Cognitive Dysfunction in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome—Aetiology and Potential Treatments, 2025, Bansal+

Abstract
Systemic infection and inflammation impair mental function through a combination of altered attention and cognition. Here, we comprehensively review the relevant literature and report personal clinical observations to discuss the relationship between infection, peripheral inflammation, and cerebral and cognitive dysfunction in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Cognitive dysfunction in ME/CFS could result from low-grade persistent inflammation associated with raised pro-inflammatory cytokines. This may be caused by both infectious and non-infectious stimuli and lead to altered regional cerebral blood flow accompanied by disturbed neuronal function. Immune dysregulation that manifests as a subtle immunodeficiency or the autoimmunity targeting of one or more neuronal receptors may also be a contributing factor. Efforts to reduce low-grade systemic inflammation and viral reactivation and to improve mitochondrial energy generation in ME/CFS have the potential to improve cognitive dysfunction in this highly disabling condition.

Link | PDF (Int. J. Mol. Sci, February 2025, open access)

 

My cognitive dysfunction is not the result of inflammation or systemic infection.

My cognitive function is intact during viral infection and inflammation.

 

... except that there isn't any evidence that these potential treatments have any reliable effect on ME. I think that quite a lot of PWME have tried anti-inflammatories, antivirals, and mitochondrial boosters, with no improvement. Some people do report temporary improvements, but I don't think in numbers that support the claims that the treatments are working in the way the theory suggests.

 

From ME Research UK:

A research team including Professor Simon Carding – who is currently working on a project funded by ME Research UK, has published an article reviewing evidence on the relationship between infection, inflammation, and cognitive dysfunction – brain fog, in people with ME/CFS. Read more: https://tinyurl.com/ykxdwkrk