ME/CFS Evidence Browser — Classified Studies on Myalgic Encephalomyelitis

4501–4520 of 6,163 studies

E3 PreliminaryCommentaryPEM unclearEditorial

Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses, and Medical Uncertainty.

Bransfield, Robert C, Friedman, Kenneth J·Healthcare (Basel, Switzerland)·2019

Doctors often struggle to distinguish between illnesses caused by psychological factors, illnesses where physical symptoms cause psychological effects, true multisystem diseases (affecting many body systems), and situations where medical causes haven't been found yet. This article discusses how using outdated or inaccurate diagnostic labels—like 'all in your head'—can harm patients and delay proper diagnosis. The authors argue that many conditions previously thought to be purely psychological may actually involve the immune system and microbiome, and that doctors need better training to avoid misdiagnosing complex diseases like ME/CFS.

Diagnostics

E3 PreliminaryCohortPEM unclear

Severe posterior hypometabolism but normal perfusion in a patient with chronic fatigue syndrome/myalgic encephalomyelitis revealed by PET/MRI.

Sahbai, S, Kauv, P, Abrivard, M et al.·European journal of nuclear medicine and molecular imaging·2019

This study examined a single ME/CFS patient's brain using advanced imaging technology (PET/MRI) that can show both brain activity and blood flow simultaneously. The researchers found that certain areas in the back of the patient's brain showed significantly lower metabolic activity (meaning cells were using less energy), but blood flow to those same areas appeared normal. This unusual pattern suggests that ME/CFS may involve a specific type of brain dysfunction that current standard brain scans might miss.

Energy Metabolism

E3 PreliminaryDiagnosticPEM not requiredMethods-Paper

Obstacles to recruitment in paediatric studies focusing on mental health in a physical health context: the experiences of clinical gatekeepers in an observational cohort study.

Loades, Maria E, Smith, Lucie, Higson-Sweeney, Nina et al.·BMC medical research methodology·2019

This study looked at why it's hard to recruit young people with ME/CFS into research studies about mental health. Researchers interviewed doctors and nurses at a specialist ME/CFS clinic to understand what makes it difficult for them to invite patients to join studies. They found that busy schedules, emotional patient appointments, and competing studies all made recruitment harder.

E3 PreliminaryMechanismPEM requiredMechanistic

Exercise challenge alters Default Mode Network dynamics in Gulf War Illness.

Rayhan, Rakib U, Washington, Stuart D, Garner, Richard et al.·BMC neuroscience·2019

This study looked at brain activity in Gulf War Illness patients before and after exercise to understand post-exertional malaise (PEM)—a condition where symptoms get worse after physical or mental effort. Using brain scans, researchers found that after exercise, patients showed unusual patterns of brain deactivation (regions that should 'turn off' during focused tasks) compared to healthy people. This suggests PEM may involve how the brain manages activity, providing a potential biological marker for the illness.

Post-Exertional Malaise

E3 PreliminaryDiagnosticPEM not requiredMethods-Paper

Implementing guided ICBT for chronic pain and fatigue: A qualitative evaluation among therapists and managers.

van der Vaart, Rosalie, Worm-Smeitink, Margreet, Bos, Yvonne et al.·Internet interventions·2019

This study looked at how therapists and managers can successfully set up and use internet-based cognitive behavioral therapy (ICBT)—an online treatment for chronic pain and fatigue—in their clinics. Researchers interviewed staff from twelve mental health clinics to understand what helps or gets in the way when starting this new type of treatment. They found that success depends on factors like the quality of the online program, whether therapists feel confident using it, whether patients want to try online treatment, and whether the clinic has proper support and funding.

E3 PreliminaryCohortPEM unclearCross-Sectional

Dismissing chronic illness: A qualitative analysis of negative health care experiences.

