Understanding concussion in myalgic encephalomyelitis/chronic fatigue syndrome: Findings from the 2023 National Health Interview study.
Sirotiak, Zoe, Adamowicz, Jenna L, Thomas, Emily B K · Brain injury · 2026 · DOI
Quick Summary
This study found that people with ME/CFS are nearly 5 times more likely to have had a concussion in the past year compared to people without ME/CFS. People with ME/CFS also experienced more falls and dizziness or balance problems. The researchers suggest that doctors should screen patients with ME/CFS more carefully for concussions and take steps to reduce their concussion risk.
Why It Matters
This is among the first population-level studies quantifying concussion risk in ME/CFS, a condition characterized by dysautonomia and balance dysfunction that may predispose to head injuries. The findings highlight an underrecognized clinical concern and suggest healthcare providers need improved screening protocols for this vulnerable population. Better understanding of concussion vulnerability in ME/CFS may inform both prevention strategies and post-concussion management approaches.
Observed Findings
Individuals with ME/CFS had 4.89 times greater odds of reporting a past-year concussion
Individuals with ME/CFS had 2.86 times greater odds of falls in the past year
Individuals with ME/CFS had 5.88 times greater odds of reporting dizziness or balance problems in the past year
Findings remained significant after adjusting for sociodemographic factors
Inferred Conclusions
ME/CFS status is associated with elevated concussion risk in the U.S. adult population
The elevated concussion risk may be mediated by ME/CFS-related balance and vestibular dysfunction (dizziness, off-balance feelings)
Healthcare practitioners should implement enhanced concussion screening and prevention strategies for ME/CFS patients
Multidisciplinary approaches addressing balance and fall prevention may reduce concussion risk in this population
Remaining Questions
Does the association reflect ME/CFS-related balance impairment increasing concussion susceptibility, or does concussion history contribute to ME/CFS development?
What are the specific biological mechanisms linking ME/CFS symptoms (dysautonomia, vestibular dysfunction) to increased concussion vulnerability?
What This Study Does Not Prove
This study does not establish whether ME/CFS causes concussion risk, nor does it explain the biological mechanism underlying the association—it only demonstrates correlation in a single time period. The cross-sectional design cannot distinguish whether concussions preceded ME/CFS onset or whether ME/CFS-related symptoms increase susceptibility to head injury. Self-reported data means actual concussion rates and symptom severity may differ from reported values.