1
|
Casula EP, Esposito R, Dezi S, Ortelli P, Sebastianelli L, Ferrazzoli D, Saltuari L, Pezzopane V, Borghi I, Rocchi L, Ajello V, Trinka E, Oliviero A, Koch G, Versace V. Reduced TMS-evoked EEG oscillatory activity in cortical motor regions in patients with post-COVID fatigue. Clin Neurophysiol 2024; 165:26-35. [PMID: 38943790 DOI: 10.1016/j.clinph.2024.06.008] [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: 03/04/2024] [Revised: 05/13/2024] [Accepted: 06/10/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE Persistent fatigue is a major symptom of the so-called 'long-COVID syndrome', but the pathophysiological processes that cause it remain unclear. We hypothesized that fatigue after COVID-19 would be associated with altered cortical activity in premotor and motor regions. METHODS We used transcranial magnetic stimulation combined with EEG (TMS-EEG) to explore the neural oscillatory activity of the left primary motor area (l-M1) and supplementary motor area (SMA) in a group of sixteen post-COVID patients complaining of lingering fatigue as compared to a sample of age-matched healthy controls. Perceived fatigue was assessed with the Fatigue Severity Scale (FSS) and Fatigue Rating Scale (FRS). RESULTS Post-COVID patients showed a remarkable reduction of beta frequency in both areas. Correlation analysis exploring linear relation between neurophysiological and clinical measures revealed a significant inverse correlation between the individual level of beta oscillations evoked by TMS of SMA with the individual scores in the FRS (r(15) = -0.596; p = 0.012). CONCLUSIONS Post-COVID fatigue is associated with a reduction of TMS-evoked beta oscillatory activity in SMA. SIGNIFICANCE TMS-EEG could be used to identify early alterations of cortical oscillatory activity that could be related to the COVID impact in central fatigue.
Collapse
Affiliation(s)
- Elias P Casula
- Department of System Medicine, University of Tor Vergata, Via Cracovia 50, 00133, Rome, Italy; Experimental Neuropsychophysiology Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 354, 00179, Rome, Italy
| | - Romina Esposito
- Experimental Neuropsychophysiology Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 354, 00179, Rome, Italy
| | - Sabrina Dezi
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy, Teaching Hospital of the Paracelsus Medical Unversity (PMU), Salzburg, Austria; Teaching Hospital of the Paracelsus Medical University (PMU), Salzburg, Austria
| | - Paola Ortelli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy, Teaching Hospital of the Paracelsus Medical Unversity (PMU), Salzburg, Austria; Teaching Hospital of the Paracelsus Medical University (PMU), Salzburg, Austria
| | - Luca Sebastianelli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy, Teaching Hospital of the Paracelsus Medical Unversity (PMU), Salzburg, Austria; Teaching Hospital of the Paracelsus Medical University (PMU), Salzburg, Austria
| | - Davide Ferrazzoli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy, Teaching Hospital of the Paracelsus Medical Unversity (PMU), Salzburg, Austria; Teaching Hospital of the Paracelsus Medical University (PMU), Salzburg, Austria
| | - Leopold Saltuari
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy, Teaching Hospital of the Paracelsus Medical Unversity (PMU), Salzburg, Austria; Teaching Hospital of the Paracelsus Medical University (PMU), Salzburg, Austria
| | - Valentina Pezzopane
- Experimental Neuropsychophysiology Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 354, 00179, Rome, Italy
| | - Ilaria Borghi
- Experimental Neuropsychophysiology Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 354, 00179, Rome, Italy
| | - Lorenzo Rocchi
- Department of Medical Sciences and Public Health, University of Cagliari, Via Università 40, 09124 Cagliari, Italy
| | - Valentina Ajello
- Department of Cardiac Anesthesia, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Eugen Trinka
- Department of Neurology, Neurocritical Care and Neurorehabilitation, Christian Doppler University Hospital, Centre for Cognitive Neuroscience, Paracelsus Medical University, Member of the European Reference Network EpiCARE, Salzburg, Ignaz-Harrer-Straße 79, 5020 Salzburg, Austria; Neuroscience Institute, Christian Doppler University Hospital, Paracelsus Medical University and Center for Cognitive Neuroscience, Ignaz-Harrer-Straße 79, 5020 Salzburg, Austria; Karl Landsteiner Institute of Neurorehabilitation and Space Neurology, Julius Raab-Promenade 49/1, 3100 St. Pölten, Salzburg, Austria
| | - Antonio Oliviero
- FENNSI Group, Hospital Nacional de Parapléjicos, SESCAM, FINCA DE, Carr. de la Peraleda, S/N, 45004 Toledo, Spain; Center for Clinical Neuroscience, Hospital Los Madroños, M-501 Km 17, 900 - 28690 Brunete, Spain
| | - Giacomo Koch
- Experimental Neuropsychophysiology Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 354, 00179, Rome, Italy; Department of Neuroscience and Rehabilitation, University of Ferrara, Via Ludovico Ariosto 35, 44121 Ferrara, Italy
| | - Viviana Versace
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy, Teaching Hospital of the Paracelsus Medical Unversity (PMU), Salzburg, Austria; Teaching Hospital of the Paracelsus Medical University (PMU), Salzburg, Austria; Department of Neurology, Neurocritical Care and Neurorehabilitation, Christian Doppler University Hospital, Centre for Cognitive Neuroscience, Paracelsus Medical University, Member of the European Reference Network EpiCARE, Salzburg, Ignaz-Harrer-Straße 79, 5020 Salzburg, Austria.
