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” TNF-a and IL-6 have, in separate studies, both been identified as potentially key immune factors in ME/CFS The authors go on to note that, in some cases, mental fatigue persists long after the identified neural trauma has been resolved (perhaps due to a genetic predisposition or due to dendritic remodelling) and emphasise the importance of early treatment to prevent the problem becoming chronic : “Providing information about mental fatigue, its cause and the prognosis, is of utmost importance for breaking the vicious circle, which comes with the risk for secondary anxiety and depression