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Updated: Dec 25, 2025

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Chronic fatigue syndrome: progress and possibilities.

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  • 1UNSW Fatigue Clinic, UNSW, Sydney, NSW.

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Chronic fatigue syndrome (CFS) is a common condition with no diagnostic test. Research suggests functional brain changes and genetic factors may underlie CFS, necessitating further investigation and improved patient care.

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Chronic fatigue syndromeDiagnosisReview articleTreatment outcome

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Area of Science:

  • Neurology
  • Immunology
  • Genetics

Background:

  • Chronic fatigue syndrome (CFS) affects approximately 1% of primary care patients.
  • CFS is characterized by profound fatigue impacting physical and cognitive function, with post-exertional malaise.
  • No definitive diagnostic test, biomarker, or cure currently exists for CFS.

Purpose of the Study:

  • To review the current understanding of Chronic Fatigue Syndrome (CFS) pathophysiology and diagnostic approaches.
  • To highlight the need for further research into the biological basis of CFS.
  • To emphasize the importance of improving diagnosis and supportive care for CFS patients.

Main Methods:

  • Review of existing diagnostic criteria for clinical practice.
  • Analysis of case-control studies investigating the biological basis of CFS.
  • Examination of evidence for genetic contributions and functional brain changes.

Main Results:

  • Studies have largely ruled out ongoing infection, immunological, endocrine, sleep, or psychiatric disorders as sole causes.
  • Evidence points towards functional, non-structural brain changes as a potential cause of CFS.
  • Family and twin studies indicate a genetic component to CFS.

Conclusions:

  • CFS pathophysiology remains uncertain, with functional brain changes and genetic factors implicated.
  • Further functional neuroimaging and genome-wide association studies are warranted.
  • Improved clinician education can enhance the diagnosis and supportive care for individuals with CFS.