Hypothesis Glymphatic System Dysregulation as a Key Contributor to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, 2025, Nemat-Gorgani et al

John Mac

John Mac

Senior Member (Voting Rights)

Abstract​

Defined by the World Health Organization as a neurological disorder, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a disabling illness, affecting millions of people worldwide. First reported in the early nineteenth century, ME/CFS is uniquely characterized by a wide array of symptoms, including fatigue, brain fog, post-exertional malaise (PEM), sleep dysfunction, and orthostatic intolerance (OI).

Despite decades of extensive research, there are no effective medical treatments or simple diagnostics for ME/CFS, with an estimated 90% of patients remaining undiagnosed.

The recently discovered glymphatic system, a lymphatic analog of the brain, is believed to be responsible for the removal of toxic metabolic wastes accumulated in the course of daily activities, primarily during sleep. A link between glymphatic dysfunction and some neurological disorders such as Alzheimer’s disease has already been established, raising the possibility of its involvement in ME/CFS.

Accordingly, we believe the ME/CFS medical/scientific community will be interested in seriously considering GD an important contributor to its pathophysiology. If so, therapeutics that modulate glymphatic function may also benefit patients with ME/CFS.

 
Trish said:
I have no idea whether the hypothesis makes sense, but I can't help wondering, if glymphatic dysfunction is a causal factor in ME/CFS, why haven't lots of us who have had ME/CFS for decades also developed Alzheimers?
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From what I understand glympathic dysfunction as cause of Alzheimers is merely a hypothesis for Alzheimers and as pretty much anything else in the field contested. I once read an article on the topic which made it seem like it was people fighting for political prominence with work that had not been yet shown to be of relevance in humans: https://www.nature.com/articles/d41586-025-00962-y#ref-CR1.

I suspect once something new is discovered, people write papers about it whether it is of relevance or not, in particular in fields where there have been no breakthroughs for decades but where a much celebrated career awaits those that do so.
 
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