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Immunosenescence induces chronic low\u2010grade inflammation (inflammaging); alters T\u2010, NK\u2010, and B\u2010cell function; and promotes the release of senescence\u2010associated secretory phenotype (SASP) factors. These changes are proposed to cerebral blood flow (CBF) regulation, may impair endothelial nitric oxide production, and may contribute to blood\u2013brain barrier (BBB) breakdown. Consequently, brain hypoperfusion and oxidative stress are associated with impaired neuronal energy metabolism and synaptic plasticity, particularly in memory\u2010related networks such as the default mode and fronto\u2010hippocampal systems. This results in reduced ATP availability, excitotoxicity, and neurotransmitter imbalance, contributing to cognitive decline. The review proposes an \u201cimmune\u2013vascular\u2013cognitive axis\u201d linking peripheral immune aging to central neural dysfunction. It further highlights therapeutic strategies\u2014such as cytokine blockade, nitric oxide enhancement, immune modulation, and acupuncture\u2014that may ameliorate neurovascular impairments and cognitive symptoms. Understanding this integrative mechanism may offer new pathways for targeted intervention in ME\/CFS.<\/jats:p>","DOI":"10.1002\/cph4.70098","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T06:57:53Z","timestamp":1768373873000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Immunosenescence\u2010Driven Hemodynamic Dysregulation and Cognitive Impairment in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: An Integrative Perspective"],"prefix":"10.1002","volume":"16","author":[{"given":"Huimin","family":"Xu","sequence":"first","affiliation":[{"name":"Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine  Chengdu Sichuan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingzhe","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Oncology Hospital of Chengdu University of Traditional Chinese Medicine  Chengdu Sichuan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6572-4155","authenticated-orcid":false,"given":"Xi","family":"Wu","sequence":"additional","affiliation":[{"name":"Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine  Chengdu Sichuan 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