de Lange, Floris P, Koers, Anda, Kalkman, Joke S et al. · Brain : a journal of neurology · 2008 · DOI
This study found that ME/CFS patients have less brain tissue volume in certain areas compared to healthy people, but this loss can partially reverse with cognitive behavioural therapy (CBT). Patients who received CBT showed improvement in their symptoms, physical activity, and thinking speed, and their brain scans revealed increased grey matter volume in the prefrontal cortex (the front part of the brain involved in decision-making). This suggests that some of the brain changes seen in ME/CFS may not be permanent and could improve with effective treatment.
This study provides evidence that structural brain changes in ME/CFS are not irreversible, offering hope that effective treatments may restore brain function alongside symptom improvement. Understanding the reversibility of brain changes could help validate CBT as a neurobiologically meaningful intervention and advance understanding of the disease's mechanisms. The demonstration of macroscopic cortical plasticity in ME/CFS patients supports the investigation of how psychological and rehabilitative interventions affect brain structure.
This study does not prove that CBT cures ME/CFS or that brain atrophy causes the disease—it demonstrates correlation between treatment response and brain volume changes, not causation. The study does not establish whether the observed brain volume changes are the primary mechanism of symptom improvement or a secondary consequence. Results cannot be generalized to all ME/CFS patients, as the study was relatively small and involved patients who responded well to CBT, potentially excluding more severely affected individuals.
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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