E0ReviewPEM ?
Evaluating working memory functioning in individuals with myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review and meta-analysis.
2026Penson, Maddison et al.·Psychology, health & medicine·Systematic-Review
← Research Hub
NeurologyPEM-relevant
Cognitive Impairment
389 studies in the atlas
Cognitive dysfunction — commonly described as brain fog — is one of the most disabling and frequently reported symptoms of ME/CFS. It affects memory, concentration, word retrieval, and processing speed. Cognitive exertion can trigger PEM, making sustained mental activity dangerous for many patients.
What we know
- Cognitive dysfunction is reported by a majority of ME/CFS patients and significantly impacts daily functioning
- Reduced cerebral blood flow during upright posture may contribute to cognitive symptoms
- Cognitive exertion can trigger PEM, sometimes as reliably as physical exertion
- Neuropsychological testing shows measurable deficits in processing speed and attention in some studies
What remains uncertain
- Whether cognitive impairment is driven primarily by reduced cerebral blood flow, neuroinflammation, or metabolic factors
- The relationship between subjective cognitive complaints and objective neuropsychological test performance varies across studies
- Whether cognitive symptoms fluctuate in parallel with other ME/CFS symptoms or have independent drivers
- Sleep disruption may contribute to cognitive dysfunction, but the direction of causation is unclear
What is emerging
- Whether cognitive rehabilitation approaches adapted for ME/CFS (respecting PEM thresholds) can help
- The neurobiological basis of brain fog at the cellular level
- Whether cognitive biomarkers can track disease progression
- The relationship between cognitive impairment and neuroinflammatory findings
Start here
E0 ConsensusPEM required
Myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia - overlap, differences, and emerging insights.
Murovska, Modra, Krumina, Angelika, Araja, Diana et al.·Journal of translational medicine·2026
ME/CFS and fibromyalgia are two different but often overlapping illnesses that cause severe fatigue, pain, and other debilitating symptoms. While they share many similarities, ME/CFS has a distinctive feature called post-exertional malaise—where activity makes symptoms dramatically worse for hours or days—while fibromyalgia does not. This review shows that the two conditions have different immune system patterns and may require different treatment approaches.
Research Momentum
381 publications over 37 years. Recent trend: steady (17/year over the last 3 years).
Top Studies
60 of 389, sorted by evidence level and year
E0ReviewPEM ?
Neuroendocrine signature of ME/CFS: Meta-analytic evidence for bioactive cortisol deficit and exaggerated feedback sensitivity.
2026Woo, Tae-Wook et al.·Molecular psychiatry·Meta-Analysis
E0ReviewPEM ?
Digital Approaches for Managing Brain Fog in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Interventions, Monitoring, and Future Directions.
2026Araja, Diana et al.·Life (Basel, Switzerland)·Review-Narrative
E0ReviewPEM ✗
[Cognitive impairment in asthenic disorders].
2025Chutko, L S et al.·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·Review-Narrative
E0ReviewPEM ✓
Chronic Fatigue Syndrome: Diagnosis, Treatment, and Future Direction.
2024Graves, B Sue et al.·Cureus·Review-Narrative
E0ReviewPEM ✗
[Chronic fatigue syndrome in children].
2024Chutko, L S et al.·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·Review-Narrative
E0ReviewPEM ✗
Systematic review and meta-analysis of cognitive impairment in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
2022Aoun Sebaiti, Mehdi et al.·Scientific reports
E0ReviewPEM ✗
Stabilometric Biofeedback Training in Cognitive and Affective Function Improvement. Contribution of the Russian Scientific School. Part II.
2022Bazanova, O M et al.·Human physiology·Review-Narrative
E0ReviewPEM ?
The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS).
2021König, Rahel S et al.·Frontiers in immunology·Review-Narrative
E0ReviewPEM ✓
Review of case definitions for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
2020Lim, Eun-Jin et al.·Journal of translational medicine·Systematic-Review
E0ReviewPEM ?
A systematic review of neurological impairments in myalgic encephalomyelitis/ chronic fatigue syndrome using neuroimaging techniques.
2020Maksoud, Rebekah et al.·PloS one·Systematic-Review
E0ReviewPEM ✓
[Neurologic Abnormalities in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Review].
2018Komaroff, Anthony L et al.·Brain and nerve = Shinkei kenkyu no shinpo·Review-Narrative
E0ReviewPEM ✗
Attentional and interpretive bias towards illness-related information in chronic fatigue syndrome: A systematic review.
2016Hughes, Alicia et al.·British journal of health psychology·Systematic-Review
E0ReviewPEM ✗
Cognitive functioning in chronic fatigue syndrome: a meta-analysis.
2010Cockshell, S J et al.·Psychological medicine·Meta-Analysis
E0ReviewPEM ✗
Evidence-based efficacy of adaptogens in fatigue, and molecular mechanisms related to their stress-protective activity.
