This month’s Research Digest highlights several emerging areas of ME/CFS research, spanning cognition, sensory processing and vascular biology. New studies explore whether virtual reality-based reaction time testing may offer an objective way to assess cognitive fatigue, while EEG research suggests that sensory difficulties in ME/CFS may relate more to higher-order brain processing than to early sensory gating. We also feature a review proposing endothelial senescence and impaired blood flow as a possible mechanism contributing to ME/CFS and long COVID, while emphasising that this remains a hypothesis requiring further study. Finally, a personal story from Lily Schubert provides a powerful reminder of the lived reality of severe ME/CFS and the importance of continuing to amplify patient voices.
Contributing Digesters: Sarah, Lauren, Anna & Simone.
Please note: The Research Digest shares current scientific findings for awareness and discussion. It is not a substitute for medical advice or treatment guidance, as much of the research featured is in its early stages and requires further confirmation.
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COGNITION
3D virtual reality performance metrics as a future fatigue biomarker in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
Authors: Ladek A-M, Priebe L, Harrer T, Harrer E, Michelson G, Knauer T …& Hohberger B (Friedrich-Alexander-Universität, Germany)
Publication: Biomedicines (April 2026)
Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC13113152/pdf/biomedicines-14-00855.pdf
Easy Read Overview: The study compared reaction times in 60 people with ME/CFS and 60 healthy people using a virtual reality test. People with ME/CFS had significantly slower reaction times at all three difficulty levels. Both groups improved with repeated testing, but the ME/CFS group improved less than the healthy group. The authors suggest that the slower improvement may reflect the effects of fatigue.
Virtual reality-based systems have been used to diagnose or track several neurological conditions. Among these, virtual reality-oculomotor test systems (VR-OTS) have been used to assess sports-related head trauma. These authors aimed to quantitively and objectively assess the effects of cognitive impairment in ME/CFS through the use of three-dimensional VR-OTS.
120 participants were included in this study, recruited following a call for participants across the Universität of Erlangen-Nürnberg and through self-help channels. 60 participants had ME/CFS (Canadian Consensus Criteria), and 60 were healthy controls. Reaction time was assessed using a virtual reality system across three gaming repetitions. The game used three disparity levels (the angle between the participant’s eyes and the object on the screen: 275, 550 and 1100 arcseconds. Participants also completed questionnaires measuring fatigue and physical capacity.
The authors found that the estimated means (EM) for reaction time were significantly prolonged in the ME/CFS group across all three disparity levels. Gender was not found to significantly influence results; however, age was a significant covariate, and the authors attempted to account for age differences in the statistical analysis. Both the ME/CFS and control groups showed improvement in reaction time with repetitions; however the ME/CFS group showed significantly lower improvements than the control group. Reaction time was not found to be related to participant self-assessment scores.
The authors conclude that this study demonstrates that ME/CFS patients have significantly slower reaction time compared to controls. It was also found that the difference between people with ME/CFS and controls became more pronounced during the later, easier repetitions of the gaming test, which may reflect the effects of fatigue.
BIOLOGY
Virus-induced endothelial senescence as a cause and driving factor for ME/CFS and long COVID: mediated by a dysfunctional immune system
Author: Nunes M, Kell L, Slaghekke A, Wüst RCI, Fielding BC, Kell DB, Pretorius E (Stellenbosch University, South Africa)
Publication: Cell Death and Disease (2026)
Link: https://doi.org/10.1038/s41419-025-08162-2
Easy Read Overview: The authors reviewed evidence suggesting that problems with the cells lining blood vessels may play a role in ME/CFS and long COVID. They propose that viral infections may cause these cells to become damaged and remain in a state that promotes inflammation and affects blood flow. This may reduce the delivery of blood and oxygen to muscles and other tissues, which could contribute to symptoms such as PEM, brain fog and gastrointestinal problems. However, this is still a hypothesis, and more research is needed to find out whether these blood vessel changes cause ME/CFS or result from the illness.
Evidence of vascular dysfunction and reduced blood flow in ME/CFS has led researchers to investigate whether abnormalities in the endothelium (the cells lining blood vessels) could contribute to persistent symptoms. In this review, the authors proposed that viral infections may trigger endothelial senescence, a state in which cells stop dividing but remain metabolically active and release inflammatory and other signalling molecules.
The authors reviewed evidence relating to endothelial dysfunction and senescence, viral infection, immune function, blood flow, gastrointestinal function, skeletal muscle and post-exertional malaise (PEM). They aimed to develop a mechanism linking viral infection, endothelial dysfunction, immune abnormalities and the persistence of ME/CFS and long COVID.
