Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME)
Chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a complex and serious debilitating medical condition with a diverse range of symptoms. Profound physical and/or mental fatigue is the most well-known, while others include pain, disturbed sleep patterns and gastrointestinal problems. Each patient experiences their own personal combination of symptoms.
- Research strategy
- Understanding the mechanisms of CFS/ME – a call for proposals
- MRC CFS/ME Expert Group
- MRC CFS/ME research workshop 2009
- MRC CFS/ME prioritisation meeting
- MRC-funded research projects
- Previous MRC activities
- How does the MRC decide which research proposals to fund?
CFS/ME is currently a highlighted area and a high priority for the MRC. In 2008 we set up the CFS/ME Expert Group to consider how new high-quality research into CFS/ME, and partnerships between researchers already working on CFS/ME and those in associated areas, might be encouraged. This work follows on from the Research Advisory Group set up in 2003 and the joint workshop held with Action for ME in 2006.
As part of our continuing commitment to the area, in 2011, a call for proposals made available up to £1.5million for new research into the mechanisms of CFS/ME.
Research proposals focused on one or more of six priority areas identified by experts in the fields (see below). A key aim of this call was to encourage new and innovative partnerships between researchers already working on CFS/ME and those in associated areas.
The call focused on the following research areas:
- Autonomic dysfunction
- Cognitive symptoms
- Immune dysregulation (eg through viral infection)
- Sleep disorders
Additionally, the call encouraged capacity building in CFS/ME research and the entry of new researchers into the field.
Proposals were assessed by expert peer-review and prioritised for funding by a panel at a prioritisation meeting (PDF, 17KB). Click on a member for their declaration of interest.
- Professor Stephen Holgate (Chairman), University of Southampton – Chair of the MRC’s Population and Systems Medicine Board
- Professor Malcolm Jackson, University of Liverpool – Member of the MRC’s Population and Systems Medicine Board
- Professor Frank Kelly, King's College London – Member of the MRC’s Molecular and Cellular Medicine Board
- Professor Paul Moss, University of Birmingham – Deputy Chair of the MRC’s Infection and Immunity Board
- Professor Hugh Perry, University of Southampton – Chair Designate of the MRC’s Neurosciences and Mental Health Board
- Professor Nancy Pedersen, Karolinska Institute, Stockholm – International Member
- Professor Neil Scolding, University of Bristol – Member of the MRC’s Neurosciences and Mental Health Board
Five projects with a total value of over £1.6m were funded through the call. For details see MRC-funded research projects below.
The group is chaired by Professor Stephen Holgate, chair of our Population and Systems Medicine Board. The group brings together leading experts in the field of CFS/ME and from associated fields that may be involved in the underlying mechanisms of CFS/ME, in addition to representatives from the charity sector.
Click on a member for their declaration of interest.
- Professor Stephen Holgate - University of Southampton (Chairman)
- Professor Jill Belch - University of Dundee
- Dr Esther Crawley - University of Bristol
- Professor Philip Cowen - University of Oxford
- Professor Malcolm Jackson - University of Liverpool
- Dr Jonathan Kerr - St George’s University of London
- Professor Ian Kimber - University of Manchester
- Professor Hugh Perry - University of Southampton
- Dr Derek Pheby - National CFS/ME Observatory
- Professor Anthony Pinching - Peninsula Medical School
- Dr Charles Shepherd - ME Association
- Sir Peter Spencer - Action for ME
- Professor Peter White - Bart’s and the London School of Medicine and Dentistry
The aim of the group is to explore ways in which to encourage new research in the CFS/ME field. The group looks at new technologies and associated areas of research that could help inform the diverse range of symptoms and possible underlying causes of CFS/ME.
Terms of reference
- To consider and review the status of current research in CFS/ME.
- To consider the underlying mechanisms and sub-phenotypes of CFS/ME.
- To identify research opportunities incorporating new technologies and conjoint areas and encourage new research towards understanding the basis of CFS/ME.
- To produce a framework for conducting high quality CFS/ME research in the future.
- To work to achieve clear lines of communication and synergy between all stakeholders with an interest in this area.
Notes from group meetings
- 1st meeting of the CFS/ME Expert Group – December 2008 (PDF, 122KB)
- 2nd meeting of the CFS/ME Expert Group – March 2009 (PDF, 38KB)
- 3rd meeting of the CFS/ME Expert Group – March 2010 (PDF, 29KB)
The MRC held a small research workshop for CFS/ME in 2009.
