Habermann-Horstmeier & Horstmeier (2025)
- Authors: Lotte Habermann-Horstmeier, Lukas M. Horstmeier
- Institutes: Villingen Institute of Public Health (VIPH), Villingen-Schwenningen, Germany
- Publisher: Research Square
- Link: DOI
Summary
This study provides statistical validation for the observation that ME/CFS symptoms are not random but group into specific clusters related to body systems. By bridging patient-reported experiences with biological theories, it supports the classification of ME/CFS as a neuro-immunological multisystem disease. These findings offer a framework for clinicians to move toward more personalized, pathophysiology-guided diagnostic and treatment strategies.
What was researched?
The study aimed to empirically test and validate hypothesis-driven symptom clusters in ME/CFS to see if they align with known pathophysiological systems like the brain, gut, and immune system.
Why was it researched?
ME/CFS is a highly heterogeneous condition, and understanding how symptoms group together can help clarify the underlying disease mechanisms and improve clinical subgrouping.
How was it researched?
Researchers analyzed symptom data from 748 adult ME/CFS patients from the APAV-ME/CFS study using Exploratory and Confirmatory Factor Analysis and Structural Equation Modeling. Symptoms were mapped to predefined groups representing neurological, gastrointestinal, immunological, and vegetative (autonomic) systems.
What has been found?
The analysis successfully identified four coherent symptom clusters: Brain (cognitive/sensory), Gut (gastrointestinal), Immune (immunological), and Vegetative (autonomic). Brain-related symptoms like brain fog and sensory hypersensitivity formed the most coherent factor, while gastrointestinal and immunological symptoms were found to be distinct but related components.
Discussion
The results demonstrate that the wide variety of ME/CFS symptoms can be systematically attributed to specific functional body systems. A major strength is the large patient cohort and the use of robust statistical modeling to confirm these clinical subgroups.
Conclusion & Future Work
The study reinforces the view of ME/CFS as a complex neuro-immunological disease and suggests that symptom-based subgrouping can inform the development of individualized therapeutic approaches.