Perfusion Across Scales in ME/CFS: From Capillary Density to Cerebral Blood Flow

In her poster presentation, Annabell Sprenger reported on research on vascular dysregulation as a key mechanism in ME/CFS, which is being conducted as part of the MIRACLE study. So far, 36 patients and 25 healthy controls have been enrolled, with 16 patients and 12 healthy controls and approximately 9800 capillaries analysed to date. Assessments cover capillary density, length, diameter, and morphological abnormalities. The work also includes assessment of cerebral blood flow using transcranial Doppler at baseline and after passive ten-minute standing tests. At baseline no relevant group differences were observed, following orthostatic stress, however, healthy controls showed consistently higher flow velocities across all parameters. This may indicate a trend towards lower cerebral perfusion in ME/CFS. These preliminary findings suggest that vascular dysregulation may affect multiple levels of the vascular system in ME/CFS. The ongoing prospective study is working towards creating a multimodal diagnostic framework combining practical and clinically accessible tools. Based on this, the aim is to develop a data-driven multimodal diagnostic score for ME/CFS that integrates functional, autonomic and vascular parameters.