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1 Introduction Brain is a major body organ that integrate several neurodegenerative diseases including Alzheimer disease (AD), Parkinson disease (PD), primary tauopathies, frontotemporal dementia (FTD), amyotrophic lateral sclerosis (ALS), synucleinopathies (such as Lewy body dementia [LBD] and multisystem atrophy [MSA]), polyglutamine-related diseases (Huntington disease (HD) and spinocerebellar ataxias [SCA]), prion disease (PrD), traumatic brain injury (TBI), chronic traumatic encephalopathy (CTE), spinal cord injury (SCI), and multiple sclerosis (MS) (Wilson et al., 2023)

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The five symptoms we included in our primary analysis were selected to align with IOMs core diagnostic criteria for ME/CFS: 1) fatigue or low energy, 2) feeling worse after normal exertion (PEM), 3) POTS, 4) brain fog, and 5) unrefreshing sleep

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