Cited by 185Fibromyalgia and Chronic Fatigue Syndrome ResearchLong-Term Effects of COVID-19Cardiovascular Syncope and Autonomic Disorders

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Review of case definitions for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

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Lim, Eun-Jin, Son, Chang-Gue·2020·Journal of Translational Medicine

DOI 10.1186/s12967-020-02455-0PMC PMC7391812

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Abstract

Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating disease with unknown causes. From the perspectives on the etiology and pathophysiology, ME/CFS has been labeled differently, which influenced changes in case definitions and terminologies. This review sought to feature aspects of the history, developments, and differential symptoms in the case definitions. Methods: A search was conducted through PubMed published to February 2020 using the following search keywords: case definition AND chronic fatigue syndrome [MeSH Terms]. All reference lists of the included studies were checked. Of the included studies, the number of citations and the visibility in the literatures of the definitions were considered for comparisons of the criteria. Results: Since the first 'ME' case definition was developed in 1986, 25 case definitions/diagnostic criteria were created based on three conceptual factors (etiology, pathophysiology, and exclusionary disorders). These factors can be categorized into four categories (ME, ME/CFS, CFS, and SEID) and broadly characterized according to primary disorder (ME-viral, CFS-unknown, ME/CFS-inflammatory, SEID-multisystemic), compulsory symptoms (ME and ME/CFS-neuroinflammatory, CFS and SEID-fatigue and/or malaise), and required conditions (ME-infective agent, ME/CFS, CFS, SEID-symptoms associated with fatigue, e.g., duration of illness). ME and ME/CFS widely cover all symptom categories, while CFS mainly covers neurologic and neurocognitive symptoms. Fatigue, cognitive impairment, PEM, sleep disorder, and orthostatic intolerance were the overlapping symptoms of the 4 categories, which were included as SEID criteria. Conclusions: This study comprehensively described the journey of the development of case definitions and compared the symptom criteria. This review provides broader insights and explanations to understand the complexity of ME/CFS for clinicians and researchers.

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Fig. 1 Developmental timeline of ME/CFS case definitions and terminologies. ME/CFS myalgic encephalomyelitis and chronic fatigue syndrome, CDC Centers for Disease Control and Prevention, NICE National Institute for Health and Clinical Excellence, IOM Institute of Medicine, SEID systemic exertion intolerance disease. Case definition, a specific set of criteria used to define a disease for surveillance. Diagnostic criteria, guidance to indicate the presence of an illness (signs and symptoms, test results)CC BY · PubMed Central

Fig. 2 Scope of ME/CFS symptoms by case definitions. CFS, chronic fatigue syndrome, IOM, Institute of Medicine. SEID, systemic exertion intolerance disorder. ME myalgic encephalitis, CCC Canadian Consensus Criteria, ICC International Consensus Criteria, GI gastro-intestinal, GU genito-urinary symptomsCC BY · PubMed Central

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Additional file 1 of Systematic review of fatigue severity in ME/CFS patients: insights from randomized controlled trials
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Additional file 2 of Evaluation of viral infection as an etiology of ME/CFS: a systematic review and meta-analysis
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Additional file 6 of Systematic review of fatigue severity in ME/CFS patients: insights from randomized controlled trials
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Additional file 1 of Presence of depression and anxiety with distinct patterns of pharmacological treatments before the diagnosis of chronic fatigue syndrome: a population-based study in Taiwan
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Additional file 5 of Systematic review of fatigue severity in ME/CFS patients: insights from randomized controlled trials
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Additional file 2 of Clinical evidence of the link between gut microbiome and myalgic encephalomyelitis/chronic fatigue syndrome: a retrospective review
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Additional file 3 of Evaluation of viral infection as an etiology of ME/CFS: a systematic review and meta-analysis
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Additional file 3 of Systematic review of fatigue severity in ME/CFS patients: insights from randomized controlled trials
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Additional file 4 of Systematic review of fatigue severity in ME/CFS patients: insights from randomized controlled trials
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Additional file 7 of Systematic review of fatigue severity in ME/CFS patients: insights from randomized controlled trials
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Additional file 3 of Clinical evidence of the link between gut microbiome and myalgic encephalomyelitis/chronic fatigue syndrome: a retrospective review
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Authors: Lim, E.-J., & Son, C.-G.
Affiliations: Daejeon University (KR)
Corresponding author: Son, Chang-Gue
ORCID: Lim, Eun-Jin
Son, Chang-Gue
Venue: Journal of Translational Medicine
Publisher: Springer Science and Business Media LLC
Published: 2020-07-29
Volume: 18
Issue: 1
Pages: 289-289
ISSN: 1479-5876 (ISSN-L)
DOI: 10.1186/s12967-020-02455-0
PMC: PMC7391812
OpenAlex: W3045864147
Cited by: 185
References: 61
Citations by year: 2026: 21 · 2025: 22 · 2024: 55 · 2023: 37 · 2022: 31 · 2021: 17 · 2020: 2
FWCI: 3.60
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (tdm)
creativecommons.org/licenses/by/4.0 (vor)
Locations: Journal of Translational Medicine (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: National Research Foundation of Korea (NRF-2018R1A6A1A03025221)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
Keywords: chronic fatigue syndrome, case definition, diagnostic criteria, etiology, pathophysiology, post-infectious fatigue, post-viral fatigue, post-infectious encephalomyelitis, fatigue, cognitive impairment, post-exertional malaise, sleep disorder, orthostatic intolerance, symptom criteria
MeSH terms: Humans, Sleep Wake Disorders, Fatigue Syndrome, Chronic, Orthostatic Intolerance

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Review of case definitions for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

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