The authors identified evidence suggestive of endothelial senescence in ME/CFS, including increased levels of several endothelial and senescence-associated markers such as endothelin-1 (ET-1), VEGF-A, VCAM-1, ICAM-1 and PAI-1. They propose that senescent endothelial cells favour vasoconstriction, impair tissue perfusion and oxygen delivery, and contribute to inflammation and abnormal coagulation. In skeletal muscle, impaired blood flow and waste removal during exertion could contribute to PEM and delayed recovery. Endothelial dysfunction in the brain and gastrointestinal tract could similarly contribute to cognitive and gastrointestinal symptoms.
The authors propose that immune dysfunction may prevent effective clearance of senescent endothelial cells, allowing this process to persist after the initial infection. They emphasise that this remains a hypothesis: cell-specific biomarkers and studies directly measuring endothelial senescence in people with ME/CFS are needed to determine whether it is a cause or consequence of the disease.
COGNITION
Higher-order brain processes, rather than early processing, underlie sensory problems in ME/CFS: evidence from ERPs
Author: r S, Veldhuis A, Yazdani F (Oxford Brookes University, United Kingdom)
Publication:Frontiers in Medicine (June 2026)
Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC13322831/
Easy Read Overview: This study compared sensory processing in 31 people with ME/CFS and 30 healthy controls using EEG, sensory tasks and questionnaires. People with ME/CFS reported more sensory sensitivity, sensory overload and avoiding sensations, but less sensation seeking than controls. The EEG results found no clear differences in early sensory processing, but showed a smaller P300 response to less frequent sounds, which may suggest differences in later brain processes that help assess and respond to sensory information. The authors suggest that these higher-level brain processes may contribute to sensory problems in ME/CFS, but larger studies are needed to confirm the findings.
There is a paucity of knowledge about the sensory problems associated with ME/CFS (such as hypersensitivity to light and sound). Previous research using electroencephalogram (EEG) in ME/CFS has produced inconsistent findings regarding sensory processing. This study examined the role of early sensory gating (preventing information overload by suppressing trivial and repetitive sensory information) and late sensory brain processing systems in ME/CFS.
This study included 31 medically diagnosed participants with ME/CFS (29 females) and 30 healthy, age-matched controls (16 females). Event-related potentials (ERPs) were collected via EEG during auditory tasks to investigate early sensory gating (P50, N100) and later cognitive control processes that regulate sensory processing (N200, P300). There were two auditory tasks: in the (i) auditory oddball task, two tones were played, and participants were instructed to press the spacebar when they heard the higher-pitched, less frequent tone. In the (ii) auditory paired click task, two clicks were played with varying intervals between them. Participants were instructed to focus on a white cross on the screen, and no response was required.
In addition, participants completed questionnaires measuring ME/CFS symptoms, mental health symptoms and sensory experiences.
Analysis of self-reported measures found the ME/CFS group had higher scores compared with controls in: Low Registration, suggesting a need for stronger stimuli to react, and perhaps missing some stimuli; Sensory Sensitivity, suggesting quick responses to low stimuli, and greater environmental awareness; and Sensation-Avoiding, suggesting being overwhelmed, leading to avoidance of stimuli. The ME/CFS group also scored lower on Sensation Seeking.
Aligning with findings from other studies, this study found no evidence of early sensory processing problems in the ME/CFS group.
In contrast to previous research, when examining later sensory processing, the findings indicate that the ME/CFS group had reduced amplitude response in the P300 time window for the infrequent oddball trials compared with the control group. This indicates suboptimal working memory and response inhibition, and failure to manage sensory changes and evaluate sensory stimulus relevance. However, as P300 potentials could also be affected by other factors, further investigation is needed.
The findings suggest control-based brain mechanisms may contribute to sensory problems experienced by people with ME/CFS. The authors suggest further research assess these issues in real-world environments with a larger sample. Improved understanding of these processes could inform pharmacological treatments or cognitive interventions directed toward higher-order brain systems.
MEDIA
‘Would anyone ever be able to help me?’: For six years, Lily couldn’t leave her bed
Author: Teh M
Publication: The Australian Women’s Weekly
Link: https://www.womensweekly.com.au/health/me-cfs-symptoms/
In this article, Lily Schubert describes her experience of being bedbound with ME/CFS for six years. “It was really like human experience stripped back to its barest form.” Lily described feeling isolated and wondering if she would ever recover.
Anne Wilson, Emerge Australia’s CEO, compared living with ME/CFS to having a battery which doesn’t charge properly. “If you go to bed at night and you charge your phone, your expectation is that you’ll get up in the morning and your phone will be charged, and you’ll be able to use it. But for someone with ME/CFS … they get up in the morning and their battery hasn’t charged.”
At 25, Lily’s condition has improved enough that she can work part time and enjoy her life. She describes feeling grateful she can do things that were once impossible. Now a chronic illness advocate, Lily shares her experience on social media to show what living with ME/CFS can really look like.
“Using my voice after being voiceless for so long was so important for me,” she says. “I’m so aware of how many people continue to be voiceless, made voiceless by this condition, so I will continue to use my voice as much as I can.”
