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Analgesic opioid use in a health-insured epilepsy population during 2012: Consider migralepsy. Epilepsy Behav 2016; 60:238. [PMID: 27177993 DOI: 10.1016/j.yebeh.2016.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 04/02/2016] [Indexed: 11/22/2022]
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Hanken K, Eling P, Hildebrandt H. Is there a cognitive signature for MS-related fatigue? Mult Scler 2014; 21:376-81. [DOI: 10.1177/1352458514549567] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The compensatory approach of fatigue argues that it is a state caused by task load. The neuropsychiatric approach argues that fatigue is a trait (like depression), unrelated to environmental challenges. We propose that fatigue is an internal state that can be measured behaviorally only by applying specific cognitive tasks. PubMed was searched for articles concerning the relation between fatigue and cognitive performance or brain atrophy or functional MRI, distinguishing between the following cognitive domains: learning/memory, cognitive speed/selective attention, language, visuospatial processing, working memory, alerting/vigilance. Only tasks assessing alerting/vigilance are strongly related to fatigue. Areas with brain atrophy in fatigue patients overlap with brain regions activated in healthy controls performing alerting/vigilance tasks. Fatigue is not a compensatory state, nor a psychogenic trait. It is a feeling with behavioral effects that seems to be caused by brain atrophy or a neurochemical dysfunction of the alerting/vigilance system.
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Affiliation(s)
| | - Paul Eling
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, the Netherlands
| | - Helmut Hildebrandt
- Klinikum Bremen-Ost, Germany/University of Oldenburg, Institute of Psychology, Germany
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