- Agenda (PDF, 45KB)
- Participants) (PDF, 42KB)
- Notes (PDF, 3.02MB) (including copy of the presentations from the meeting at annex 1)
Papers circulated prior to the meeting:
- CFS/ME literature review Jan 2004 - June 2009 (PDF, 3.04MB)
- Detection of an infectious retrovirus, XMRV, in blood cells of patients with chronic fatigue syndrome: Lombardi VC et al. Science. 2009 326:585-9
The workshop in 2009 identified an extensive list of research areas that were in need of investigation. Subsequently, we set up a prioritisation group, comprising members of the Expert Group and other workshop attendees, to discuss and prioritise the research topics raised according to short, medium and long-term goals.
The MRC has supported the following projects relating to CFS/ME:
Currently funded projects
|Professor Anne McArdle||University of Liverpool||Determination of mitochondrial function and cytokine production in skeletal muscle of patients with CFS|
|Professor Julia Newton||Newcastle University||Understanding the pathogenesis of autonomic dysfunction in chronic fatigue syndrome and its relationship with cognitive impairment|
|Dr Wan Ng||Newcastle University||Identifying the biological fingerprints of fatigue|
|Professor David Nutt||Imperial College London||Can enhancing SWS improve daytime function in patients with CFS?|
|Dr Carmine Pariante||King's College London||Persistent Fatigue Induced by Interferon-alpha: A New Immunological Model for Chronic Fatigue Syndrome|
Recently completed projects
|Dr P White||Queen Mary College, University of London||The PACE trial; A RCT of CBT, graded exercise, adaptive pacing and usual medical care for the chronic fatigue syndrome (ended May 2011)|
|Professor K Bhui||Queen Mary College, University of London||Chronic Fatigue & Ethnicity (ended November 2008)|
|Dr C Clark||Queen Mary College, University of London||General and specific risk markers & preventive factors for chronic fatigue and irritable bowel syndromes (ended May 2010)|
|Professor F H Creed||University of Manchester||The feasibility of a population based study of CFS, IBS and CWP (ended June 2007)|
|Prof R K Morriss||University of Liverpool||Exploratory RCT of training General Practitioners to mange patients with persistent Medically Unexplained Symptoms (MUS) (ended December 2005)|
|Dr A Wearden||University of Manchester||Randomised controlled trial of nurse led self-help treatment for primary care patients with chronic fatigue syndrome (ended October 2008)|
Further information on current research supported by the MRC, which includes CFS/ME can be found on the Gateway to Research.
Joint Action for ME (AfME) and MRC research summit
In November 2006, Action for ME (AfME) and the MRC held a joint research summit with the aim of stimulating further research into CFS/ME. A report of the research summit (PDF) has been published.
2003 research strategy
In 2003 we set up an advisory group, made up of independent scientists and patient representatives, to develop a research strategy. The advisory group made a number of recommendations, and in particular that in the short term the research community should be encouraged to develop high quality research proposals addressing case definition, understanding of the symptoms of CFS/ME, and new approaches to disease management.
The group believed that significant advances that could impact on the health and quality of life of those with CFS/ME could be made without the need to fully understand underlying causes or triggers.
- Research strategy for CFS/ME – full report (PDF, 400KB)
- Research strategy for CFS/ME – summary report (PDF, 44KB)
In response to the advisory group’s recommendations we issued a notice highlighting CFS/ME as a strategic priority.
All proposals for MRC grant funding are assessed through a two-stage process involving independent expert reviewers and the MRC research boards/panels. The core assessment criteria are the importance of the scientific questions being asked, the research programme’s potential for advancing biomedical science, and the justification for the resources requested.
Usually, applications are assigned to one of the research boards. However, if an application is investigating an area that crosses the remits of the boards, one board will be assigned as the lead and will consider input from the other relevant board. Ideally every research proposal we receive is reviewed by at least three independent scientific experts before we decide whether or not to fund it. These independent reviewers judge the quality of the proposed science, whether it addresses an important health question, and whether the study is appropriately designed to meet its aims. Known as peer review, this process is the internationally recognised method for ensuring quality control in science.
One of our research boards – also made up of independent scientific experts – then considers the external reviewers’ comments, taking account of any MRC strategic priorities before making a final decision. CFS/ME is currently one of our priority areas.
Applications for MRC research grants are highly competitive. During 2008/09 we were only able to fund 86 per cent of proposals rated by the boards as internationally competitive. Proposals that are funded are high-quality, well-focused and clearly presented, and successfully address the three core criteria of assessment:
- Importance of the questions, or gaps in knowledge that are being addressed.
- Scientific potential of the proposal ie what are the prospects for good scientific progress.
- Justification of resources.
Researchers considering submitting a proposal should discuss their plans with MRC head office at an early stage.