Chronic fatigue syndrome: neurological findings may be related to blood--brain barrier permeability

Med Hypotheses. 2001 Aug;57(2):231-7. doi: 10.1054/mehy.2001.1306.


Despite volumes of international research, the etiology of chronic fatigue syndrome (CFS) remains elusive. There is, however, considerable evidence that CFS is a disorder involving the central nervous system (CNS). It is our hypothesis that altered permeability of the blood-brain barrier (BBB) may contribute to ongoing signs and symptoms found in CFS. To support this hypothesis we have examined agents that can increase the blood-brain barrier permeability (BBBP) and those that may be involved in CFS. The factors which can compromise the normal BBBP in CFS include viruses, cytokines, 5-hydroxytryptamine, peroxynitrite, nitric oxide, stress, glutathione depletion, essential fatty acid deficiency, and N-methyl-D-aspartate overactivity. It is possible that breakdown of normal BBBP leads to CNS cellular dysfunction and disruptions of neuronal transmission in CFS. Abnormal changes in BBBP have been linked to a number of disorders involving the CNS; based on review of the literature we conclude that the BBB integrity in CFS warrants investigation.

Publication types

  • Review

MeSH terms

  • Blood-Brain Barrier*
  • Central Nervous System / physiopathology*
  • Fatigue Syndrome, Chronic / physiopathology*
  • Humans
  • Permeability