Finkelmeyer, Andreas, He, Jiabao, Maclachlan, Laura et al. · PloS one · 2018 · DOI
Many people with ME/CFS experience dizziness or lightheadedness when standing up—a condition called orthostatic intolerance. This study used brain imaging to measure how well the brain's blood vessels and fluid systems adjust to position changes. Researchers found that ME/CFS patients with worse symptoms had less flexible brain spaces and higher blood flow at rest, suggesting their brains may struggle to maintain proper blood flow when standing.
Orthostatic intolerance is a debilitating symptom affecting many ME/CFS patients, yet its mechanisms remain poorly understood. This study provides objective neuroimaging evidence linking brain biomechanics to orthostatic symptoms, potentially opening new avenues for diagnosis and targeted interventions. Understanding these physiological mechanisms may help validate patient experiences and guide future treatment development.
This study cannot establish causation—low intracranial compliance may cause OI symptoms, result from them, or both may stem from a common underlying process. The small sample size (40 patients, 10 controls) and cross-sectional design limit generalizability and prevent assessment of whether these findings are specific to CFS or shared with other conditions. The authors note these findings may not be unique to CFS, so broader validation is needed.
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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