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MADD is a disorder that results from mutations in either of the two genes that encode the protein components of the heterodimeric complex identified as electron transfer flavoprotein (ETF) or the gene encoding electron transfer flavoprotein dehydrogenase (encoded by the ETFDH gene)

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It is diagnosed according to the Canadian consensus criteria, at least 6 months after onset when the following symptoms are present: fatigue, post-exertional malaise with a recovery period of at least 24 h, sleep dysfunction, pain, at least two neurological/neurocognitive symptoms and at least two symptoms involving the autonomic, neuroendocrine or immune system [19]