E3 PreliminaryPreliminaryPEM unclearCross-SectionalPeer-reviewedMachine draft
Vestibular function test anomalies in patients with chronic fatigue syndrome.
Ash-Bernal, R, Wall, C, Komaroff, A L et al. · Acta oto-laryngologica · 1995 · DOI
Quick Summary
Many people with ME/CFS experience dizziness and balance problems, but doctors weren't sure where these problems originated in the body. This study tested the balance and inner ear function of 11 ME/CFS patients using specialized equipment and found several abnormalities—particularly difficulty with tests that rely heavily on the inner ear and brain working together. The pattern of results suggested the problem may be in how the brain processes balance signals rather than damage to the inner ear itself.
Why It Matters
Balance dysfunction is a common but poorly understood symptom in ME/CFS. This study provides objective evidence that balance problems in ME/CFS may originate from how the central nervous system processes balance information, which could direct future research and clinical assessment strategies.
Observed Findings
- Below-average performance on dynamic posturography with significant falls, particularly on tests requiring vestibular system reliance
- Significantly reduced earth-vertical-axis rotation gains at 0.1–1.0 Hz frequency range compared to healthy controls (p < 0.05)
- Elevated optokinetic nystagmus bias during eyes-open-in-dark conditions (p < 0.05)
- Abnormal optokinetic nystagmus buildup in 5 of 11 subjects, with velocity exceeding target by up to 14 degrees/s
- One patient with abnormal caloric test results and three with abnormally low EVA gains at higher frequencies
Inferred Conclusions
- Central nervous system deficits appear more likely than peripheral vestibular dysfunction in ME/CFS-related balance problems
- Abnormalities in how the brain processes vestibular and optokinetic signals may underlie dizziness and balance complaints in CFS patients
- Vestibular function testing can objectively document balance dysfunction in some ME/CFS patients
Remaining Questions
- What causes the central nervous system vestibular processing deficits observed in this population?
- Are vestibular abnormalities present in all ME/CFS patients or only a subset, and do they correlate with symptom severity?
What This Study Does Not Prove
This study does not establish the cause of the observed vestibular abnormalities, nor does it prove these findings are unique to ME/CFS or universal across all patients with the condition. The small sample size and lack of comparison controls limit the ability to draw firm conclusions about disease mechanisms.
Tags
Symptom:Fatigue
Method Flag:No ControlsSmall SampleExploratory Only
Metadata
- DOI
- 10.3109/00016489509133339
- PMID
- 7762393
- Review status
- Machine draft
- Evidence level
- Early hypothesis, preprint, editorial, or weak support
- Last updated
- 8 April 2026
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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