Cerebral blood flow is reduced in ME/CFS during head-up tilt testing even in the absence of hypotension or tachycardia
C. M. C. van Campen, F. C. Visser, P. C. Rowe · Journal of Internal Medicine · 2020 · DOI
Quick Summary
In the largest study of its kind, 429 ME/CFS patients underwent head-up tilt testing with simultaneous cerebral blood flow monitoring. Nearly all ME/CFS patients showed significantly reduced cerebral blood flow when upright, even when blood pressure and heart rate were normal. The reduction correlated with symptom severity.
Why It Matters
This large study demonstrates that reduced brain blood flow in upright posture is nearly universal in ME/CFS — even without classic POTS criteria being met. It explains the cognitive symptoms and post-exertional worsening that many patients experience and suggests that hemodynamic support may be a treatment avenue.
What This Study Does Not Prove
This study cannot determine whether reduced cerebral blood flow is a cause of ME/CFS, a consequence, or simply a feature. Treatment implications require separate trial evidence.
Topics
Tags
Metadata
- DOI
- 10.1111/joim.13042
- Case definition
- IOM/SEID Criteria
- Sample size
- 429 patients
- Control group
- Yes
- Review status
- Editor reviewed
- Evidence level
- Replicated human evidence from multiple independent studies
- Last updated
- 7 April 2026