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Silva Vilela Terra AM, Santos PDG, Gomes M, Santos ATS, Pezarat-Correia P. Effects of auriculotherapy on muscle fatigue: A randomized crossover trial. J Bodyw Mov Ther 2024; 37:209-219. [PMID: 38432808 DOI: 10.1016/j.jbmt.2023.11.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 11/15/2023] [Accepted: 11/24/2023] [Indexed: 03/05/2024]
Abstract
OBJECTIVE This study aimed investigate the effect of auriculotherapy on exercise-induced muscle fatigue, isometric torque production, and surface electromyographic activity (EMG). METHODS Design: Randomized Crossover Trial. The sample consisted of 18 males' volunteers who exercised at least twice a week. THE SAMPLE WAS RANDOMLY ASSIGNED TO TWO GROUPS Placebo Group (n = 9) and Treated Group (n = 9), and after seven days, the groups were crossed. The data analysis included 18 participants in each group. MAIN OUTCOME MEASURE The muscle fatigue index, force production rate, and EMG of the quadriceps were used for evaluation. The evaluation moments included baseline pre-fatigue, baseline post-fatigue, 48 h post-intervention pre-fatigue, and 48 h post-intervention post-fatigue. Mixed two-way test ANOVA was used to compare times and groups. RESULTS The fatigue index for peak torque and work showed no significant effect on time, groups, or interaction (p > 0.05). However, for isometric torque, force production rate, and EMG median frequency and average, the results indicate a positive change in values over time (p < 0.05) (with little practical relevance), with no differences observed between the groups or interaction (p > 0.05). CONCLUSIONS In conclusion, auriculotherapy had no effect on exercise-induced muscle fatigue, isometric torque production, and surface electromyographic activity.
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Affiliation(s)
- Andréia Maria Silva Vilela Terra
- Neuromuscular Research Lab, Faculty of Human Kinetics, Lisbon University, 1499-002, Cruz Quebrada-Dafundo, Portugal; Human Performance Research Laboratory, Alfenas Federal University, 37133-840, Santa Clara, Alfenas, MG, Brazil.
| | - Paulo Duarte Guia Santos
- Neuromuscular Research Lab, Faculty of Human Kinetics, Lisbon University, 1499-002, Cruz Quebrada-Dafundo, Portugal
| | - Miguel Gomes
- Neuromuscular Research Lab, Faculty of Human Kinetics, Lisbon University, 1499-002, Cruz Quebrada-Dafundo, Portugal
| | - Adriana Teresa Silva Santos
- Human Performance Research Laboratory, Alfenas Federal University, 37133-840, Santa Clara, Alfenas, MG, Brazil
| | - Pedro Pezarat-Correia
- Neuromuscular Research Lab, Faculty of Human Kinetics, Lisbon University, 1499-002, Cruz Quebrada-Dafundo, Portugal; CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Dafundo, Portugal
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Socolovsky M, Bonilla G, Lovaglio AC, Masi GD. Differences in strength fatigue when using different donors in traumatic brachial plexus injuries. Acta Neurochir (Wien) 2020; 162:1913-1919. [PMID: 32556814 DOI: 10.1007/s00701-020-04454-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/08/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The purpose of this study was to assess the results of elbow flexion strength fatigue, rather than the maximal power of strength, after brachial plexus re-innervation with phrenic and spinal accessory nerves. We designed a simple but specific test to study whether statistical differences were observed among those two donor nerves. METHOD We retrospectively reviewed patients with severe brachial plexus palsy for which either phrenic nerve (PN) or spinal accessory nerve (SAN) to musculocutaneous nerve (MCN) transfer was performed. A dynamometer was used to determine the maximal contraction strength. One and two kilograms circular weights were utilized to measure isometrically the duration of submaximal and near-maximal contraction time. Statistical analysis was performed between the two groups. RESULTS Twenty-eight patients were included: 21 with a PN transfer while 7 with a SAN transfer for elbow flexion. The mean time from trauma to surgery was 7.1 months for spinal accessory nerve versus 5.2 for phrenic nerve, and the mean follow-up was 57.7 and 38.6 months, respectively. Statistical analysis showed a quicker fatigue for the PN, such that patients with the SAN transfer could hold weights of 1 kg and 2 kg for a mean of 91.0 and 61.6 s, respectively, while patients with transfer of the phrenic nerve could hold 1 kg and 2 kg weights for just a mean of 41.7 and 19.6 s, respectively. Both differences were statistically significant (at p = 0.006 and 0.011, respectively). Upon correlation analysis, endurances at 1 kg and 2 kg were strongly correlated, with r = 0.85 (p < 0.001). CONCLUSIONS Our results suggest that phrenic to musculocutaneous nerve transfer showed an increased muscular fatigue when compared with spinal accessory nerve to musculocutaneous transfer. Further studies designed to analyze this relation should be performed to increase our knowledge about strength endurance/fatigue and muscle re-innervation.
