this serious illness. They discussed how ME/CFS develops, better ways to diagnose it, and new treatments being tested. The conference highlighted that while COVID-19 has brought more attention and funding to ME/CFS research, the disease is still not well understood and needs much more study.

Energy MetabolismImmune SystemPost-Exertional Malaise

E3 PreliminaryCohortPEM unclearObservational

Treatment of post-COVID symptoms with auricular vagus nerve stimulation.

Gebetsroither, Patrick, Ettenauer, Thomas, Likar, Rudolf·Wiener medizinische Wochenschrift (1946)·2026

Researchers tested a treatment called auricular vagus nerve stimulation (mild electrical stimulation applied to the ear) in 9 patients with long COVID symptoms. After 4 weeks of treatment, patients reported improvement in 28 out of 35 symptoms they were tracked for, with particular benefits for pain, fatigue, exhaustion after activity, sleep problems, and heart/blood pressure irregularities. Many of these improvements lasted when patients were checked again 12 weeks later.

Post-Exertional Malaise

E3 PreliminaryReviewPEM requiredReview-Narrative

Lactate, Capnia, and Fat Oxidation as Therapeutic Axes for SARS-CoV-2 Spike Protein-Induced Sequelae.

Gracidas, Carlos, Levy, Rakeem, Varon, Joseph et al.·Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme·2026

This review suggests that ME/CFS and long COVID symptoms—including exhaustion, brain fog, and crashing after activity—may be caused by problems with how the body's energy-producing structures (mitochondria) work. The authors propose that treatments targeting three areas could help: improving the body's ability to handle lactate (a byproduct of exertion), increasing oxygen delivery to tissues, and helping the body burn fat for energy more efficiently, similar to how endurance athletes train.

Post-Exertional Malaise

E3 PreliminaryCohortPEM requiredCase-Control

Significant aggravation of pre-existing myalgic encephalomyelitis/chronic fatigue syndrome following proton beam therapy for sphenoid wing meningioma: case report.

Fischer, Christian, Seidlitz, Annekatrin, Krause, Mechthild·Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]·2026

This is a single case report of a 46-year-old woman with ME/CFS whose condition severely worsened after receiving proton beam radiation therapy for a brain tumor. Over months following treatment, she went from being ambulatory to completely bedridden, with worsening fatigue, pain, dizziness, and cognitive problems. The report suggests that radiation may have triggered this deterioration, but it remains unclear whether this outcome would occur in other ME/CFS patients undergoing similar treatment.

Pain and SensitizationSevere MEEnergy MetabolismCognitive Impairment

E3 PreliminaryCohortPEM requiredCase-Control

Resolution of Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome symptoms following kanshoho, a low-pressure muscle relaxation technique: A case report.

Amitani, Haruka, Sakato, Takashi, Asakawa, Akihiro·Explore (New York, N.Y.)·2026

A woman with Long COVID and ME/CFS who had severe fatigue, pain, brain fog, and sleep problems tried a gentle hands-on relaxation technique called kanshoho along with activity pacing advice. After 10 treatment sessions over 2.5 months, her symptoms completely resolved, and she was able to stop her antidepressant medication without symptom worsening. While this is just one person's experience, it suggests this low-pressure approach might help some ME/CFS patients who cannot tolerate exercise-based treatments.

Post-Exertional Malaise

E3 PreliminaryCommentaryPEM not requiredEditorial

An Overview of Severe Myalgic Encephalomyelitis.

Vink, Mark, Vink-Niese, Alexandra·Journal of clinical medicine·2026

This article reviews what we know about severe ME/CFS, a serious illness that can leave people completely bedbound and dependent on caregivers. Currently, there is no blood test or scan that can diagnose ME/CFS, though a special two-day exercise test can help document the problem. The authors emphasize that severe ME/CFS is a major medical condition that has received very little research funding, and there are currently no proven treatments available.

Severe MEPost-Exertional Malaise

E3 PreliminaryReviewPEM requiredReview-Narrative

Mechanistic Insights Into Long Covid: Viral Persistence, Immune Dysregulation, and Multi-Organ Dysfunction.

