Despite this, some studies have reported raised levels of TNFα in ME/CFS patients [70,82,83,84] which is of particular interest as it is a mediator of malaise and a feature of CNS inflammatory disorders [85,86] and via its action on vaso-vagal reflex circuits in the brainstem can disrupt autonomic control [87]. This evidence concerns the gene TNF and myalgic encephalomeyelitis/chronic fatigue syndrome.