McManimen, Stephanie, McClellan, Damani, Stoothoff, Jamie et al.·Health care for women international·2019

This study looked at why some ME/CFS patients feel dismissed by their doctors. Researchers asked patients online to describe negative experiences with healthcare providers and found common themes in how they were treated. The study highlights that many doctors don't have proper training about ME/CFS, which leads to unhelpful advice like exercising more or seeing a psychiatrist, and suggests ways the healthcare system can better support these patients.

E3 PreliminaryMechanismPEM not requiredObservational

Network structure underpinning (dys)homeostasis in chronic fatigue syndrome; Preliminary findings.

Clark, James E, Ng, Wan-Fai, Rushton, Stephen et al.·PloS one·2019

This study looked at how three key body systems (nervous system, stress hormone system, and immune system) work together in ME/CFS patients compared to healthy people. Researchers measured blood pressure, heart rate, and stress hormones at rest, then used a special mathematical approach to map how these measurements connect to each other. They found that in ME/CFS patients, these connections form a different pattern than in healthy controls, with a few key measurements being especially influential.

Immune System

E3 PreliminaryCohortPEM not requiredCase-Control

Cannabis-induced Acute Coronary Syndrome: A Coincidence or Not?

Landa, Eric, Vigandt, Erika, Andreev, Alexander et al.·Cureus·2019

This case report describes one patient who had a heart attack (myocardial infarction) shortly after smoking marijuana. The patient was a 42-year-old man with no previous heart problems who experienced chest pain at rest about one hour after using marijuana. The authors suggest that marijuana may have triggered the heart attack, though this is considered a rare occurrence.

E3 PreliminaryTrialPEM not requiredRCT

Treatment for Gulf War Illness (GWI) with KPAX002 (methylphenidate hydrochloride + GWI nutrient formula) in subjects meeting the Kansas case definition: A prospective, open-label trial.

Holodniy, Mark, Kaiser, Jon D·Journal of psychiatric research·2019

Researchers tested a combination treatment called KPAX002—containing a stimulant medication (methylphenidate) plus vitamins and nutrients meant to support energy production in cells—in 17 people with Gulf War Illness. After 12 weeks, patients reported about 25% improvement in their overall symptoms, including better fatigue, brain fog, sleep, and pain. The treatment was generally safe and well-tolerated, though a larger, more rigorous study is needed to confirm these results.

Pain and SensitizationSleepCognitive Impairment

E3 PreliminaryReviewPEM not requiredReview-Narrative

Astaxanthin: A Potential Mitochondrial-Targeted Antioxidant Treatment in Diseases and with Aging.

Sztretye, Mónika, Dienes, Beatrix, Gönczi, Mónika et al.·Oxidative medicine and cellular longevity·2019

This review examines astaxanthin, a powerful natural antioxidant found in marine organisms, and how it might help protect cells from damage caused by oxidative stress—an imbalance that occurs in ME/CFS and many other diseases. The authors explain how astaxanthin may work by targeting and protecting mitochondria, the energy-producing structures in our cells. They suggest this compound could potentially help prevent or slow disease progression and aging-related health problems.

Energy Metabolism

E3 PreliminaryDiagnosticPEM not requiredMethods-Paper

RIFD - A brief clinical research interview for functional somatic disorders and health anxiety.

Petersen, Marie Weinreich, Schröder, Andreas, Jørgensen, Torben et al.·Journal of psychosomatic research·2019

Researchers developed a new interview tool called RIFD to help doctors identify people with chronic fatigue syndrome and similar conditions that cause long-term physical symptoms. Instead of relying only on questionnaires, trained doctors conducted phone interviews with nearly 1,600 people from Denmark to see if the tool could accurately spot cases. The interview was quick, easy to do, and people were satisfied with it.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Oxidative stress in exercise training: the involvement of inflammation and peripheral signals.

