Evidence Atlas

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Showing 1–20 of 6113 studies

6113 studies

E0 ConsensusPEM requiredModerate confidenceEditorialMachine-drafted

Myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia - overlap, differences, and emerging insights.

Murovska, Modra, Krumina, Angelika, Araja, Diana et al.·Journal of translational medicine·2026

ME/CFS and fibromyalgia are two different but often overlapping illnesses that cause severe fatigue, pain, and other debilitating symptoms. While they share many similarities, ME/CFS has a distinctive feature called post-exertional malaise—where activity makes symptoms dramatically worse for hours or days—while fibromyalgia does not. This review shows that the two conditions have different immune system patterns and may require different treatment approaches.

Severe MEImmune DysregulationCognitive ImpairmentPost-Exertional Malaise

E0 ConsensusPEM unclearModerate confidenceSystematic-ReviewMachine-drafted

Exercise interventions for physical function, psychological health, and quality of life in patients with myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia: A systematic review and network meta-analysis.

Gao, Jiawen, Liu, Yunyang, Wang, Shun et al.·Journal of psychosomatic research·2026

This study looked at 57 different research trials involving over 4,200 patients with ME/CFS and fibromyalgia to find out which types of exercise work best. The researchers found that different exercises help with different symptoms: combined exercise and high-intensity interval training (HIIT) are best for improving physical fitness and quality of life, aerobic exercise and combined exercise help most with anxiety and depression, and aquatic (water-based) exercise works best for pain relief. The type of exercise matters much more than how often or how long you do it.

E0 ConsensusPEM unclearHigher confidenceMeta-AnalysisMachine-drafted

Emotional and behavior problems in children and adolescents with chronic physical health conditions: an updated meta-analysis.

Pinquart, Martin·Journal of pediatric psychology·2026

This study looked at 1,337 research papers to understand how children with long-term health conditions—including chronic fatigue syndrome (ME/CFS)—experience emotional and behavioral challenges. Children with these conditions had higher rates of anxiety, depression, and behavior problems compared to healthy peers. The study found that parents reported more problems than teenagers themselves did, and that ME/CFS was particularly linked to emotional difficulties.

E0 ConsensusPEM requiredModerate confidenceMethods-PaperMachine-drafted

Recommended long COVID outcome measures and their implications for clinical trial design, with a focus on post-exertional malaise.

Soares, Letícia, Davis, Hannah, Spier, Ezra et al.·EBioMedicine·2026

This paper provides guidance for researchers designing clinical trials to test treatments for long COVID, with special attention to post-exertional malaise (PEM)—a key symptom where people feel much worse after physical or mental activity. The authors recommend that trials should carefully measure patients at the start, track them over time, include a placebo group for comparison, and make sure patients in different treatment groups have similar severity of illness. The paper highlights that the field urgently needs funding to develop better ways to measure these outcomes before large-scale treatment trials can succeed.

Post-Exertional Malaise

E0 ConsensusPEM unclearModerate confidenceGuidelineMachine-drafted

[Psychiatric and psychotherapeutic recommendations for long/post-COVID and ME/CFS: a narrative review of international guidelines].

Kaya, Gizem, Kroehn-Liedtke, Franziska, Kalinowski, Olivia et al.·Der Nervenarzt·2026

This review examined what major international health organizations recommend about mental health care and psychological treatments for ME/CFS and long COVID. The guidelines agree that while mental health support can help manage symptoms, it is not a cure for these conditions. They emphasize the importance of individualized, paced approaches to activity rather than pushing patients to exercise harder, especially when postexertional malaise (worsening after activity) is present.

Post-Exertional Malaise

E0 ConsensusPEM unclearModerate confidenceSystematic-ReviewMachine-drafted

Evaluating working memory functioning in individuals with myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review and meta-analysis.

Penson, Maddison, Kelly, Kate·Psychology, health & medicine·2026

This study reviewed 34 research papers to understand how ME/CFS affects working memory—the ability to hold and use information in your mind briefly. The researchers found that people with ME/CFS have significant difficulties with verbal working memory (remembering words and language), but their ability to remember visual information (like images or patterns) appeared similar to people without ME/CFS. This suggests that cognitive problems in ME/CFS may affect certain types of thinking more than others.