2009Panossian, Alexander et al.·Current clinical pharmacology·Review-Narrative
E0ReviewPEM ✗
Neuropsychological functioning in chronic fatigue syndrome: a review.
2001Michiels, V et al.·Acta psychiatrica Scandinavica·Review-Narrative
E0ReviewPEM ✗
Neuropsychology of chronic fatigue syndrome: a critical review.
1997Tiersky, L A et al.·Journal of clinical and experimental neuropsychology·Review-Narrative
E0ReviewPEM ✗
Neurocognitive functioning in chronic fatigue syndrome.
1996DiPino, R K et al.·Neuropsychology review·Review-Narrative
E0ReviewPEM ✗
Cognitive and mood-state changes in patients with chronic fatigue syndrome.
1991Grafman, J et al.·Reviews of infectious diseases·Review-Narrative
E0ReviewPEM ✗
Chronic fatigue syndrome and depression: cause, effect, or covariate.
1991Abbey, S E et al.·Reviews of infectious diseases·Review-Narrative
E0ReviewPEM ✗
Functional neurological disorder in people with long COVID: A systematic review.
2023Teodoro, Tiago et al.·European journal of neurology·Systematic-Review
E0ReviewPEM ?
Post-viral fatigue in COVID-19: A review of symptom assessment methods, mental, cognitive, and physical impairment.
2022Campos, Maria Cristine et al.·Neuroscience and biobehavioral reviews·Systematic-Review
E0ReviewPEM ✗
Epidemiology, pathophysiology, and classification of the neurological symptoms of post-COVID-19 syndrome.
2021Carod-Artal, F J et al.·Neurology perspectives·Review-Narrative
E0ReviewPEM ✓
Myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia - overlap, differences, and emerging insights.
2026Murovska, Modra et al.·Journal of translational medicine·Editorial
E0ReviewPEM ?
Pathophysiological mechanisms of post-exertional malaise: an integrative analysis based on the metabolism-immune-neuro interaction model.
2026Jin, Hongjiao et al.·Frontiers in immunology·Systematic-Review
E0ReviewPEM ✓
Differential Characteristics and Comparison Between Long-COVID Syndrome and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).
2025Ivanovska, Mariya et al.·Biomedicines·Review-Narrative
E0ReviewPEM ?
Herpesvirus Infection of Endothelial Cells as a Systemic Pathological Axis in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.
2024Nunes, Jean M et al.·Viruses·Review-Narrative
E0ReviewPEM ✗
Cognitive symptoms after COVID-19.
2021Altuna, M et al.·Neurology perspectives·Review-Narrative
E0ReviewPEM ✗
Identification of mental health and quality of life outcomes in primary care databases in the UK: a systematic review.
2019Carreira, Helena et al.·BMJ open·Systematic-Review
E0ReviewPEM ✗
Psychological impact of fibromyalgia: current perspectives.
2019Galvez-Sánchez, Carmen M et al.·Psychology research and behavior management·Review-Narrative
E0ReviewPEM ✗
A unifying theory for cognitive abnormalities in functional neurological disorders, fibromyalgia and chronic fatigue syndrome: systematic review.
2018Teodoro, Tiago et al.·Journal of neurology, neurosurgery, and psychiatry·Systematic-Review
E0ReviewPEM ?
Dysfunctional syndromes and fibromyalgia: a 2012 critical digest.
2012Sarzi-Puttini, Piercarlo et al.·Clinical and experimental rheumatology·Review-Narrative
E0ReviewPEM ✗
Central nervous system abnormalities in fibromyalgia and chronic fatigue syndrome: new concepts in treatment.
2008Gur, Ali et al.·Current pharmaceutical design·Editorial
E0ReviewPEM ?
War syndromes and their evaluation: from the U.S. Civil War to the Persian Gulf War.
1996Hyams, K C et al.·Annals of internal medicine·Review-Narrative
E0ReviewPEM ✗
Post-Lyme borreliosis syndrome: a meta-analysis of reported symptoms.
2005Cairns, Victoria et al.·International journal of epidemiology·Meta-Analysis
E0ReviewPEM ✗
[Efficacy and safety of fonturacetam in asthenia: a systematic review and meta-analysis].
2025Devlikamova, F I et al.·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·Meta-Analysis
E0ReviewPEM ✗
Review: How has cognitive behaviour therapy been adapted for adolescents with comorbid depression and chronic illness? A scoping review.
2021Morey, Alice et al.·Child and adolescent mental health·Systematic-Review
E0ReviewPEM ?
A systematic review of the association between fatigue and cognition in chronic noncommunicable diseases.
2021Menzies, Victoria et al.·Chronic illness·Systematic-Review
E0ReviewPEM ✗
A Review Study on the Beneficial Effects of Baduanjin.