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Affiliation(s)
- Mariano Socolovsky
- Peripheral Nerve & Brachial Plexus Surgery Program, Department of Neurosurgery, Hospital de Clinicas, University of Buenos Aires School of Medicine, 1175 Torre 2 5A, 1428, Buenos Aires, La Pampa, Argentina.
| | - Gonzalo Bonilla
- Peripheral Nerve & Brachial Plexus Surgery Program, Department of Neurosurgery, Hospital de Clinicas, University of Buenos Aires School of Medicine, 1175 Torre 2 5A, 1428, Buenos Aires, La Pampa, Argentina
| | - Ana Carolina Lovaglio
- Peripheral Nerve & Brachial Plexus Surgery Program, Department of Neurosurgery, Hospital de Clinicas, University of Buenos Aires School of Medicine, 1175 Torre 2 5A, 1428, Buenos Aires, La Pampa, Argentina
| | - Gilda di Masi
- Peripheral Nerve & Brachial Plexus Surgery Program, Department of Neurosurgery, Hospital de Clinicas, University of Buenos Aires School of Medicine, 1175 Torre 2 5A, 1428, Buenos Aires, La Pampa, Argentina
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3
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Mahmoodi M, Nahvi A. Driver drowsiness detection based on classification of surface electromyography features in a driving simulator. Proc Inst Mech Eng H 2019; 233:395-406. [PMID: 30823855 DOI: 10.1177/0954411919831313] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Driver drowsiness is a significant cause of fatal crashes every year in the world. In this research, driver's drowsiness is detected by classifying surface electromyography signal features. The tests are conducted on 13 healthy subjects in a driving simulator with a monotonous route. The surface electromyography signal from the upper arm and shoulder muscles are measured including mid deltoid, clavicular portion of the pectoralis major, and triceps and biceps long heads. Signals are separated into 30-s epochs. Five features including range, variance, relative spectral power, kurtosis, and shape factor are extracted. The Observer Rating of Drowsiness evaluates the level of drowsiness. A binormal function is fitted for each feature. For classification, six classifiers are applied. The results show that the k-nearest neighbor classifier predicts drowsiness by 90% accuracy, 82% precision, 77% sensitivity, and 92% specificity.
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Affiliation(s)
- Mohammad Mahmoodi
- Department of Mechatronics Engineering, Faculty of Mechanical Engineering, K. N. Toosi University of Technology, Tehran, Iran
| | - Ali Nahvi
- Department of Mechatronics Engineering, Faculty of Mechanical Engineering, K. N. Toosi University of Technology, Tehran, Iran
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4
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Lombardo J, Sun J, Harrington MA. Rapid activity-dependent modulation of the intrinsic excitability through up-regulation of KCNQ/Kv7 channel function in neonatal spinal motoneurons. PLoS One 2018; 13:e0193948. [PMID: 29579068 PMCID: PMC5868771 DOI: 10.1371/journal.pone.0193948] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 02/21/2018] [Indexed: 11/25/2022] Open
Abstract
Activity-dependent changes in the properties of the motor system underlie the necessary adjustments in its responsiveness on the basis of the environmental and developmental demands of the organism. Although plastic changes in the properties of the spinal cord have historically been neglected because of the archaic belief that the spinal cord is constituted by a hardwired network that simply relays information to muscles, plenty of evidence has been accumulated showing that synapses impinging on spinal motoneurons undergo short- and long-term plasticity. In the brain, brief changes in the activity level of the network have been shown to be paralleled by changes in the intrinsic excitability of the neurons and are suggested to either reinforce or stabilize the changes at the synaptic level. However, rapid activity-dependent changes in the intrinsic properties of spinal motoneurons have never been reported. In this study, we show that in neonatal mice the intrinsic excitability of spinal motoneurons is depressed after relatively brief but sustained changes in the spinal cord network activity. Using electrophysiological techniques together with specific pharmacological blockers of KCNQ/Kv7 channels, we demonstrate their involvement in the reduction of the intrinsic excitability of spinal motoneurons. This action results from an increased M-current, the product of the activation of KCNQ/Kv7 channels, which leads to a hyperpolarization of the resting membrane potential and a decrease in the input resistance of spinal motoneurons. Computer simulations showed that specific up-regulations in KCNQ/Kv7 channels functions lead to a modulation of the intrinsic excitability of spinal motoneurons as observed experimentally. These results indicate that KCNQ/Kv7 channels play a fundamental role in the activity-dependent modulation of the excitability of spinal motoneurons.
