ME/CFS and Fibromyalgia May Fall Along Same Illness Spectrum, CSF Analysis Suggests

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and fibromyalgia do not appear to be distinct conditions, according to an analysis of cerebrospinal fluid (CSF) proteomes. Researchers published their findings in the Annals of Medicine.

“Using mass spectrometry to analyze spinal fluid, the liquid that bathes the brain, we found that these two illnesses may fall along a common disease spectrum,” said corresponding author Steven Schutzer, MD, professor of medicine at the Rutgers New Jersey Medical School, Newark, New Jersey.

Specifically, the study used quantitative mass spectrometry-based proteomics to examine CSF of 15 patients with ME/CFS alone and 15 patients with ME/CFS and fibromyalgia. Researchers wanted to investigate whether CSF proteins considered diagnostically and therapeutically important were similar or different between the two groups of patients.

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Evidence from the analysis suggested a relationship between ME/CFS and fibromyalgia. Researchers quantified a total 2083 proteins. Among them, 1789 proteins were present in both groups of patients, according to the study.

“There do not appear to be discrete CSF proteins for ME/CFS which allow that group of patients to be clearly differentiated from those for ME/CFS + fibromyalgia,” researchers wrote. “Thus, this proteomic study did not support the hypothesis that ME/CFS has an entirely different underlying pathophysiology from CFS + fibromyalgia in the central nervous system.”

The research team advised that more research is necessary to validate their results. Additionally, further study should investigate CSF proteins in patients with fibromyalgia alone.

The study also demonstrates how unbiased quantitative mass spectrometry-based proteomics can be used to shed light on CSF proteins associated with certain diagnoses and potential therapeutic avenues.

“The results have implications for how the conditions can be investigated,” Dr Schutzer said, “while the technique may help advance treatment approaches with these diseases, and many others.”

References

Schutzer SE, Liu T, Tsai CF, et al. Myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia are indistinguishable by their cerebrospinal fluid proteomes. Ann Med. 2023;55(1):2208372. doi:10.1080/07853890.2023.2208372

Bruno G. Decoding the mysteries of medically unexplained neurologic diseases. News release. Rutgers University-New Brunswick; January 10, 2024. Accessed January 15, 2024.