Magherini, Francesca, Fiaschi, Tania, Marzocchini, Riccardo et al.·Free radical research·2019

When we exercise, our bodies produce harmful molecules called free radicals that can damage cells. While some free radicals are normal and needed for muscle function, too many can cause problems. This review explains how intense exercise, stress, and not eating enough can create excessive free radicals and inflammation, which might lead to chronic fatigue and overtraining syndrome—conditions where the body cannot recover properly from exercise.

Immune SystemPost-Exertional Malaise

E3 PreliminaryMechanismPEM not requiredMechanistic

Hyperactivation of proprioceptors induces microglia-mediated long-lasting pain in a rat model of chronic fatigue syndrome.

Yasui, Masaya, Menjyo, Yuki, Tokizane, Kyohei et al.·Journal of neuroinflammation·2019

This study used rats exposed to chronic stress to understand why ME/CFS patients experience widespread pain without obvious tissue damage. Researchers found that stress caused sensory nerve fibers (proprioceptors) that detect body position to become overactive, which then triggered immune cells in the spinal cord called microglia to activate and cause pain. When they immobilized the ankle to reduce proprioceptor signaling, both the immune activation and pain behavior decreased.

Neuroinflammation

E3 PreliminaryMechanismPEM not requiredMechanistic

Persistent fatigue induced by interferon-alpha: a novel, inflammation-based, proxy model of chronic fatigue syndrome.

Russell, Alice, Hepgul, Nilay, Nikkheslat, Naghmeh et al.·Psychoneuroendocrinology·2019

This study suggests that some people treated with interferon-alpha (a drug used for hepatitis C) develop persistent fatigue that continues even after treatment ends—similar to ME/CFS. Researchers found that people who later developed long-lasting fatigue had a stronger immune response early in treatment, with higher levels of certain immune molecules. Importantly, the fatigue persisted even after the immune trigger was gone, suggesting that something in the body's initial overreaction may set off a lasting problem.

Immune System

E3 PreliminaryCohortPEM not requiredCase-Control

[Use of Modafinil in Co-existing Major Depression and ErectileDysfunction: A Case Report].

Karaş, Hakan, Kaşer, Muzaffer·Turk psikiyatri dergisi = Turkish journal of psychiatry·2019

This case report describes one patient with depression who also had erectile dysfunction and fatigue. When the antidepressant fluoxetine alone did not fully help his symptoms, doctors added a stimulant medication called modafinil. After adding modafinil, the patient reported improvements in both his fatigue and erectile dysfunction alongside his mood symptoms.

E3 PreliminaryReviewPEM unclearReview-Narrative

Differential diagnosis between "chronic fatigue" and "chronic fatigue syndrome".

Son, Chang-Gue·Integrative medicine research·2019

This article discusses the important difference between regular chronic fatigue (long-lasting tiredness) and Chronic Fatigue Syndrome (ME/CFS), a serious medical condition. The author explains why it's crucial to distinguish between these two conditions, since ME/CFS involves specific symptoms and has different causes than simple persistent tiredness.

Diagnostics

E3 PreliminaryReviewPEM not requiredReview-Narrative

Gulf War Illness: Unifying Hypothesis for a Continuing Health Problem.

Mawson, Anthony R, Croft, Ashley M·International journal of environmental research and public health·2019

Gulf War Illness (GWI) affects 25-32% of veterans from the 1991 Gulf War and causes chronic pain, fatigue, weakness, headaches, and thinking problems. This paper proposes that a combination of vaccinations and exposure to chemicals like an anti-nerve-agent drug (pyridostigmine bromide) may have damaged veterans' livers, causing them to release vitamin A at toxic levels into the bloodstream. This liver-based explanation could also help explain similar conditions like ME/CFS, fibromyalgia, and multiple chemical sensitivities.

E3 PreliminaryReviewPEM unclearReview-Narrative

Neurasthenia: Modern Malady or Historical Relic?