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Affiliation(s)
- Joseph Lombardo
- Department of Biology, Delaware State University, Dover, Delaware, United States of America
| | - Jianli Sun
- Department of Biology, Delaware State University, Dover, Delaware, United States of America
| | - Melissa A. Harrington
- Department of Biology, Delaware State University, Dover, Delaware, United States of America
- * E-mail:
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5
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Cadigan EWJ, Collins BW, Philpott DTG, Kippenhuck G, Brenton M, Button DC. Maximal Voluntary Activation of the Elbow Flexors Is under Predicted by Transcranial Magnetic Stimulation Compared to Motor Point Stimulation Prior to and Following Muscle Fatigue. Front Physiol 2017; 8:707. [PMID: 28979211 PMCID: PMC5611415 DOI: 10.3389/fphys.2017.00707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 09/01/2017] [Indexed: 01/12/2023] Open
Abstract
Transcranial magnetic (TMS) and motor point stimulation have been used to determine voluntary activation (VA). However, very few studies have directly compared the two stimulation techniques for assessing VA of the elbow flexors. The purpose of this study was to compare TMS and motor point stimulation for assessing VA in non-fatigued and fatigued elbow flexors. Participants performed a fatigue protocol that included twelve, 15 s isometric elbow flexor contractions. Participants completed a set of isometric elbow flexion contractions at 100, 75, 50, and 25% of maximum voluntary contraction (MVC) prior to and following fatigue contractions 3, 6, 9, and 12 and 5 and 10 min post-fatigue. Force and EMG of the bicep and triceps brachii were measured for each contraction. Force responses to TMS and motor point stimulation and EMG responses to TMS (motor evoked potentials, MEPs) and Erb's point stimulation (maximal M-waves, Mmax) were also recorded. VA was estimated using the equation: VA% = (1−SITforce/PTforce) × 100. The resting twitch was measured directly for motor point stimulation and estimated for both motor point stimulation and TMS by extrapolation of the linear regression between the superimposed twitch force and voluntary force. MVC force, potentiated twitch force and VA significantly (p < 0.05) decreased throughout the elbow flexor fatigue protocol and partially recovered 10 min post fatigue. VA was significantly (p < 0.05) underestimated when using TMS compared to motor point stimulation in non-fatigued and fatigued elbow flexors. Motor point stimulation compared to TMS superimposed twitch forces were significantly (p < 0.05) higher at 50% MVC but similar at 75 and 100% MVC. The linear relationship between TMS superimposed twitch force and voluntary force significantly (p < 0.05) decreased with fatigue. There was no change in triceps/biceps electromyography, biceps/triceps MEP amplitudes, or bicep MEP amplitudes throughout the fatigue protocol at 100% MVC. In conclusion, motor point stimulation as opposed to TMS led to a higher estimation of VA in non-fatigued and fatigued elbow flexors. The decreased linear relationship between TMS superimposed twitch force and voluntary force led to an underestimation of the estimated resting twitch force and thus, a reduced VA.
