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ME/CFS Atlas — A public knowledge atlas for ME/CFS

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ME/CFS Atlas is an evidence reference platform, not a medical provider. Content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.

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ME/CFS Evidence Browser — Classified Studies on Myalgic Encephalomyelitis

Evidence browser

Search and filter 6,167 studies by evidence level, diagnostic criteria, PEM status, and research domain. Each entry links to the original source.

Studies sorted by evidence level, then year. Browse by topic instead →

Evidence level (E0–E3) reflects study type and replication, not methodological quality. A weak systematic review still sits at E0. How evidence levels work →

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517 studies

E0 — Consensus643E1 — Replicated320E2 — Moderate2,782E3 — Preliminary2,422

ME/CFS4,025Long COVID217Post-infectious189Overlapping1,050

Required for diagnosis414Not specified / unclear2,219Not required3,534

Post-Exertional Malaise1,064Cognitive Dysfunction1,735Pain1,620Unrefreshing Sleep799Orthostatic Intolerance478

Cytokines818Gene Expression567Metabolomics473Neuroimaging468Autoantibodies458

Infection-Triggered1,174Long COVID Overlap588Pediatric493Severe231

Strong Phenotyping438Sex-Stratified326Severe ME Included118

Systematic Review265Meta-Analysis60RCT300

Peer-reviewed6,110Preprint3Unclear54

501–517 of 517 studies

E3 PreliminaryCommentaryPEM not requiredEditorial

Is chronic fatigue syndrome synonymous with effort syndrome?

Rosen, S D, King, J C, Wilkinson, J B et al.·Journal of the Royal Society of Medicine·1990

This 1990 study examined whether chronic fatigue syndrome (CFS) might actually be caused by a breathing pattern problem called chronic hyperventilation. The researchers found that 93 out of 100 patients diagnosed with CFS showed signs of this breathing issue instead. They suggest doctors should check patients for hyperventilation problems before diagnosing them with ME or CFS.

E3 PreliminaryReviewPEM unclearReview-Narrative

The chronic fatigue syndrome: a return to common sense.

Denman, A M·Postgraduate medical journal·1990

This 1990 opinion piece argues that ME/CFS should be understood through practical, straightforward clinical observation rather than overly complex theories. The author advocates for a 'common sense' approach to recognizing and managing the condition based on what doctors actually observe in patients.

E3 PreliminaryCommentaryPEM not requiredEditorial

Neurasthenia in the 1980s: chronic mononucleosis, chronic fatigue syndrome, and anxiety and depressive disorders.

Greenberg, D B·Psychosomatics·1990

In the 1980s, doctors thought chronic fatigue syndrome might be caused by a virus called Epstein-Barr virus (the virus that causes mononucleosis). This editorial explains that while this seemed like a logical explanation, the virus is not actually the cause of chronic fatigue syndrome. The author points out that many people with chronic fatigue also have depression or anxiety, and notes that these mental health conditions should be carefully evaluated and treated rather than overlooked.

E3 PreliminaryReviewPEM unclearReview-Narrative

Confounding features of the fibromyalgia syndrome: a current perspective of differential diagnosis.

Bennett, R M·The Journal of rheumatology. Supplement·1989

This article discusses how fibromyalgia syndrome can be confused with many other conditions, including chronic fatigue syndrome, because they share similar symptoms like pain and tiredness. When doctors misdiagnose fibromyalgia or take too long to identify it, patients may receive wrong treatments and become frustrated with their care. Understanding the differences between these conditions is important so patients get the correct diagnosis and appropriate help.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Chronic fatigue syndrome. A critical appraisal of the role of Epstein-Barr virus.

Koo, D·The Western journal of medicine·1989

Early research suggested that a virus called Epstein-Barr virus (EBV) might cause ME/CFS, leading to the disease sometimes being called "chronic EBV syndrome." However, this review shows that the antibody levels used to detect EBV exposure are similar in people with ME/CFS, healthy people, and people with other illnesses, making it impossible to prove EBV actually causes the condition. Since most people have been exposed to EBV at some point, we cannot easily tell whether the virus causes ME/CFS or if people with ME/CFS simply show different antibody patterns because they are already sick.

E3 PreliminaryReviewPEM unclearReview-Narrative

Myalgic encephalomyelitis.

Gordon, N·Developmental medicine and child neurology·1988

This is a review article about myalgic encephalomyelitis (ME), a serious condition that causes extreme tiredness, muscle pain, and cognitive difficulties. The author examines what was known about ME in 1988, including how it affects the brain and nervous system, and discusses different theories about what might cause it.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Chronic fatigue syndrome--a diagnosis for consideration.

Portwood, M F·The Nurse practitioner·1988

This article helps doctors recognize ME/CFS by describing its many symptoms, which can range from mild tiredness to severe disability. Patients often report feeling exhausted, achy, and unable to concentrate, yet standard medical tests often appear normal. The article emphasizes that doctors should take these symptoms seriously and help patients manage their condition, even though there is currently no cure.

E3 PreliminaryReviewPEM not requiredReview-Narrative

The chronic fatigue syndrome (myalgic encephalomyelitis)--myth or mystery?

