Kasatkin, D S, Spirin, N N · Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova · 2006
This review describes how fatigue in multiple sclerosis (MS) can happen in different ways: tiredness even at rest, exhaustion during activity, and fatigue linked to MS flare-ups. The authors explain that fatigue likely involves both brain-based and body-based mechanisms, and often occurs alongside depression and sleep problems, suggesting these conditions may share common biological causes related to brain chemicals like serotonin.
This study is relevant to ME/CFS because it proposes specific mechanistic pathways (neurochemical, endocrine, autoimmune) that may explain different fatigue phenotypes, potentially informing targeted treatment approaches. The distinction between fatigue at rest versus during exertion parallels post-exertional malaise in ME/CFS and suggests that mechanism-based classification could improve diagnostic accuracy and personalized therapy.
This is a narrative review and does not present original research data or empirical evidence; it cannot prove causal mechanisms or validate proposed biological pathways. The overlap it describes between fatigue, depression, and sleep disturbances does not establish whether these share a common cause or are separate problems that often co-occur. The study does not include ME/CFS patients and may not directly apply to ME/CFS pathophysiology.
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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