This article, published on 3rd March 2025 in ‘Science Reports', compared how the cerebrospinal fluid in people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and healthy yet sedentary people changes before and after exercise. It showed significant differences in brain chemistry in people with ME/CFS, suggesting people with ME have trouble with brain energy production and maintaining healthy nerve coverings.
Baraniuk, J.N.
Summary of the article
- The researchers studied the fluid around the brain and spine (called cerebrospinal fluid) in people with ME/CFS and compared it to healthy people who don’t exercise much. They checked how the fluid changed before and after exercise. They found some important differences in the brain chemistry of people with ME/CFS:
- Higher levels of a substance called serine, which helps make proteins and fats needed for brain cells.
- Lower levels of certain vitamins and chemicals (like 5-methyltetrahydrofolate) that help with energy production and maintaining healthy cells.
- Problems with how the body processes amino acids (the building blocks of proteins) and certain fats that protect nerves (like sphingomyelins).
- After exercise, people with ME/CFS used up more nutrients, while healthy people actually produced more.
- These differences suggest that people with ME/CFS might have trouble with brain energy production and maintaining healthy nerve coverings (myelin). The findings could help explain why people with ME/CFS experience such severe exhaustion and other symptoms after even small amounts of activity.
Extracts
“The novel findings generate new hypotheses regarding serine-folate-glycine one carbon and serine-phospholipid metabolism, elevation of end products of catabolic pathways, shifts in folate, thiamine and other vitamins with exercise, and changes in sphingomyelins that may indicate myelin and white matter dysfunction in ME/CFS. The current results can be used to power future confirmatory investigations of the cerebrospinal fluid metabolome in ME/CFS.”
MEA Comment
There is obviously a lot of very complex science in this research paper and we already know from previous research involving analysis of the cerebrospinal fluid (CSF) by Natelson et al that abnormalities, including increased numbers of white blood cells, can be present in people with ME/CFS.
These findings are interesting and are potentially important indicators of problems in some of the chemical pathways that are linked to inflammation, nerve cell repair and even post exertional malaise in ME/CFS.
However, they will need to be replicated in larger studies and validated by other independent research groups before any firm conclusions can be made.
This is not an easy task in view of the fact that obtaining cerebrospinal fluid (CSF) is a procedure that is not normally carried out on people with ME/CFS and can cause unpleasant side effects.
Dr Charles Shepherd,
Trustee and Hon. Medical Adviser to the ME Association,
Member of the 2018-2021 NICE guideline on ME/CFS committee,
Member of the 2002 Chief Medical Officer's Working Group on ME/CFS
