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Neuroinflammation in ME/CFS was initially suggested by studies showing elevated levels of pro-inflammatory cytokines, and decreased anti-inflammatory cytokines, in cerebrospinal fluid from lumbar punctures in ME/CFS patients [62, 63], and further supported by a positron emission tomography (PET) study [64], which showed increased binding of a radioligand to 18 kDa translocator protein (TSPO) receptor, the expression of which increases when microglia are activated