Cognitive Impairment

E0 ConsensusPEM unclearPreliminarySystematic-ReviewMachine-drafted

Systematic literature review: treatment of postural orthostatic tachycardia syndrome (POTS).

Schiweck, Nicole, Langer, Katharina, Maier, Andrea et al.·Clinical autonomic research : official journal of the Clinical Autonomic Research Society·2026

This review examined treatments for POTS (postural orthostatic tachycardia syndrome), a condition where your heart rate jumps significantly when you stand up, causing dizziness and fatigue. POTS is common in people with ME/CFS. The researchers looked at 45 studies and found that simple first-line treatments like compression socks, physical training, extra salt, and a vagus nerve stimulation device may help, while certain medications like ivabradine and beta-blockers also showed promise in some studies.

Autonomic Nervous System

E0 ConsensusPEM unclearPreliminarySystematic-ReviewMachine-drafted

Use of artificial intelligence and machine learning for the management of fibromyalgia: a scoping review.

Clempi Almeida E Silva, Ana Laura, Reis, Victor Hugo Palhares Flávio, Lamoglia, Antonieta Santos Andrade et al.·The Journal of manual & manipulative therapy·2026

This review looked at 43 studies from 2011–2024 to see how artificial intelligence (AI) and machine learning can help diagnose fibromyalgia and other conditions like ME/CFS. Researchers found that AI tools can identify unique patterns in brain scans, genes, eye imaging, and blood markers that differ between sick patients and healthy people. While some AI models showed very high accuracy (up to 100%), most studies tested only small groups of patients, so we need bigger, more rigorous research before these tools can be used reliably in clinics.

Diagnostics

E0 ConsensusPEM unclearPreliminaryReview-NarrativeMachine-drafted

Metabolic reprogramming in diabetes and other endocrine and metabolic disorders: exploring the Warburg effect, ketones, and SGLT2 inhibitors.

Carrera-Bastos, Pedro, Muskiet, Marcel H A, Mata-Ordoñez, Fernando et al.·Reviews in endocrine & metabolic disorders·2026

This review examines a cellular energy pattern called the Warburg effect, which causes cells to shift from their normal energy-making processes to a different system that prioritizes cell growth over efficient energy production. The authors suggest this pattern occurs not just in cancer, but also in conditions like ME/CFS, diabetes, and other chronic diseases. They explore whether treatments like fasting, special diets, ketone supplements, and certain diabetes medications might help by reversing this metabolic shift.

Metabolic Dysfunction

E0 ConsensusPEM unclearModerate confidenceSystematic-ReviewMachine-drafted

Chronic fatigue syndrome: From etiology and mechanism to diagnosis and treatment.

Xu, Qing, Zhao, Mengyu, Wang, Qin et al.·Journal of psychiatric research·2026

This review article summarizes current knowledge about ME/CFS, a long-lasting illness characterized by extreme fatigue that rest doesn't improve, along with muscle pain, sore throat, and mood problems. The article examines what might cause ME/CFS, how doctors can better diagnose it, and what treatments may help. The authors note that ME/CFS cases are increasing worldwide, especially since COVID-19, and that current treatments have limited effectiveness.

Post-Exertional Malaise

E0 ConsensusPEM unclearPreliminaryReview-NarrativeMachine-drafted

[Herbal treatment options for post-viral symptoms and long COVID].

Krassnig, Katharina, Bauer, Rudolf, Glasl, Sabine et al.·Wiener medizinische Wochenschrift (1946)·2026

This review examined herbal medicines and plant-based treatments that may help with long COVID and post-viral symptoms, including ME/CFS. The authors looked at nearly 100 scientific papers and clinical experience to identify which herbs might help with common symptoms like fatigue, brain fog, breathing problems, digestive issues, and loss of smell. They found that several traditional plant remedies appear to help manage these symptoms based on available evidence and doctors' real-world experience.

