Preprint Analysis of Potential Subgroups in Vaes ME/CFS Patient Clusters, 2025, Squires

[forestglip]

Analysis of Potential Subgroups in Vaes ME/CFS Patient Clusters

Erik Squires

Background: Vaes et al. (2023)[@vaes2023] identified 13 symptom clusters in a large cohort of ME/CFS patients. Symptom intensity is broadly correlated with post-exertional malaise (PEM) severity, with variation across clusters that seems disorganized. Despite this research, no broadly accepted organizing principle has emerged from this paper or other attempts at phenotyping ME/CFS.

Objective: To identify and characterize potential subgroups defined by symptom domain severity relative to PEM within the original Vaes symptom clusters.

Our analysis identified two groups of patient clusters with distinct symptom-domain profiles.

Anchoring symptom domains to PEM collapses the 13 Vaes clusters into two reproducible families: one characterized by parallel offsets (autonomic, neuroendocrine, other) and one by amplified slopes (pain, neurocognitive), with high-end convergence after accounting for a single influential cluster. This subgroup's symptom trends could align with those of fibromyalgia.

Further exploration with individual patient data is needed to validate these findings.

Web | Preprint: Preprints.org | Open Access

 

[forestglip]

Vaes et al. (2023)[@vaes2023] identified 13 symptom clusters in a large cohort of ME/CFS patients.

Refers to this study (link to thread): Symptom-based clusters in people with ME/CFS: an illustration of clinical variety in a cross-sectional cohort 2023,Vaes,Jason et al

 

[Utsikt]

Almost 90% of the participants fulfilled the Fukuda case definition, compared to 80%, 59% and 39% fulfilling the IOM, CCC and ME-ICC case definitions, respectively. More than a quarter of the participants met the criteria for all four different case definitions, whilst 5% of the participants met none of the abovementioned case definitions,…

^Something to keep in mind.

This is based on DSQ-2, so it doesn’t include all relevant symptoms. The (in my opinion) substantial flaws with the wording in questionnaire also means that it might not give an accurate image of how symptoms differ between when in PEM and not in PEM.

Ideally, this analysis would be based on a survey of confirmed ME/CFS cases with an extensive list of symptoms where you answer two questions per symptom (on a scale): how bad is this symptom normally, and how bad is this symptoms when in PEM?

I think the concept is interesting, but we need better data to work with.