Nijs, Jo, Meeus, Mira, Van Oosterwijck, Jessica et al. · European journal of clinical investigation · 2012 · DOI
This review examined whether ME/CFS involves a nervous system that becomes overly sensitive to pain and other sensations. Researchers found that people with ME/CFS do show heightened responses to various types of stimuli—including touch, pressure, heat, and electrical stimulation—across multiple body areas. Importantly, this nervous system sensitivity tends to get worse, not better, after exercise or stress, suggesting a fundamental difference in how the central nervous system responds in ME/CFS.
This review provides an integrated framework for understanding why ME/CFS patients experience widespread pain, sensory overload, and symptom exacerbation after physical exertion. Establishing central sensitisation as a biological mechanism—rather than a psychological one—validates patient experiences and may redirect treatment approaches toward nervous system dysfunction rather than deconditioning.
This review does not establish causation; it demonstrates correlation between central sensitisation and ME/CFS. It does not determine whether central sensitisation is a primary cause of ME/CFS, a secondary consequence of the illness, or one of several parallel mechanisms. The narrative design also means systematic quality appraisal of included studies is not reported.
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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