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Cerebral blood flow and heart rate variability predict fatigue severity in patients with CFS


Brain Imaging Behav. 2018 May 31. doi: 10.1007/s11682-018-9897-x. [Epub ahead of print]
Cerebral blood flow and heart rate variability predict fatigue severity in patients with chronic fatigue syndrome.
Boissoneault J1, Letzen J2, Robinson M1, Staud R3.
Author information

Prolonged, disabling fatigue is the hallmark of chronic fatigue syndrome (CFS). Previous neuroimaging studies have provided evidence for nervous system involvement in CFS etiology, including perturbations in brain structure/function. In this arterial spin labeling (ASL) MRI study, we examined variability in cerebral blood flow (CBFV) and heart rate (HRV) in 28 women: 14 with CFS and 14 healthy controls. We hypothesized that CBFV would be reduced in individuals with CFS compared to healthy controls, and that increased CBFV and HRV would be associated with lower levels of fatigue in affected individuals. Our results provided support for these hypotheses. Although no group differences in CBFV or HRV were detected, greater CBFV and more HRV power were both associated with lower fatigue symptom severity in individuals with CFS. Exploratory statistical analyses suggested that protective effects of high CBFV were greatest in individuals with low HRV. We also found novel evidence of bidirectional association between the very high frequency (VHF) band of HRV and CBFV. Taken together, the results of this study suggest that CBFV and HRV are potentially important measures of adaptive capacity in chronic illnesses like CFS. Future studies should address these measures as potential therapeutic targets to improve outcomes and reduce symptom severity in individuals with CFS.

Arterial spin labeling; Brain imaging; Cerebral blood flow; Chronic fatigue; Heart rate variability; Regional signal variability



Senior Member
Northants UK
What this apparently shows is there is no difference in blood flow between ME and normal but if you happen to have higher blood flow and get ME you have reduced fatigue symptoms.

I have had ME since 1986 in the middle of a zoology degree. I was very noticeably ill from the start and it affected my brain noticeably but it got even worse after partial recovery and relapse. Fortunately I was always able to walk but physical exertion caused PEM and this affected my brain and I was for many years like a zombie, shuffling walk and very tired and aching upper body especially shoulders. I had been very fit at onset due to about 6 years of rowing training. I believe if I had not been so fit I would have been bed bound.

On the occasions I tried to exercise after onset I noticed zero anabolic response, i.e. no muscle growth after exercise, there was some aspect of ME blocking it.

One thing that occurs to me from my experience is that by the time you have ME its too late to develope changes in heart volume. Exercise will not help and will likely cause PEM and relapse. So any interventions designed to improve blood flow need to be based on improving blood consistency (due to the high ESR for PWME) and ultra low impact activity to improve circulation, perhaps like slow yoga (to stretch blood vessels and release muscle tension) but cannot proceed on the assumption that people will respond positively to exercise.

I think there is a danger this paper could be used to promote GET.