![]() ![]() Despite these limitations, however, the committee was able to glean evidence of symptoms, signs, and objective measures for ME/CFS. Issues related to external and internal validity and to reliability frequently have led to inconsistent results across studies, as well as other shortcomings. ![]() One of the most significant challenges to achieving a better understanding of ME/CFS results from the methodological limitations of the current research base. The chapter then examines in turn the evidence on fatigue, post-exertional malaise (PEM), sleep-related symptoms, neurocognitive manifestations, and orthostatic intolerance and autonomic dysfunction in ME/CFS. This review of the evidence on major ME/CFS symptoms and manifestations begins with a discussion of the limitations of the research base in this area. Review of the Evidence on Major ME/CFS Symptoms and Manifestations ![]()
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