Spracklen, F H·South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde·1988

This 1988 review article discusses chronic fatigue syndrome (also called myalgic encephalomyelitis) and explains why there has been so much confusion about this condition. The author reviews what doctors know about the illness, including its possible causes and symptoms, and discusses why having a clear definition of the disease is important for research and treatment. The article emphasizes that better understanding and more rigorous studies are needed to help patients.

E3 PreliminaryReviewPEM unclearReview-Narrative

The myalgic encephalomyelitis syndrome.

Murdoch, J C·Family practice·1988

This review examines myalgic encephalomyelitis (ME), a relapsing illness that primarily affects young women and causes severe muscle pain and exhaustion. The authors looked at research from the United Kingdom, United States, and New Zealand over 40 years to understand what might cause this condition. They discuss how difficult it is to treat patients when doctors don't know what's causing the illness, and suggest renaming it 'myalgic exhaustion syndrome.'

E3 PreliminaryDiagnosticPEM not requiredMethods-Paper

Chronic fatigue syndrome: a working case definition.

Holmes, G P, Kaplan, J E, Gantz, N M et al.·Annals of internal medicine·1988

This landmark 1988 paper proposed a new name and formal definition for what was previously called 'chronic Epstein-Barr virus syndrome.' The authors recognized that the condition was poorly understood and inconsistently diagnosed, so they renamed it 'chronic fatigue syndrome' (ME/CFS) and created a working definition to help doctors identify and study it more consistently. This definition focused on severe, ongoing fatigue along with other symptoms like sore throat, headaches, and muscle pain.

E3 PreliminaryReviewPEM unclearReview-Narrative

The post-viral syndrome: a review.

Archer, M I·The Journal of the Royal College of General Practitioners·1987

This 1987 review examines post-viral syndrome (now often called ME/CFS), a condition that develops after viral infections. The author discusses whether the illness is caused by ongoing viral infection, psychological factors, or a combination of both. The review notes that different doctors diagnosed the condition at very different rates, and that many patients struggled to accept psychiatric support as part of their treatment.

E3 PreliminaryCohortPEM unclear

Myalgic encephalomyelitis "an obscene cosmic joke"?

Church, A J·The Medical journal of Australia·1980

This 1980 case-control study examined patients with myalgic encephalomyelitis (ME/CFS) to better understand the condition. While the full details are limited, the study represents an early medical investigation into a disease that was not well understood at the time and was often dismissed by the medical community.

E3 PreliminaryCohortPEM unclear

Benign myalgic encephalomyelitis: an outbreak in a nurses' school in Athens.

DAIKOS, G K, GARZONIS, S, PALEOLOGUE, A et al.·Lancet (London, England)·1959

This 1959 study documented an outbreak of ME/CFS-like illness among nursing students in Athens, Greece. Multiple students developed similar symptoms including muscle pain, fatigue, and neurological problems over a short period. The researchers observed the outbreak and recorded what happened, helping establish that ME/CFS can occur in groups of people.

E3 PreliminaryCohortPEM unclear

Benign myalgic encephalomyelitis.

BHATIA, B B, CHANDRA, S, BHUSHAN, C·Journal of the Indian Medical Association·1958

This is an early case-control study from 1958 examining what was then called benign myalgic encephalomyelitis. The researchers described and compared cases of the condition, though specific details about their findings are not available in the abstract. This represents one of the earliest formal medical investigations into what we now know as ME/CFS.

E3 PreliminaryCohortPEM unclear

Benign myalgic encephalomyelitis.

GALPINE, J F, BRADY, C·Lancet (London, England)·1957

This 1957 case-control study by Galpine and Brady documented cases of myalgic encephalomyelitis and compared them with control groups to understand the condition's features. The researchers aimed to establish that ME was a distinct medical condition with identifiable characteristics, rather than a purely psychological disorder. This early study helped establish the medical legitimacy of what patients and some doctors were observing as a real illness.

E3 PreliminaryCohortPEM unclearObservational

EPIDEMIC myalgic encephalomyelitis.

British medical journal·1957

This 1957 study from the British Medical Journal documents cases of myalgic encephalomyelitis occurring in epidemic form—meaning multiple people in a community became ill at the same time. The researchers observed patients with this condition to better understand how it presented and spread.

E3 PreliminaryCohortPEM unclearObservational

Benign myalgic encephalomyelitis (Akureyri disease, Iceland disease).

BLATTNER, R J·The Journal of pediatrics·1956

This 1956 study describes an outbreak of a disease called Akureyri disease (also known as Iceland disease) that affected multiple people in Iceland. The disease caused muscle pain and fatigue similar to what we now call ME/CFS. This early medical observation helped document that ME/CFS-like illnesses have occurred in clusters and have affected communities for decades.

Or browse by topic

PEM Immune Neuro Metabolic Biomarkers Severe ME Long COVID Cognitive

Curated Collections

Thematic groupings by clinical question or research area.

Neuroinflammation Evidence

PET imaging and other studies providing evidence for brain inflammation in ME/CFS.

Metabolism & Mitochondria

Metabolomics and mitochondrial function studies revealing energy metabolism disruption.

Biomarkers

Studies identifying potential biological markers for ME/CFS diagnosis and stratification.

PEM-Specific Research

Studies specifically examining post-exertional malaise, the hallmark symptom of ME/CFS.