Post-Exertional Malaise

E0 ConsensusPEM requiredPreliminaryGuidelineMachine-drafted

Clinical practice guideline for long COVID prevention and treatment.

Cao, Bin, Soriano, Joan B, Wang, Quanyi et al.·The European respiratory journal·2026

This guideline summarizes the best available evidence on preventing and treating long COVID (also called post-COVID syndrome). A large international team of experts reviewed research studies and patient experiences to create 10 practical recommendations for doctors. The main suggestions include using vaccines or antivirals early during acute COVID infection to prevent long COVID, avoiding certain medications that don't help, and recommending probiotics, cognitive behavioral therapy for fatigue, and rehabilitation as helpful treatments.

Post-Exertional Malaise

E0 ConsensusPEM not requiredModerate confidenceReview-NarrativeMachine-drafted

Persistent physical symptoms not explained by structural abnormalities or disease processes: a primary care approach to promote recovery.

Abrahamsen, Cathrine, Beadsworth, Mike, Bostock, Will et al.·Scandinavian journal of primary health care·2026

This guideline helps doctors understand why some patients have lasting physical symptoms like fatigue, pain, and brain fog that don't show up on tests or scans. The authors explain that these symptoms often arise from how the brain responds to perceived threats, influenced by what people expect and have learned from past experiences. They recommend that doctors validate patients' symptoms, explain why they persist, and work with patients to create personalized treatment plans that address physical, psychological, and social factors together.

E0 ConsensusPEM requiredPreliminarySystematic-ReviewMachine-drafted

Potential application of brain-gut axis-based treatments in Long COVID and ME/CFS: a case-based systematic review.

Kim, Do-Young, Youn, Jaeyoung, Kang, Naeun et al.·Journal of translational medicine·2026

This study looked at how treating the connection between the brain and gut might help people with ME/CFS and Long COVID. Researchers reviewed eight previous studies testing different treatments—including special nerve stimulation and probiotics—and also followed one patient who improved with a type of needle stimulation. Many of these treatments showed promise in reducing fatigue and post-exertional malaise, possibly by helping restore healthy gut bacteria and reduce brain inflammation.

NeuroinflammationPost-Exertional Malaise

E0 ConsensusPEM unclearPreliminarySystematic-ReviewMachine-drafted

AI in Medical Questionnaires: Scoping Review.

Luo, Xuexing, Li, Yiyuan, Xu, Jing et al.·Journal of medical Internet research·2025

Researchers reviewed 14 studies about using artificial intelligence (AI) to improve medical questionnaires—the forms doctors use to diagnose conditions. They found that AI can help doctors distinguish ME/CFS from long COVID with over 92% accuracy, develop better questionnaires, and predict disease risk. However, most research is still early-stage, and more testing is needed before AI tools are ready for everyday clinical use.

E0 ConsensusPEM unclearPreliminaryMeta-AnalysisMachine-drafted

The efficacy of acupuncture-based chinese medicine in chronic fatigue syndrome: A meta-analysis.

Feng, Chuwen, Qu, Yuanyuan, Wu, Jianli et al.·Medicine·2025

This review examined multiple studies testing whether acupuncture can help people with ME/CFS feel less tired and improve their quality of life. The researchers found that acupuncture appeared to reduce fatigue in the short term and long term, and seemed to help with depression and overall wellbeing. However, the studies reviewed had some weaknesses, so these results should be interpreted cautiously and larger, better-designed studies are needed to confirm whether acupuncture truly helps.

E0 ConsensusPEM unclearHigher confidenceSystematic-ReviewMachine-drafted

Health-related quality of life in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Post COVID-19 Condition: a systematic review.

Weigel, Breanna, Inderyas, Maira, Eaton-Fitch, Natalie et al.·Journal of translational medicine·2025

This review looked at 16 research studies comparing how ME/CFS and long COVID affect people's quality of life compared to healthy people. The findings show that both conditions severely impact physical health, daily activities, work, and pain levels. People with these illnesses struggle significantly more than healthy individuals across all areas of life, highlighting the urgent need for better support services and disability recognition.

