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3D Virtual Reality Performance Metrics as a Future Fatigue Biomarker in Myalgic Encephalomyelitis/Chronic Fatigue
Anja-Maria Ladek1,2, Leonie Priebe1, Thomas Harrer3,4,5
1Department of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany.
Biomedicines
|May 4, 2026
Summary
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients exhibit significantly slower reaction times (RT) in 3D visual tasks compared to healthy controls. This objective cognitive impairment may be linked to the fatigue characteristic of ME/CFS.
Area of Science:
- Neuroscience
- Cognitive Psychology
- Medical Research
Background:
- Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, debilitating illness marked by profound fatigue and cognitive dysfunction.
- Objective quantification of cognitive impairments in ME/CFS is crucial for diagnosis and understanding disease mechanisms.
Purpose of the Study:
- To objectively assess and compare reaction time (RT) metrics in 3D visual tasks between ME/CFS patients and healthy controls.
- To investigate the impact of task complexity (stimulus disparity) and repetition on cognitive performance in ME/CFS.
Main Methods:
- 120 participants (60 ME/CFS patients, 60 controls) underwent a virtual reality-oculomotor test assessing RT across three 3D stimulus disparities and three repetitions.
- Mixed-effects models analyzed group differences, controlling for age and gender.
- Validated fatigue questionnaires were administered, and their correlation with RT was examined.
Main Results:
- ME/CFS patients demonstrated significantly prolonged RTs across all tested 3D disparities compared to controls (p < 0.0023).
- While both groups improved RT over repetitions, ME/CFS patients showed significantly less improvement, particularly in later repetitions (p = 0.0042).
- No significant correlation was found between RT metrics and self-reported fatigue scores.
Conclusions:
- ME/CFS patients exhibit objective, persistent cognitive deficits in visual processing speed, as evidenced by prolonged RTs.
- The reduced improvement in RT over repetitions suggests that fatigue significantly impacts cognitive performance in ME/CFS.
- RT assessment in 3D tasks offers a valuable objective measure for cognitive impairment in ME/CFS.
