PEM is confirmed in CFS.
The following abstract is in error, and should be retracted.
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Psychiatry Research
Volume 200, Issues 2–3, 30 December 2012, Pages 754–760
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Myalgic Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS), and Chronic Fatigue (CF) are distinguished accurately: Results of supervised learning techniques applied on clinical and inflammatory data
Michael Maesa, Corresponding author contact information, E-mail the corresponding author, E-mail the corresponding author, Frank N.M. Twiskb, Cort Johnsonc
a Maes Clinics @ TRIA, Piyavate Hospital, 998 Rimklongsamsen Road, Bangkok 10310, Thailand
b ME-de-patiënten Foundation, Limmen, the Netherlands
c Phoenix, Las Vegas, USA
Abstract
There is much debate on the diagnostic classification of Myalgic Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS) and chronic fatigue (CF). Post-exertional malaise (PEM) is stressed as a key feature. This study examines whether CF and CFS, with and without PEM, are distinct diagnostic categories.
Using fatigue, a subjective feeling of infection and PEM we found that ME, CFS, and CF were distinct categories. Patients with ME had significantly higher scores on concentration difficulties and a subjective experience of infection, and higher levels of IL-1, TNFα, and neopterin than patients with CFS. These biomarkers were significantly higher in ME and CFS than in CF patients. PEM loaded highly on the first two factors subtracted from the data set, i.e. “malaise-sickness” and “malaise-hyperalgesia”.
Fukuda's criteria are adequate to make a distinction between ME/CFS and CF, but ME/CFS patients should be subdivided into ME (with PEM) and CFS (without PEM).
It is pending publication though, and I do not know if the paper has been accepted anywhere.