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Affiliation(s)
- Edward W J Cadigan
- Human Neurophysiology Laboratory, School of Human Kinetics and Recreation, Memorial University of NewfoundlandSt. John's, NL, Canada
| | - Brandon W Collins
- Human Neurophysiology Laboratory, School of Human Kinetics and Recreation, Memorial University of NewfoundlandSt. John's, NL, Canada
| | - Devin T G Philpott
- Human Neurophysiology Laboratory, School of Human Kinetics and Recreation, Memorial University of NewfoundlandSt. John's, NL, Canada
| | - Garreth Kippenhuck
- Human Neurophysiology Laboratory, School of Human Kinetics and Recreation, Memorial University of NewfoundlandSt. John's, NL, Canada
| | - Mitchell Brenton
- Human Neurophysiology Laboratory, School of Human Kinetics and Recreation, Memorial University of NewfoundlandSt. John's, NL, Canada
| | - Duane C Button
- Human Neurophysiology Laboratory, School of Human Kinetics and Recreation, Memorial University of NewfoundlandSt. John's, NL, Canada.,BioMedical Sciences, Faculty of Medicine, Memorial University of NewfoundlandSt. John's, NL, Canada
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Sodium Pumps Mediate Activity-Dependent Changes in Mammalian Motor Networks. J Neurosci 2017; 37:906-921. [PMID: 28123025 PMCID: PMC5296784 DOI: 10.1523/jneurosci.2005-16.2016] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 11/29/2016] [Accepted: 12/07/2016] [Indexed: 12/24/2022] Open
Abstract
Ubiquitously expressed sodium pumps are best known for maintaining the ionic gradients and resting membrane potential required for generating action potentials. However, activity- and state-dependent changes in pump activity can also influence neuronal firing and regulate rhythmic network output. Here we demonstrate that changes in sodium pump activity regulate locomotor networks in the spinal cord of neonatal mice. The sodium pump inhibitor, ouabain, increased the frequency and decreased the amplitude of drug-induced locomotor bursting, effects that were dependent on the presence of the neuromodulator dopamine. Conversely, activating the pump with the sodium ionophore monensin decreased burst frequency. When more "natural" locomotor output was evoked using dorsal-root stimulation, ouabain increased burst frequency and extended locomotor episode duration, whereas monensin slowed and shortened episodes. Decreasing the time between dorsal-root stimulation, and therefore interepisode interval, also shortened and slowed activity, suggesting that pump activity encodes information about past network output and contributes to feedforward control of subsequent locomotor bouts. Using whole-cell patch-clamp recordings from spinal motoneurons and interneurons, we describe a long-duration (∼60 s), activity-dependent, TTX- and ouabain-sensitive, hyperpolarization (∼5 mV), which is mediated by spike-dependent increases in pump activity. The duration of this dynamic pump potential is enhanced by dopamine. Our results therefore reveal sodium pumps as dynamic regulators of mammalian spinal motor networks that can also be affected by neuromodulatory systems. Given the involvement of sodium pumps in movement disorders, such as amyotrophic lateral sclerosis and rapid-onset dystonia parkinsonism, knowledge of their contribution to motor network regulation also has considerable clinical importance. SIGNIFICANCE STATEMENT The sodium pump is ubiquitously expressed and responsible for at least half of total brain energy consumption. The pumps maintain ionic gradients and the resting membrane potential of neurons, but increasing evidence suggests that activity- and state-dependent changes in pump activity also influence neuronal firing. Here we demonstrate that changes in sodium pump activity regulate locomotor output in the spinal cord of neonatal mice. We describe a sodium pump-mediated afterhyperpolarization in spinal neurons, mediated by spike-dependent increases in pump activity, which is affected by dopamine. Understanding how sodium pumps contribute to network regulation and are targeted by neuromodulators, including dopamine, has clinical relevance due to the role of the sodium pump in diseases, including amyotrophic lateral sclerosis, parkinsonism, epilepsy, and hemiplegic migraine.
