Background: Vaes et al. (2023)@vaes2023 identified 13 symptom clusters in a large cohort of ME/CFS patients. Symptom intensity is broadly correlated with post-exertional malaise (PEM) severity, with variation across clusters that seems disorganized. Despite this research, no broadly accepted organizing principle has emerged from this paper or other attempts at phenotyping ME/CFS. Objective: To identify and characterize potential subgroups defined by symptom domain severity relative to PEM within the original Vaes symptom clusters. Our analysis identified two groups of patient clusters with distinct symptom-domain profiles. Anchoring symptom domains to PEM collapses the 13 Vaes clusters into two reproducible families: one characterized by parallel offsets (autonomic, neuroendocrine, other) and one by amplified slopes (pain, neurocognitive), with high-end convergence after accounting for a single influential cluster. This subgroup's symptom trends could align with those of fibromyalgia. Further exploration with individual patient data is needed to validate these findings.
Erik Squires (Tue,) studied this question.