Gupta, Gautam, Buonsenso, Danilo, Wood, John et al.·Comprehensive Physiology·2025

This review examines how Long Covid causes persistent symptoms affecting multiple body systems. The research suggests that SARS-CoV-2 virus may hide in body tissues, trigger ongoing immune problems, and damage how cells produce energy, which could explain fatigue and post-exertion crashes. These mechanisms appear similar to ME/CFS, suggesting the two conditions may share common biological pathways.

NeuroinflammationImmune SystemPost-Exertional Malaise

E3 PreliminaryPEM unclear

Perspectives of Rehabilitation Professionals on Long COVID Interventions to Facilitate Return-to-Work.

MacKinnon, Cassandra, Castro-Barquero, Cassandra, Kontis, Alexandra et al.·Canadian journal of occupational therapy. Revue canadienne d'ergotherapie·2025

This study asked rehabilitation professionals in Quebec about their experiences helping people with long COVID return to work. The professionals emphasized that education, gradually increasing activity, and self-management are the most helpful approaches, but they noted that returning to work is very difficult without workplace accommodations and proper support for managing post-exertional malaise (when symptoms worsen after activity).

Post-Exertional Malaise

E3 PreliminaryMechanismPEM requiredMechanistic

Gulf War Illness Induced Sex-Specific Transcriptional Differences Under Stressful Conditions.

Frank, Joshua, Tehrani, Lily, Gamer, Jackson et al.·International journal of molecular sciences·2025

Researchers studied how the immune system responds to physical stress in Gulf War veterans with Gulf War Illness (GWI), a condition similar to ME/CFS with fatigue, brain fog, and exhaustion. They found that men and women with GWI have different patterns of immune system activation during and after exercise, suggesting their bodies handle stress differently. These differences could help doctors develop better tests and treatments tailored to each person's sex.

BiomarkersImmune SystemPost-Exertional Malaise

E3 PreliminaryMechanismPEM requiredMechanistic

Heightened innate immunity may trigger chronic inflammation, fatigue and post-exertional malaise in ME/CFS.

Che, Xiaoyu, Ranjan, Amit, Guo, Cheng et al.·npj metabolic health and disease·2025

This study examined blood samples and immune responses in ME/CFS patients to understand why they experience extreme fatigue and feeling worse after activity. Researchers found that patients' immune systems overreact to germs, their bodies have trouble producing energy efficiently, and they have several chemical imbalances in their blood. These problems got worse after exercise and matched how sick patients felt.

Energy MetabolismImmune SystemPost-Exertional Malaise

E3 PreliminaryBehavioralPEM requiredCase-Control

Recovery from Myalgic Encephalomyelitis/Chronic Fatigue syndrome developed after severe acute respiratory syndrome coronavirus 2 vaccination: A case report.

Kurotori, Isaku, Sasao, Wataru, Abe, Masahiko·PCN reports : psychiatry and clinical neurosciences·2025

This case report describes a 65-year-old woman who developed ME/CFS symptoms after receiving her third COVID-19 vaccine, including severe tiredness, worsening after activity, and dizziness. After 30 months of symptoms, she recovered using a combination approach that included careful activity management, medications, and mental health support. This is the first documented case showing full recovery from vaccine-associated ME/CFS.

Post-Exertional Malaise

E3 PreliminaryMechanismPEM requiredMechanistic

Uncovering the genetic architecture of ME/CFS: a precision approach reveals impact of rare monogenic variation.

Birch, Camille L, Wilk, Brandon M, Gajapathy, Manavalan et al.·Journal of translational medicine·2025

Researchers studied the DNA of 31 people with ME/CFS from 25 families to find genetic causes of the illness. They found that about 39% of participants had gene mutations that could contribute to ME/CFS, and these mutations affected how bodies produce energy and handle stress. While the specific genes varied between patients, they all seemed to affect similar biological pathways, suggesting ME/CFS may be caused by different genetic problems that lead to the same symptoms.