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7
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Picton LD, Zhang H, Sillar KT. Sodium pump regulation of locomotor control circuits. J Neurophysiol 2017; 118:1070-1081. [PMID: 28539392 DOI: 10.1152/jn.00066.2017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/03/2017] [Accepted: 05/16/2017] [Indexed: 12/21/2022] Open
Abstract
Sodium pumps are ubiquitously expressed membrane proteins that extrude three Na+ ions in exchange for two K+ ions, using ATP as an energy source. Recent studies have illuminated additional, dynamic roles for sodium pumps in regulating the excitability of neuronal networks in an activity-dependent fashion. We review their role in a novel form of short-term memory within rhythmic locomotor networks. The data we review derives mainly from recent studies on Xenopus tadpoles and neonatal mice. The role and underlying mechanisms of pump action broadly match previously published data from an invertebrate, the Drosophila larva. We therefore propose a highly conserved mechanism by which sodium pump activity increases following a bout of locomotion. This results in an ultraslow afterhyperpolarization (usAHP) of the membrane potential that lasts around 1 min, but which only occurs in around half the network neurons. This usAHP in turn alters network excitability so that network output is reduced in a locomotor interval-dependent manner. The pumps therefore confer on spinal locomotor networks a temporary memory trace of recent network performance.
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Affiliation(s)
- Laurence D Picton
- School of Psychology and Neuroscience, University of St. Andrews, St Andrews, Fife, Scotland, United Kingdom; and
| | - HongYan Zhang
- Centre for Neuroregeneration, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Keith T Sillar
- School of Psychology and Neuroscience, University of St. Andrews, St Andrews, Fife, Scotland, United Kingdom; and
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8
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Solianik R, Skurvydas A, Pukėnas K, Brazaitis M. Comparison of the effects of whole-body cooling during fatiguing exercise in males and females. Cryobiology 2015; 71:112-8. [DOI: 10.1016/j.cryobiol.2015.04.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/29/2015] [Indexed: 11/25/2022]
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9
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Aydin L, Kiziltan E, Gundogan NU. Polyphasic Temporal Behavior of Finger-Tapping Performance: A Measure of Motor Skills and Fatigue. J Mot Behav 2015; 48:72-8. [PMID: 25988674 DOI: 10.1080/00222895.2015.1040111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Successive voluntary motor movement involves a number of physiological mechanisms and may reflect motor skill development and neuromuscular fatigue. In this study, the temporal behavior of finger tapping was investigated in relation to motor skills and fatigue by using a long-term computer-based test. The finger-tapping performances of 29 healthy male volunteers were analyzed using linear and nonlinear regression models established for inter-tapping interval. The results suggest that finger-tapping performance exhibits a polyphasic nature, and has several characteristic time points, which may be directly related to muscle dynamics and energy consumption. In conclusion, we believe that future studies evaluating the polyphasic nature of the maximal voluntary movement will lead to the definition of objective scales that can be used in the follow up of some neuromuscular diseases, as well as, the determination of motor skills, individual ability, and peripheral fatigue through the use of a low cost, easy-to-use computer-based finger-tapping test.
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Affiliation(s)
- Leyla Aydin
- a Department of Physiology , Baskent University Faculty of Medicine , Ankara , Turkey
| | - Erhan Kiziltan
- a Department of Physiology , Baskent University Faculty of Medicine , Ankara , Turkey
| | - Nimet Unay Gundogan
- a Department of Physiology , Baskent University Faculty of Medicine , Ankara , Turkey
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10
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Morris G, Berk M, Galecki P, Walder K, Maes M. The Neuro-Immune Pathophysiology of Central and Peripheral Fatigue in Systemic Immune-Inflammatory and Neuro-Immune Diseases. Mol Neurobiol 2015; 53:1195-1219. [PMID: 25598355 DOI: 10.1007/s12035-015-9090-9] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 01/05/2015] [Indexed: 01/18/2023]
Abstract
Many patients with systemic immune-inflammatory and neuro-inflammatory disorders, including depression, rheumatoid arthritis, systemic lupus erythematosus, Sjögren's disease, cancer, cardiovascular disorder, Parkinson's disease, multiple sclerosis, stroke, and chronic fatigue syndrome/myalgic encephalomyelitis, endure pathological levels of fatigue. The aim of this narrative review is to delineate the wide array of pathways that may underpin the incapacitating fatigue occurring in systemic and neuro-inflammatory disorders. A wide array of immune, inflammatory, oxidative and nitrosative stress (O&NS), bioenergetic, and neurophysiological abnormalities are involved in the etiopathology of these disease states and may underpin the incapacitating fatigue that accompanies these disorders. This range of abnormalities comprises: increased levels of pro-inflammatory cytokines, e.g., interleukin-1 (IL-1), IL-6, tumor necrosis factor (TNF) α and interferon (IFN) α; O&NS-induced muscle fatigue; activation of the Toll-Like Receptor Cycle through pathogen-associated (PAMPs) and damage-associated (DAMPs) molecular patterns, including heat shock proteins; altered glutaminergic and dopaminergic neurotransmission; mitochondrial dysfunctions; and O&NS-induced defects in the sodium-potassium pump. Fatigue is also associated with altered activities in specific brain regions and muscle pathology, such as reductions in maximum voluntary muscle force, downregulation of the mitochondrial biogenesis master gene peroxisome proliferator-activated receptor gamma coactivator 1-alpha, a shift to glycolysis and buildup of toxic metabolites within myocytes. As such, both mental and physical fatigue, which frequently accompany immune-inflammatory and neuro-inflammatory disorders, are the consequence of interactions between multiple systemic and central pathways.
