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Abstract Background Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has garnered substantial scientific and clinical interest, due to its rising global prevalence and significant pathophysiological overlap with post-acute COVID-19 syndrome (PACS)

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This surge in neurotransmitter production enhances synaptic transmission, improves neuronal communication, and helps lift the dense, disorienting brain fog that so many patients experience

the definition of this profile showed a good level of homogeneity (mean inter-item Spearman 0.25) [41] and has been extensively described previously as belonging to the immuno-metabolic depression (IMD) domain, based on previous findings on individual symptoms with immuno-metabolic dysregulation [2]