Aberrant recruitment of the striatum and insula is associated with recalling and suppressing fatigue- and anger-related memories in people with chronic fatigue syndrome/myalgic encephalomyelitis. — CFSMEATLAS
Aberrant recruitment of the striatum and insula is associated with recalling and suppressing fatigue- and anger-related memories in people with chronic fatigue syndrome/myalgic encephalomyelitis.
Rimes, Katharine A, Giampietro, Vincent, Chalder, Trudie et al. · Brain communications · 2026 · DOI
Quick Summary
This brain imaging study compared how people with ME/CFS and healthy people process memories related to fatigue and anger. Researchers found that people with ME/CFS use different brain regions—particularly areas called the striatum and insula—when recalling or trying to suppress these emotional memories. These findings suggest that ME/CFS may involve changes in how the brain handles emotions and memories, which could help explain some experiences people with ME/CFS report.
Why It Matters
Understanding how ME/CFS affects emotional processing and memory regulation could provide objective neural markers for the condition and inform why emotional memories feel particularly difficult to manage. These insights may eventually guide development of targeted interventions that work with the brain's emotional regulatory systems. The identification of specific brain regions involved opens new research directions for investigating the neurobiological basis of ME/CFS.
Observed Findings
Patients with ME/CFS showed higher activation in the left rostral caudate when suppressing fatigue-related memories and higher activation in the right rostral caudate when suppressing anger-related memories.
Insulin activation increased in patients during active recall (not suppression) of anger and fatigue-related memories, contrasting with striatal suppression patterns.
Patients and controls showed different patterns of posterior putamen recruitment when recalling versus suppressing emotional memories.
These brain activation differences occurred despite both groups performing the experimental task.
Inferred Conclusions
ME/CFS is associated with demonstrable physiological changes in how emotional information is processed in the brain.
The rostral caudate and insula represent candidate brain regions for further investigation into ME/CFS pathophysiology.
Emotional regulation in ME/CFS may involve different neural strategies than in healthy individuals, particularly for fatigue- and anger-related memories.
The dissociation between striatal and insular activation patterns suggests complex, region-specific changes in emotional processing.
Remaining Questions
Do these brain activation patterns reflect a cause, consequence, or compensatory response to ME/CFS, and how do they relate to symptom severity?
What This Study Does Not Prove
This study does not prove that altered brain activation causes ME/CFS symptoms or that emotional regulation problems are the primary driver of fatigue. The small sample size (20 per group) and observational design mean findings cannot establish causation or be confidently generalized to all ME/CFS populations. It remains unclear whether these brain differences are unique to ME/CFS or reflect general effects of chronic illness.
Tags
Symptom:Fatigue
Biomarker:Neuroimaging
Method Flag:Weak Case DefinitionSmall SampleExploratory Only
Are these neural differences specific to ME/CFS or do they occur in other chronic conditions associated with fatigue and mood changes?
Do these brain activation patterns correlate with behavioral outcomes, such as actual success in suppressing emotional memories or symptom improvement with treatment?
Could interventions targeting the rostral caudate or insula improve emotional regulation and potentially reduce fatigue in ME/CFS?