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Affiliation(s)
- Gerwyn Morris
- Tir Na Nog, Bryn Road seaside 87, Llanelli, SA152LW, Wales, UK
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, P.O. Box 291, Geelong, 3220, Australia.,Orygen Youth Health Research Centre and the Centre of Youth Mental Health, Poplar Road 35, Parkville, 3052, Australia.,The Florey Institute for Neuroscience and Mental Health, University of Melbourne, Kenneth Myer Building, Royal Parade 30, Parkville, 3052, Australia.,Department of Psychiatry, University of Melbourne, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville, 3052, Australia
| | - Piotr Galecki
- Department of Adult Psychiatry, Medical University of Lodz, Lodz, Poland
| | - Ken Walder
- Metabolic Research Unit, Deakin University, Geelong, Australia
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, P.O. Box 291, Geelong, 3220, Australia. .,Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina, Brazil. .,Impact Strategic Research Center, Deakin University, Geelong, Australia.
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11
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Cai B, Allexandre D, Rajagopalan V, Jiang Z, Siemionow V, Ranganathan VK, Davis MP, Walsh D, Dai K, Yue GH. Evidence of significant central fatigue in patients with cancer-related fatigue during repetitive elbow flexions till perceived exhaustion. PLoS One 2014; 9:e115370. [PMID: 25532032 PMCID: PMC4274034 DOI: 10.1371/journal.pone.0115370] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 11/21/2014] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To investigate whether fatigue induced by an intermittent motor task in patients with cancer-related fatigue (CRF) is more central or peripheral. METHODS Ten patients with CRF who were off chemo and radiation therapies and 14 age-matched healthy controls were enrolled. Participants completed a Brief Fatigue Inventory (BFI) and performed a fatigue task consisting of intermittent elbow-flexion contractions at submaximal (40% maximal voluntary contraction) intensity till self-perceived exhaustion. Twitch force was elicited by an electrical stimulation applied to the biceps brachii muscle. The relative degree of peripheral (muscle) vs. central contribution to fatigue induced by the intermittent motor task (IMT) was assessed using twitch force ratio (TF ratio) defined as post IMT twitch force to pre IMT twitch force. The total number of trials (intermittent contractions) and total duration of all trials performed by each subject were also quantified. RESULTS BFI scores were higher (p < 0.001) in CRF than controls, indicating greater feeling of fatigue in CRF patients than controls. A significantly smaller number of trials and shorter total duration of the trials (p < 0.05) were observed in CRF than control participants. The TF ratio (0.81 ± 0.05) in CRF was higher (p < 0.05) compared with that of controls (0.62 ± 0.05), suggesting CRF patients experienced a significantly lower degree of muscle (peripheral) fatigue at the time of perceived exhaustion. CONCLUSION Consistent with prior findings for fatigue under submaximal sustained contraction, our results indicate that motor fatigue in CRF is more of central than peripheral origin during IMT. Significant central fatigue in CRF patients limits their ability to prolong motor performance.