Overholser, James C, Beale, Eleanor E·The Journal of nervous and mental disease·2019

This article looks back at a condition called neurasthenia that doctors diagnosed frequently between 1869 and 1930, then largely abandoned. The authors found that many symptoms people with neurasthenia experienced—like exhaustion, mental fog, and physical weakness—are still seen today in conditions like chronic fatigue syndrome (ME/CFS) and fibromyalgia. By understanding neurasthenia's history, modern doctors may better recognize and treat these conditions and improve how they listen to their patients.

Diagnostics

E3 PreliminaryCohortPEM not requiredCase-Control

Paroxysmal Kinesigenic Dyskinesia Symptoms Markedly Reduced with Parenteral Vitamins and Minerals: A Case Report.

Bruton, Alisha, Fuller, Leslie·The Permanente journal·2019

This report describes one woman who had both a rare movement disorder (paroxysmal kinesigenic dyskinesia) and chronic fatigue syndrome. When she received weekly injections of vitamins and minerals, her movement disorder symptoms almost completely went away, and she was able to return to her normal daily activities. Genetic testing found several mutations that may help explain why this treatment worked so well for her.

Interventions

E3 PreliminaryMechanismPEM unclearMechanistic

Epstein-Barr Virus dUTPase Induces Neuroinflammatory Mediators: Implications for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Williams PhD, Marshall V, Cox, Brandon, Lafuse PhD, William P et al.·Clinical therapeutics·2019

This study explores whether a protein from the Epstein-Barr virus (EBV) may trigger brain inflammation in ME/CFS patients. Researchers found that this viral protein can change how brain cells function and alter important chemical pathways involved in energy, mood, and pain processing. The findings suggest that in some ME/CFS patients, this viral protein might contribute to fatigue, pain, and thinking difficulties.

NeuroinflammationImmune System

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Evidence Atlas

Evidence browser

Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses, and Medical Uncertainty.

Severe posterior hypometabolism but normal perfusion in a patient with chronic fatigue syndrome/myalgic encephalomyelitis revealed by PET/MRI.

Obstacles to recruitment in paediatric studies focusing on mental health in a physical health context: the experiences of clinical gatekeepers in an observational cohort study.

Exercise challenge alters Default Mode Network dynamics in Gulf War Illness.

Implementing guided ICBT for chronic pain and fatigue: A qualitative evaluation among therapists and managers.

Dismissing chronic illness: A qualitative analysis of negative health care experiences.

Network structure underpinning (dys)homeostasis in chronic fatigue syndrome; Preliminary findings.

Cannabis-induced Acute Coronary Syndrome: A Coincidence or Not?

Treatment for Gulf War Illness (GWI) with KPAX002 (methylphenidate hydrochloride + GWI nutrient formula) in subjects meeting the Kansas case definition: A prospective, open-label trial.

Astaxanthin: A Potential Mitochondrial-Targeted Antioxidant Treatment in Diseases and with Aging.

RIFD - A brief clinical research interview for functional somatic disorders and health anxiety.

Oxidative stress in exercise training: the involvement of inflammation and peripheral signals.

Hyperactivation of proprioceptors induces microglia-mediated long-lasting pain in a rat model of chronic fatigue syndrome.

Persistent fatigue induced by interferon-alpha: a novel, inflammation-based, proxy model of chronic fatigue syndrome.

[Use of Modafinil in Co-existing Major Depression and ErectileDysfunction: A Case Report].

Differential diagnosis between "chronic fatigue" and "chronic fatigue syndrome".

Gulf War Illness: Unifying Hypothesis for a Continuing Health Problem.

Neurasthenia: Modern Malady or Historical Relic?

Paroxysmal Kinesigenic Dyskinesia Symptoms Markedly Reduced with Parenteral Vitamins and Minerals: A Case Report.

Epstein-Barr Virus dUTPase Induces Neuroinflammatory Mediators: Implications for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Curated Collections

Neuroinflammation Evidence

Metabolism & Mitochondria

Biomarkers

PEM-Specific Research