The Study
Disrupted glymphatic function and its relationship with sleep and cognitive impairment in ME/CFS assessed via DTI-ALPS
This study looked at a picture of the brain and noticed that people with ME/CFS seemed to have a slower cleanup system than healthy people, and that those with worse sleep or trouble concentrating also had slower cleanup. But it didn’t prove that the slow cleanup caused the symptoms — maybe the symptoms made the cleanup slower, or something else caused both.
Analysis score
Maximum 44 for a cross-sectional study.
Where the score came from
This study looked at how well the brain cleans out waste while we sleep, using a special MRI scan.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 544 / 100
Quality score
Snapshots of a population at a single point in time, or descriptions of small groups. Can identify correlations and prevalence, but cannot determine cause and effect.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Yes — worse brain cleaning was tied to worse sleep and brain fog, which are core symptoms of ME/CFS.
- 2People with ME/CFS had lower brain waste-cleaning scores (1.44 vs.
- 31.51 in healthy people), especially on the right side of the brain.
- 4Lower scores were linked to worse sleep and trouble concentrating.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
Frontiers in Neuroscience
Year
2026
Authors
Kiran Thapaliya, Sonya Marshall-Gradisnik, Maira Inderyas, L. Barnden
Related Content
Claims (6)
The difference in glymphatic system asymmetry between people with ME/CFS and healthy individuals is not statistically detectable.
People with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome show lower scores on a brain imaging measure of waste clearance in the brain compared to healthy individuals, and this difference is linked to higher levels of neurotoxic waste and symptoms like cognitive impairment and sleep disruption.
In people with ME/CFS, lower values of a brain imaging measure of waste clearance are linked to more severe sleep disturbances.
In people with ME/CFS, lower values of a brain imaging measure of waste clearance are linked to worse problems with concentration.
Impaired clearance of waste products from the brain by the glymphatic system is involved in the biological processes underlying chronic fatigue syndrome.
In people with ME/CFS, brain imaging shows reduced glymphatic system activity in the right hemisphere compared to the left hemisphere, a difference not seen in healthy individuals.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.