E0 ConsensusPEM unclearModerate confidenceSystematic-ReviewMachine-drafted

Decreased Heart Rate Variability Is Associated with Increased Fatigue Across Different Medical Populations: A Systematic Review.

Penfold, Sophie Maria, Cunningham, James, Whelan, Pauline et al.·Pathophysiology : the official journal of the International Society for Pathophysiology·2025

This review looked at 17 studies examining the link between fatigue and heart rate variability (HRV)—a measure of how well your nervous system is working. The researchers found that people who feel more fatigued tend to have imbalanced heart rate patterns, suggesting their autonomic nervous system (the part controlling automatic body functions) may not be working properly. ME/CFS patients were the most studied group, making this particularly relevant to understanding fatigue in this condition.

Autonomic Nervous System

E0 ConsensusPEM requiredModerate confidenceReview-NarrativeMachine-drafted

Insights into the Complex Biological Network Underlying Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Dudova, Dobrina, Bozhkova, Martina, Petrov, Steliyan et al.·International journal of molecular sciences·2025

This review brings together research showing that ME/CFS involves multiple body systems going wrong at the same time—including problems with the immune system, energy production in cells, hormone balance, and gut health. These problems appear to feed into each other, creating a cycle that keeps the illness going. The findings suggest ME/CFS is not just one thing breaking down, but rather many interconnected systems all struggling together.

NeuroinflammationMetabolic DysfunctionImmune DysregulationPost-Exertional Malaise

E0 ConsensusPEM unclearModerate confidenceReview-NarrativeMachine-drafted

Biomarkers over Time: From Visual Contrast Sensitivity to Transcriptomics in Differentiating Chronic Inflammatory Response Syndrome and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Dooley, Ming·International journal of molecular sciences·2025

This review examines how doctors can better distinguish between two similar-looking illnesses: Chronic Inflammatory Response Syndrome (CIRS) and ME/CFS. The authors trace how testing methods have evolved from simple vision tests to advanced blood tests that read genetic activity. They suggest that some patients diagnosed with ME/CFS may actually have CIRS, which is treatable if properly identified.

BiomarkersImmune Dysregulation

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Evidence Atlas

The research, structured.

Myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia - overlap, differences, and emerging insights.

Exercise interventions for physical function, psychological health, and quality of life in patients with myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia: A systematic review and network meta-analysis.

Emotional and behavior problems in children and adolescents with chronic physical health conditions: an updated meta-analysis.

Recommended long COVID outcome measures and their implications for clinical trial design, with a focus on post-exertional malaise.

[Psychiatric and psychotherapeutic recommendations for long/post-COVID and ME/CFS: a narrative review of international guidelines].

Evaluating working memory functioning in individuals with myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review and meta-analysis.

Systematic literature review: treatment of postural orthostatic tachycardia syndrome (POTS).

Use of artificial intelligence and machine learning for the management of fibromyalgia: a scoping review.

Metabolic reprogramming in diabetes and other endocrine and metabolic disorders: exploring the Warburg effect, ketones, and SGLT2 inhibitors.

Chronic fatigue syndrome: From etiology and mechanism to diagnosis and treatment.

[Herbal treatment options for post-viral symptoms and long COVID].

Clinical practice guideline for long COVID prevention and treatment.

Persistent physical symptoms not explained by structural abnormalities or disease processes: a primary care approach to promote recovery.

Potential application of brain-gut axis-based treatments in Long COVID and ME/CFS: a case-based systematic review.

AI in Medical Questionnaires: Scoping Review.

The efficacy of acupuncture-based chinese medicine in chronic fatigue syndrome: A meta-analysis.

Health-related quality of life in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Post COVID-19 Condition: a systematic review.

Decreased Heart Rate Variability Is Associated with Increased Fatigue Across Different Medical Populations: A Systematic Review.

Insights into the Complex Biological Network Underlying Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Biomarkers over Time: From Visual Contrast Sensitivity to Transcriptomics in Differentiating Chronic Inflammatory Response Syndrome and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Research Collections

Neuroinflammation Evidence

Metabolism & Mitochondria

Biomarkers

PEM-Specific Research