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ME and CFS: The essence of objective assessment, accurate diagnosis, and acknowledging biological and clinical subgroups

  [ 12 votes ]   [ 2 Comments ]
By Frank N. Twisk • • March 24, 2014

Note: The doi number for this article has been incorrectly entered by the publisher. If you click on the journal (in "Source") you will be taken to another article by the same author. This is an error that can only be corrected by the editors of the journal.

By Frank N. Twisk


Myalgic Encephalomyelitis (ME) was identified as a new clinical entity in 1959 and has been acknowledged as a disease of the central nervous system/neurological disease by the World Health Organisation since 1969. Cognitive impairment, (muscle) weakness, circulatory disturbances, marked variability of symptoms, and, above all, post-exertional malaise: a long-lasting increase of symptoms after minor exertion, are distinctive symptoms of ME.

Chronic Fatigue Syndrome (CFS) was introduced in 1988 and was redefined into clinically evaluated, unexplained (persistent or relapsing) chronic fatigue, accompanied by at least four out of a list of eight symptoms, e.g. headaches and unrefreshing sleep, in 1994.

Although the labels are used interchangeably, ME and CFS define distinct diagnostic entities. Post-exertional malaise and cognitive deficits e.g. are not mandatory for the diagnosis CFS, while obligatory for the diagnosis ME. "Fatigue" is not obligatory for the diagnosis ME.

Since fatigue and other symptoms are subjective and ambiguous, research has been hampered. Despite this and other methodological issues, research has observed specific abnormalities in ME/CFS repetitively, e.g. immunological abnormalities, oxidative and nitrosative.

Citation: Twisk FN (2014). Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS): The essence of objective assessment, accurate diagnosis, and acknowledging biological and clinical subgroups. Front. Physiol. 5:109. doi: 10.3389/fphys.2014.00109

Please Discuss This Article:   Post a Comment 

Posted by: sPeeDeeBee
Mar 30, 2014
This surely sounds like a great commentary article to have, so I went to the source. When I requested the full article, what came up has an abstract very unlike the one you've printed here. Just wondering how that happened...
Reply Reply

The status of and future research into ME and: the need of accurate diagnosis, objective assessment
Posted by: franktwisk
May 21, 2014
You can download the PDF of the manuscript and the appendix here:
Reply Reply
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