[Neurologic Abnormalities in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Review].
Komaroff, Anthony L, Takahashi, Ryosuke, Yamamura, Takashi et al. · Brain and nerve = Shinkei kenkyu no shinpo · 2018 · DOI
Quick Summary
This review examines objective, measurable evidence that ME/CFS is a real physical illness, not just a psychological condition. Researchers looked at studies showing that ME/CFS involves problems with the brain, immune system, and how the body uses energy. They found that immune activation—where the body's defense system becomes overactive—may be a key driver of ME/CFS symptoms.
Why It Matters
This review provides evidence that ME/CFS has measurable biological markers rather than being primarily psychological, which can help validate patient experiences and support clinical recognition. Understanding immune activation as a potential trigger offers a mechanistic framework that may guide future treatment development and biomarker-based diagnostic approaches.
Observed Findings
Objective neuroimaging abnormalities detected in ME/CFS patients
Abnormal blood biomarkers including inflammatory cytokine elevation
Impaired energy metabolism and mitochondrial dysfunction documented in patient samples
OrthostaticIntolerance and cardiovascular dysregulation measurable through objective testing
Cognitive impairment correlating with neurological markers
Inferred Conclusions
ME/CFS involves demonstrable objective biological abnormalities, contradicting the notion that it is purely subjective or psychological
Immune activation and cytokine release may be key pathophysiological mechanisms triggering neurological symptoms
Multiple biological systems (neurological, immunological, metabolic) are dysregulated in ME/CFS, suggesting a complex systemic illness
Remaining Questions
Which specific immune markers or cytokine profiles are most central to ME/CFS pathogenesis, and do they differ across patient subgroups?
What causes the initial immune activation and triggers the transition to persistent illness in susceptible individuals?
What This Study Does Not Prove
This review does not prove that any single cause definitively explains all ME/CFS cases, as the evidence reviewed suggests multiple overlapping biological abnormalities. It also does not establish the causal direction between immune activation and symptoms—immune markers could be secondary responses rather than primary triggers. The review summarizes existing studies but does not establish new treatment efficacy or provide definitive diagnostic criteria.