Evidence map›Paper›PMID 40859389›Full record

SynthesisJournal of translational medicine2025

Mapping cerebral blood flow in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and orthostatic intolerance: insights from a systematic review.

Elena M Christopoulos, Darcy Tantanis, Katherine Huang, Elena K Schneider-Futschik, Paul R Gooley, Kegan J Moneghetti, Christopher W Armstrong

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of translational medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Elena M ChristopoulosDepartment of Biochemistry and Pharmacology, Bio21 Institute, The University of Melbourne, Parkville, VIC, 3052, Australia.ORCID 0000-0001-9765-4390
Darcy TantanisDepartment of Biochemistry and Pharmacology, Bio21 Institute, The University of Melbourne, Parkville, VIC, 3052, Australia.
Katherine HuangDepartment of Biochemistry and Pharmacology, Bio21 Institute, The University of Melbourne, Parkville, VIC, 3052, Australia.
Elena K Schneider-FutschikDepartment of Biochemistry and Pharmacology, Bio21 Institute, The University of Melbourne, Parkville, VIC, 3052, Australia.
Paul R GooleyDepartment of Biochemistry and Pharmacology, Bio21 Institute, The University of Melbourne, Parkville, VIC, 3052, Australia.
Kegan J MoneghettiCardiometabolic Health and Exercise Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
Christopher W ArmstrongDepartment of Biochemistry and Pharmacology, Bio21 Institute, The University of Melbourne, Parkville, VIC, 3052, Australia. christopher.armstrong@unimelb.edu.au.ORCID 0000-0002-5964-5618

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMyalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex and debilitating condition with a large proportion of patients that experience orthostatic intolerance (OI). This systematic review aimed to assess whether cerebral blood flow (CBF) is reduced in ME/CFS and OI, and whether the presence of both conditions leads to an additional decline in CBF.

methodsPubMed (from 1943), MEDLINE (from 1946), EMBASE (from 1947) and Cochrane were searched from inception to February 14th, 2025, using terms including "chronic fatigue syndrome", "myalgic encephalomyelitis", "orthostatic intolerance" and "cerebral blood flow". Article selection required the following criteria: published in English; CBF measured in participants with either ME/CFS or OI, or both ME/CFS and OI combined. Quality assessment and risk of bias was assessed using the Newcastle-Ottawa Scale and the systematic review was conducted in accordance with the PRISMA 2020 guidelines.

resultsOf 14,928 articles, 118 were included, 26 (22.1%) of which studied CBF in ME/CFS alone, 81 (68.6%) in OI alone and 11 (9.3%) in both ME/CFS and OI. Overall, the articles included 9185 participants, with a mean age of 39.1 years (SD = 8.8), and 73.8% of participants were female. Studies found CBF was significantly reduced in 12 of the articles focused on ME/CFS and in 56 of those focused on OI; compared to controls. Additionally, in 4 out of 11 studies that examined both conditions, CBF was further reduced in participants suffering from both conditions compared to those with ME/CFS alone.

conclusionsCBF is reduced in ME/CFS and OI alone and having both conditions comorbidly amplifies CBF reductions. Therefore, observing CBF changes in ME/CFS with and without OI may be important in monitoring disease severity. Despite this, few studies focus on the combination of ME/CFS and OI, and OI may be a confounding factor in CBF in a large portion of ME/CFS studies.

Indexed as

Brain MappingCerebrovascular CirculationFatigue Syndrome, ChronicOrthostatic IntoleranceFemaleHumansCerebral blood flowChronic fatigue syndromeME/CFSMyalgic encephalomyelitisOrthostatic intolerance

Identifiers

PMID40859389
PMCPMC12382099

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.