ArticleFrontiers in neuroscience2026
Effects of Tai Chi on fatigue and resting-state brain activity in chronic fatigue syndrome: a randomized controlled fMRI study.
Article in Frontiers in neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Chronic fatigue syndrome (CFS) is a complex disorder characterized by persistent fatigue, sleep disturbance, and cognitive impairment. It substantially impairs both physical and mental health. Tai Chi, a traditional Chinese mind-body exercise, may improve symptoms in patients with CFS. However, its neural mechanisms remain unclear. This study investigated the effects of Tai Chi on spontaneous brain activity in patients with CFS using resting-state functional magnetic resonance imaging (rs-fMRI) and amplitude of low-frequency fluctuations (ALFF). Methods: Sixty patients with CFS were randomly assigned in a 1:1 ratio to either a Tai Chi group or a health education group; 57 participants completed both fMRI scans and fatigue assessments and were included in the complete-case analysis. Both groups underwent a 12-week intervention consisting of three 60-min sessions per week. Adherence was monitored using weekly logs. Fatigue severity was assessed before and after the intervention using the Multidimensional Fatigue Inventory (MFI-20). Resting-state fMRI data were acquired at both time points. Preprocessing included motion correction, normalization to Montreal Neurological Institute space, and spatial smoothing. ALFF was calculated to quantify regional spontaneous neural activity. Correlation analyses were performed to assess associations between changes in ALFF and MFI-20 scores. Harms were monitored throughout the intervention period. Results: Fifty-seven participants were included in the complete-case analysis (Tai Chi, Conclusion: A 12-week Tai Chi intervention was associated with greater fatigue improvement than health education and with region-specific changes in resting-state spontaneous brain activity in patients with CFS. Tai Chi was associated with reduced fatigue and altered spontaneous brain activity in prefrontal, hippocampal, motor, and sensory-related regions in patients with CFS. These findings suggest that Tai Chi may modulate fatigue-related brain function, which may contribute to improvements in fatigue severity. Future studies should replicate and extend existing network-level findings using prespecified, adequately powered connectivity and mediation analyses with active exercise comparators and longer-term follow-up. Chinese clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=223860, ChiCTR2400082268; March 26, 2024.
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