Maes, Michael, Almulla, Abbas F, Vojdani, Elroy et al. · Neuro endocrinology letters · 2025
This study looked at whether reactivation of two common viruses—Epstein-Barr virus (EBV) and Human herpesvirus 6 (HHV-6)—are connected to fatigue, depression, and anxiety in people with a type of multiple sclerosis called RRMS. Researchers measured immune responses (antibodies) to these viruses in MS patients and healthy controls, and found that higher antibody levels were strongly linked to worse fatigue and mood symptoms. The findings suggest that when these dormant viruses become active in the body, they may trigger or worsen fatigue and psychiatric symptoms.
For ME/CFS patients, this research is important because it provides evidence that herpesvirus reactivation may drive fatigue and psychiatric symptoms—a mechanism that could potentially be targeted with antivirals or immune therapies. While this study focuses on MS patients, the overlap between viral reactivation, immune activation, and fatigue/mood symptoms mirrors mechanisms hypothesized in ME/CFS, offering new avenues for understanding and treating similar symptoms in other conditions.
This study does not prove that viral reactivation *causes* fatigue and psychiatric symptoms in RRMS; it demonstrates association only and cannot establish directionality (symptoms could drive reactivation rather than vice versa). The study was conducted in MS patients, not ME/CFS patients, so findings may not directly apply to ME/CFS. The cross-sectional design cannot account for temporal relationships or rule out confounding variables.
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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