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Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Neurological Entity?

LaNCE-Neuropharm Group, Neuroscience Department, University of the Basque Country (UPV-EHU), 48940 Leioa, Bizkaia, Spain
Experimental Psychology Laboratory, CONICET, Department Pathology, Universidad Nacional de Cuyo, Mendoza 5500, Argentina
Neurodegenerative Disease Group, Biocruces Research Institute, 48903 Barakaldo, Bizkaia, Spain
Author to whom correspondence should be addressed.
Academic Editor: Olli J. Polo
Medicina 2021, 57(10), 1030;
Received: 31 July 2021 / Revised: 2 September 2021 / Accepted: 22 September 2021 / Published: 27 September 2021
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a disorder of unknown physiopathology with multisystemic repercussions, framed in ICD-11 under the heading of neurology (8E49). There is no specific test to support its clinical diagnosis. Our objective is to review the evidence in neuroimaging and dysautonomia evaluation in order to support the neurological involvement and to find biomarkers serving to identify and/or monitor the pathology. The symptoms typically appear acutely, although they can develop progressively over years; an essential trait for diagnosis is “central” fatigue together with physical and/or mental exhaustion after a small effort. Neuroimaging reveals various morphological, connectivity, metabolic, and functional alterations of low specificity, which can serve to complement the neurological study of the patient. The COMPASS-31 questionnaire is a useful tool to triage patients under suspect of dysautonomia, at which point they may be redirected for deeper evaluation. Recently, alterations in heart rate variability, the Valsalva maneuver, and the tilt table test, together with the presence of serum autoantibodies against adrenergic, cholinergic, and serotonin receptors were shown in a subgroup of patients. This approach provides a way to identify patient phenotypes. Broader studies are needed to establish the level of sensitivity and specificity necessary for their validation. Neuroimaging contributes scarcely to the diagnosis, and this depends on the identification of specific changes. On the other hand, dysautonomia studies, carried out in specialized units, are highly promising in order to support the diagnosis and to identify potential biomarkers. ME/CFS orients towards a functional pathology that mainly involves the autonomic nervous system, although not exclusively. View Full-Text
Keywords: Myalgic Encephalomyelitis (ME); Chronic Fatigue Syndrome (CFS); neuroimaging; dysautonomia Myalgic Encephalomyelitis (ME); Chronic Fatigue Syndrome (CFS); neuroimaging; dysautonomia
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MDPI and ACS Style

Gandasegui, I.M.; Laka, L.A.; Gargiulo, P.-Á.; Gómez-Esteban, J.-C.; Sánchez, J.-V.L. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Neurological Entity? Medicina 2021, 57, 1030.

AMA Style

Gandasegui IM, Laka LA, Gargiulo P-Á, Gómez-Esteban J-C, Sánchez J-VL. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Neurological Entity? Medicina. 2021; 57(10):1030.

Chicago/Turabian Style

Gandasegui, Iñigo M., Larraitz A. Laka, Pascual-Ángel Gargiulo, Juan-Carlos Gómez-Esteban, and José-Vicente L. Sánchez 2021. "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Neurological Entity?" Medicina 57, no. 10: 1030.

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