Chronic fatigue syndrome has long been viewed as a psychological phenomenon.
However, new research now confirms that the disease, also known as myalgic encephalomyelitis (ME), is real.
For the first time, scientists have found significant differences in the immune systems and brains of CFS patients.
This suggests that the exhaustion linked with this controversial condition, which can be highly debilitating, is solely due to a discrepancy between the body’s capabilities and the brain’s perception thereof.
Experts hope this discovery, made by scientists affiliated with the US National Institutes of Health, will lead to treatments for the currently incurable condition.
The study compared results from various experiments by dozens of scientists on 17 patients over five years to those of 21 healthy controls matched for age, sex, and BMI.
This involved MRI scans of participants gripping a device while undergoing repeated assessments to measure the impact of fatigue on their brains.
CFS patients showed reduced activity in the temporal-parietal junction, a brain area essential for effort.
Thus, researchers suggest that the noticeable signs of fatigue are due to disturbances in this region.
Furthermore, comparing spinal fluid samples from the two groups, scientists found significant differences again.
A comparison of the immune systems showed that memory B cells were lower in CFS patients.
These are parts of the immune system that remember foreign substances (e.g., bacteria or viruses) to provide the body with long-lasting protection, preventing sickness each time they are encountered.
The study’s lead author, Dr. Avindra Nath, a neuroimmunology expert at the National Institutes of Health, said, “We believe that immune activation is causing biochemical changes and subsequent effects such as dysfunction of the motor, autonomic, and cardiorespiratory systems.”
Another researcher, Dr. Brian Walitt, stated, “We may have identified a physiological focal point for fatigue in this population.”
Fatigue may not stem from physical exhaustion or lack of motivation but rather from a discrepancy between an individual’s perceived capabilities and their body’s actual performance.
Researchers hope their findings, published in Nature Communications, can be replicated in a larger population.
If so, it could form the basis for new therapeutic strategies targeting the syndrome.
Experts hailed the study as a crucial and long-overdue comprehensive investigation into a condition that is poorly understood.
Dr. Karl Morten, a CFS researcher from the University of Oxford, said the results prompt further questions that need investigation.
He mentioned, “The brain may be behind the patient’s response. The critical question is why? Is there something ongoing that we are not yet aware of?”
Others warned that while the data is promising, it “does not indicate causes.”
Dr. Katharine Seton, a research scientist at the Quadram Institute Bioscience, noted the study represents a welcome shift in CFS research.
“Historically, research on ME/CFS has often focused on isolated aspects of the disorder,” she said.
“However, this paper stands out for its comprehensive list of contributors, including experts from various fields working together to piece together these aspects and reveal a more holistic understanding.
Adopting this interdisciplinary approach is crucial in advancing our understanding of this illness.”
All study participants were CFS patients who developed the syndrome following a bacterial or viral infection.
These infections are just one of several proposed causes of CFS. Other factors may include immune system dysfunction, hormonal imbalance, or genetic predisposition.
Four patients spontaneously recovered within four years after the study ended.
The study did not specify why these patients recovered or whether they provided any specific insights.
CFS symptoms vary among patients and over time.
Common symptoms include extreme physical and mental fatigue that does not improve with rest, along with sleep, cognitive, memory, and concentration difficulties.
Other symptoms include muscle or joint pain, sore throat, headaches, flu-like symptoms, dizziness, nausea, and a fast or irregular heartbeat.
CFS patients may manage daily tasks with difficulty but might need to skip social activities and hobbies to recuperate.
Those with severe CFS may be bedridden and require full-time care due to their inability to feed themselves, bathe, or use the restroom independently.
Diagnosing CFS poses a significant challenge due to the lack of diagnostic tests.
Currently, there is no such test, so diagnosis occurs through a process of elimination, where doctors gradually rule out other conditions until CFS is the only one left.
Currently, there is no cure for CFS. Treatment options include medication, lifestyle changes, and psychotherapy to manage symptoms.