2018Zou, Liye et al.·Journal of alternative and complementary medicine (New York, N.Y.)·Systematic-Review
E0ReviewPEM ✗
Behavior problems in children and adolescents with chronic physical illness: a meta-analysis.
2011Pinquart, Martin et al.·Journal of pediatric psychology·Meta-Analysis
E0ReviewPEM ?
Approved and investigational uses of modafinil : an evidence-based review.
2008Kumar, Raminder·Drugs·Review-Narrative
E0ReviewPEM ✗
Medically unexplained symptoms and neuropsychological assessment.
2004Binder, Laurence M et al.·Journal of clinical and experimental neuropsychology·Editorial
E0ReviewPEM ✗
Psychological treatment of patients with chronic toxic encephalopathy: lessons from studies of chronic fatigue and whiplash.
2003van Hout, Moniek S E et al.·Psychotherapy and psychosomatics·Systematic-Review
E1TrialPEM ?
Solriamfetol improves daily fatigue symptoms in adults with myalgic encephalomyelitis/chronic fatigue syndrome after 8 weeks of treatment.
2025Young, Joel L et al.·Journal of psychopharmacology (Oxford, England)·RCT
E1TrialPEM ?
Relationships between fatigue, cognitive function, and upright activity in a randomized trial of oxaloacetate for myalgic encephalomyelitis/chronic fatigue syndrome.
2025Vernon, Suzanne D et al.·Frontiers in neurology·RCT
E1TrialPEM ✓
Assessing fatigue in myalgic encephalomyelitis/chronic fatigue syndrome patients before and after treatment with bright light therapy: A prospective randomized controlled crossover study.
2025Ludwig, Birgit et al.·Sleep medicine·RCT
E1TrialPEM ?
Yeast Beta-Glucan Supplementation with Multivitamins Attenuates Cognitive Impairments in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial.
2023Lacasa, Marcos et al.·Nutrients·RCT
E1CohortPEM ✓
Cerebral blood flow is reduced in ME/CFS during head-up tilt testing even in the absence of hypotension or tachycardia
2020 · n=429C. M. C. van Campen et al.·Journal of Internal Medicine·Observational
E1TrialPEM ✗
Use of lisdexamfetamine dimesylate in treatment of executive functioning deficits and chronic fatigue syndrome: a double blind, placebo-controlled study.
2013Young, Joel L·Psychiatry research·RCT
E1TrialPEM ✗
Does neuropsychological test performance predict outcome of cognitive behavior therapy for Chronic Fatigue Syndrome and what is the role of underperformance?
2013Goedendorp, Martine M et al.·Journal of psychosomatic research·RCT
E1TrialPEM ✗
The effect of cognitive behaviour therapy for chronic fatigue syndrome on self-reported cognitive impairments and neuropsychological test performance.
2007Knoop, Hans et al.·Journal of neurology, neurosurgery, and psychiatry·RCT
E1TrialPEM ✗
Does methylphenidate reduce the symptoms of chronic fatigue syndrome?
2006Blockmans, Daniel et al.·The American journal of medicine·RCT
E1TrialPEM ✗
Chronic treatment with modafinil may not be beneficial in patients with chronic fatigue syndrome.
2005Randall, Delia C et al.·Journal of psychopharmacology (Oxford, England)·RCT
E1TrialPEM ✗
Exploratory open label, randomized study of acetyl- and propionylcarnitine in chronic fatigue syndrome.
2004Vermeulen, Ruud C W et al.·Psychosomatic medicine·RCT
E1TrialPEM ✗
Examining the influence of biological and psychological factors on cognitive performance in chronic fatigue syndrome: a randomized, double-blind, placebo-controlled, crossover study.
2003Smith, Simon et al.·International journal of behavioral medicine·RCT
E1TrialPEM ✗
Neuropsychological performance and noradrenaline function in chronic fatigue syndrome under conditions of high arousal.
2002Morriss, Richard K et al.·Psychopharmacology·Mechanistic
E1TrialPEM ✗
An assessment of cognitive function and mood in chronic fatigue syndrome.
1996Marshall, P S et al.·Biological psychiatry·RCT
E1TrialPEM ✗
A prospective randomized, double-blind placebo-controlled study to evaluate the effectiveness of neuroprotective therapy using functional brain MRI in patients with post-covid chronic fatigue syndrome.
2023Tanashyan, M et al.·Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie·RCT
E1TrialPEM ✗
Kinesiophobia and maladaptive coping strategies prevent improvements in pain catastrophizing following pain neuroscience education in fibromyalgia/chronic fatigue syndrome: An explorative study.
2017Malfliet, Anneleen et al.·Physiotherapy theory and practice·Observational
E1TrialPEM ✗
Homeopathy for mental fatigue: lessons from a randomized, triple blind, placebo-controlled cross-over clinical trial.
2012Dean, Michael Emmans et al.·BMC complementary and alternative medicine·RCT
Contribute
Private, reviewed by a human. Not a public comment thread.