Post-Exertional Malaise

E3 PreliminaryReviewPEM unclearReview-Narrative

Creatine and post-viral fatigue syndrome: an update.

Ostojic, Sergej M, Candow, Daren G, Tarnopolsky, Mark A·Journal of the International Society of Sports Nutrition·2025

This review examines how creatine—a natural substance that helps muscles produce energy—might help people with post-viral fatigue syndrome (the prolonged exhaustion that can follow viral infections like COVID-19). The researchers found that people with this condition often have problems with how their body produces and uses energy, particularly in the mitochondria (the cell's power centers). They suggest that taking creatine supplements could help restore energy production and reduce symptoms like fatigue and brain fog.

Post-Exertional Malaise

E3 PreliminaryMechanismPEM requiredMechanistic

Cerebrospinal fluid metabolomics, lipidomics and serine pathway dysfunction in myalgic encephalomyelitis/chronic fatigue syndroome (ME/CFS).

Baraniuk, James N·Scientific reports·2025

Researchers studied brain fluid from ME/CFS patients to understand what goes wrong with how their brains use energy. They found that ME/CFS patients have abnormal levels of certain molecules involved in energy production and brain cell function, and these problems got worse after exercise. The study suggests that ME/CFS may involve problems with how the brain processes nutrients and maintains its protective coating around nerve fibers.

Post-Exertional Malaise

← Previous Next 20 studies →

Or browse by topic

PEM Immune Neuro Metabolic Biomarkers Severe ME Long COVID Cognitive

Evidence Atlas

Evidence browser

[Transdisciplinary Expert Statement: care guide for people severely affected by ME/CFS in home-based care].

Physiotherapy management of long COVID in adults.

From fatigue to physiology: Submaximal 2-day cardiopulmonary exercise test and emerging standards in long COVID.

Molecular hydrogen as a treatment for ME/CFS: a mini-review of clinical evidence and mechanistic rationale.

Genetic depletion of the early autophagy protein ATG13 impairs mitochondrial energy metabolism, augments oxidative stress, induces the polarization of macrophages to the M1 inflammatory mode, and compromises myelin integrity in skeletal muscle.

Virus-induced endothelial senescence as a cause and driving factor for ME/CFS and long COVID: mediated by a dysfunctional immune system.

Expert perspectives on Myalgic encephalomyelitis/chronic fatigue syndrome - Insights from the 3rd International Conference of the Charité Fatigue Center.

Treatment of post-COVID symptoms with auricular vagus nerve stimulation.

Lactate, Capnia, and Fat Oxidation as Therapeutic Axes for SARS-CoV-2 Spike Protein-Induced Sequelae.

Significant aggravation of pre-existing myalgic encephalomyelitis/chronic fatigue syndrome following proton beam therapy for sphenoid wing meningioma: case report.

Resolution of Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome symptoms following kanshoho, a low-pressure muscle relaxation technique: A case report.

An Overview of Severe Myalgic Encephalomyelitis.

Mechanistic Insights Into Long Covid: Viral Persistence, Immune Dysregulation, and Multi-Organ Dysfunction.

Perspectives of Rehabilitation Professionals on Long COVID Interventions to Facilitate Return-to-Work.

Gulf War Illness Induced Sex-Specific Transcriptional Differences Under Stressful Conditions.

Heightened innate immunity may trigger chronic inflammation, fatigue and post-exertional malaise in ME/CFS.

Recovery from Myalgic Encephalomyelitis/Chronic Fatigue syndrome developed after severe acute respiratory syndrome coronavirus 2 vaccination: A case report.

Uncovering the genetic architecture of ME/CFS: a precision approach reveals impact of rare monogenic variation.

Creatine and post-viral fatigue syndrome: an update.

Cerebrospinal fluid metabolomics, lipidomics and serine pathway dysfunction in myalgic encephalomyelitis/chronic fatigue syndroome (ME/CFS).

Curated Collections

Neuroinflammation Evidence

Metabolism & Mitochondria

Biomarkers

PEM-Specific Research