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Affiliation(s)
- Bin Cai
- Department of Rehabilitation Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China
- Institute of Rehabilitation Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China
| | - Didier Allexandre
- Human Performance & Engineering Laboratory, Kessler Foundation Research Center, 1199 Pleasant Valley Way, West Orange, New Jersey 07052, United States of America
| | - Venkateswaran Rajagopalan
- Human Performance & Engineering Laboratory, Kessler Foundation Research Center, 1199 Pleasant Valley Way, West Orange, New Jersey 07052, United States of America
| | - Zhiguo Jiang
- Human Performance & Engineering Laboratory, Kessler Foundation Research Center, 1199 Pleasant Valley Way, West Orange, New Jersey 07052, United States of America
| | - Vlodek Siemionow
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio 44195, United States of America
| | - Vinoth K. Ranganathan
- Department of Physical Medicine & Rehabilitation, Cleveland Clinic, Cleveland, Ohio 44195, United States of America
| | - Mellar P. Davis
- The Harry R. Horvitz Center for Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195, United States of America
| | - Declan Walsh
- The Harry R. Horvitz Center for Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195, United States of America
| | - Kerong Dai
- Department of Orthopaedics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China
- Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, PRC, 1954 Huashan Road, Shanghai 200030, China
| | - Guang H. Yue
- Human Performance & Engineering Laboratory, Kessler Foundation Research Center, 1199 Pleasant Valley Way, West Orange, New Jersey 07052, United States of America
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio 44195, United States of America
- Department of Physical Medicine & Rehabilitation, Cleveland Clinic, Cleveland, Ohio 44195, United States of America
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Abstract
There is an interdependent relationship between insomnia and fatigue in the medical literature, but both remain distinct entities. Insomnia entails problematic sleep initiation, maintenance, or restoration with an accompanying decrease in perceived daytime function. Lethargy is a symptom that has a wide differential diagnosis that heavily overlaps with cancer-related fatigue; however, insomnia may contribute to worsened fatigue and lethargy in cancer patients. Insomnia is a major risk factor for mood disturbances such as depression, which may also contribute to lethargy in this at-risk population. The pathophysiology of fatigue and insomnia is discussed in this review, including their differential diagnoses as well as the emerging understanding of the roles of neurotransmitters, branched-chain amino acids, and inflammatory cytokines. Treatment approaches for insomnia and fatigue are also discussed and reviewed, including the role of hypnotics, psychotropics, hormonal agents, and alternative therapies.
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Abstract
OBJECTIVES Although fatigue is experienced by everyone, its definition and classification remains under debate. METHODS A review of the previously published data on fatigue. RESULTS Fatigue is influenced by age, gender, physical condition, type of food, latency to last meal, mental status, psychological conditions, personality type, life experience, and the health status of an individual. Fatigue may not only be a symptom but also a measurable and quantifiable dimension, also known as fatigability. Additionally, it may be classified as a condition occurring at rest or under exercise or stress, as physiologic reaction or pathologic condition, as spontaneous phenomenon or triggerable state, as resistant or irresistant to preconditioning, training, or attitude, as prominent or collateral experience, and as accessible or inaccessible to any type of treatment or intervention. Fatigue may be the sole symptom of a disease or one among others. It may be also classified as acute or chronic. Quantification of fatigability is achievable by fatigue scores, force measurement, electromyography, or other means. Fatigue and fatigability need to be delineated from conditions such as sleepiness, apathy, exhaustion, exercise intolerance, lack of vigor, weakness, inertia, or tiredness. Among neurological disorders, the prevalence of fatigue is particularly increased in multiple sclerosis, amyotrophic lateral sclerosis, Parkinson disease, traumatic brain injury, stroke, and bleeding and also in neuromuscular disorders. Fatigue may be influenced by training, mental preconditioning, or drugs. CONCLUSIONS Fatigue needs to be recognized as an important condition that is not only a symptom but may also be quantified and can be modified by various measures depending on the underlying cause.
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Affiliation(s)
| | - Sinda Zarrouk Mahjoub
- Laboratory of Biochemistry, UR "Human Nutrition and Metabolic Disorders" Faculty of Medicine Monastir, Monastir, Tunisie
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