Natelson, Benjamin H, Mao, Xiangling, Stegner, Aaron J et al. · Journal of the neurological sciences · 2017 · DOI
This study compared brain and spinal fluid measurements in people with ME/CFS and healthy controls to understand what physical changes occur in the condition. Researchers found that ME/CFS patients had lower levels of a protective brain chemical (glutathione), reduced blood flow to the brain, higher levels of lactate (a sign of energy problems), and more abnormalities in spinal fluid compared to healthy people. Importantly, these differences were the same whether or not ME/CFS patients also had depression or anxiety, suggesting psychiatric conditions are not making the disease worse.
This study provides objective evidence of neurobiological abnormalities in ME/CFS—findings that support the disease as a biological disorder rather than primarily psychiatric. The identification of measurable biomarkers (glutathione, lactate, cerebral blood flow, CSF abnormalities) could help validate ME/CFS diagnoses and guide future treatment development.
This study does not establish causation—lower glutathione and cerebral blood flow are associated with ME/CFS but the study does not prove these abnormalities cause the disease. The cross-sectional design cannot determine whether these biomarkers are primary drivers of illness or secondary consequences. The study also does not prove psychiatric comorbidity is never relevant to ME/CFS pathology, only that it may not exacerbate these specific neurobiological measures.
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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