Tanaka, Yoshihide · Nihon rinsho. Japanese journal of clinical medicine · 2012
This paper reviews different ways to measure stress and fatigue in the body. Instead of just asking patients how stressed they feel, researchers are looking for physical markers—like stress hormones in saliva or hair—that show whether someone is experiencing chronic stress. The authors explain how chronic stress affects the nervous system, hormones, and immune system, and discuss which biological markers might be useful for understanding chronic fatigue syndrome.
This review is important because it synthesizes knowledge about biomarkers that could help clinicians objectively diagnose ME/CFS rather than relying solely on patient-reported symptoms. For researchers, it identifies promising biological markers in accessible samples (saliva, hair) that could improve understanding of how chronic stress and immune dysfunction contribute to ME/CFS.
This review does not establish that any specific biomarker definitively diagnoses ME/CFS, nor does it prove causation between stress and CFS symptoms. As a methods paper, it presents no original data validating these biomarkers in actual patient populations, only discusses candidates and theoretical rationale.
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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