| |
Collapse
|
2
|
Sánchez-Cuesta FJ, González-Zamorano Y, Arroyo-Ferrer A, Moreno-Verdú M, Romero-Muñoz JP. Repetitive Transcranial Magnetic Stimulation of Primary Motor Cortex for stroke upper limb motor sequelae rehabilitation: A systematic review. NeuroRehabilitation 2023; 52:329-348. [PMID: 37005900 DOI: 10.3233/nre-220306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
BACKGROUND: Repetitive Transcranial Magnetic Stimulation (rTMS) over the primary motor cortex (M1) has been used to treat stroke motor sequelae regulating cortical excitability. Early interventions are widely recommended, but there is also evidence showing interventions in subacute or chronic phases are still useful. OBJECTIVE: To synthetize the evidence of rTMS protocols to improve upper limb motor function in people with subacute and/or chronic stroke. METHODS: Four databases were searched in July 2022. Clinical trials investigating the effectiveness of different rTMS protocols on upper limb motor function in subacute or chronic phases post-stroke were included. PRISMA guidelines and PEDro scale were used. RESULTS: Thirty-two studies representing 1137 participants were included. Positive effects of all types of rTMS protocols on upper limb motor function were found. These effects were heterogeneous and not always clinically relevant or related to neurophysiological changes but produced evident changes if evaluated with functional tests. CONCLUSION: rTMS interventions over M1 are effective for improving upper limb motor function in people with subacute and chronic stroke. When rTMS protocols were priming physical rehabilitation better effects were achieved. Studies considering minimal clinical differences and different dosing will help to generalize the use of these protocols in clinical practice.
Collapse
Affiliation(s)
- Francisco José Sánchez-Cuesta
- Facultad de Ciencias Experimentales, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain
- Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain
| | - Yeray González-Zamorano
- Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, King Juan Carlos University, Alcorcón, Spain
| | - Aída Arroyo-Ferrer
- Facultad de Ciencias Experimentales, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain
- Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain
| | - Marcos Moreno-Verdú
- Facultad de Ciencias Experimentales, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain
- Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain
| | - Juan Pablo Romero-Muñoz
- Facultad de Ciencias Experimentales, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain
- Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain
- Brain Damage Unit, Beata María Ana Hospital, Madrid, Spain
| |
Collapse
|
3
|
Thapaliya G, Eldeghaidy S, Asghar M, McGing J, Radford S, Francis S, Moran GW. The relationship between Central Nervous System morphometry changes and key symptoms in Crohn’s disease. Brain Imaging Behav 2022; 17:149-160. [PMID: 36409402 PMCID: PMC10049962 DOI: 10.1007/s11682-022-00742-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2022] [Indexed: 11/22/2022]
Abstract
AbstractAlterations in grey matter volume (GMV) and cortical thickness (CT) in Crohn’s disease (CD) patients has been previously documented. However, the findings are inconsistent, and not a true representation of CD burden, as only CD patients in remission have been studied thus far. We investigate alterations in brain morphometry in patients with active CD and those in remission, and study relationships between brain structure and key symptoms of fatigue, abdominal pain, and extraintestinal manifestations (EIM). Magnetic Resonance Imaging brain scans were collected in 89 participants; 34 CD participants with active disease, 13 CD participants in remission and 42 healthy controls (HCs); Voxel based morphometry (VBM) assessed GMV and white matter volume (WMV), and surface-based analysis assessed cortical thickness (CT). We show a significant reduction in global cerebrospinal fluid (CSF) volume in CD participants compared with HCs, as well as, a reduction in regional GMV, WMV and CT in the left precentral gyrus (motor cortex), and an increase in GMV in the frontal brain regions in CD compared with HCs. Atrophy of the supplementary motor area (SMA) was associated with greater fatigue in CD. We also show alterations in brain structure in multiple regions in CD associated with abdominal pain and extraintestinal inflammations (EIMs). These brain structural alterations likely reflect neuroplasticity to a chronic systemic inflammatory response, abdominal pain, EIMs and fatigue. These findings will aid our understanding of the cross-linking between chronic inflammation, brain structural changes and key unexplained CD symptomatology like fatigue.
Collapse
Affiliation(s)
- Gita Thapaliya
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
| | - Sally Eldeghaidy
- NIHR Nottingham Biomedical Research Centre, The University of Nottingham, Nottingham University Hospitals NHS Trust and School of Medicine, Nottingham, UK
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, The University of Nottingham, Nottingham, UK
- School of Biosciences and Future Food Beacon, The University of Nottingham, Nottingham, UK
| | - Michael Asghar
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, The University of Nottingham, Nottingham, UK
| | - Jordan McGing
- NIHR Nottingham Biomedical Research Centre, The University of Nottingham, Nottingham University Hospitals NHS Trust and School of Medicine, Nottingham, UK
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, The University of Nottingham, Nottingham, UK
| | - Shellie Radford
- NIHR Nottingham Biomedical Research Centre, The University of Nottingham, Nottingham University Hospitals NHS Trust and School of Medicine, Nottingham, UK
| | - Susan Francis
- NIHR Nottingham Biomedical Research Centre, The University of Nottingham, Nottingham University Hospitals NHS Trust and School of Medicine, Nottingham, UK
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, The University of Nottingham, Nottingham, UK
| | - Gordon William Moran
- NIHR Nottingham Biomedical Research Centre, The University of Nottingham, Nottingham University Hospitals NHS Trust and School of Medicine, Nottingham, UK.
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, The University of Nottingham, Nottingham, UK.
- Translational Medical Sciences Unit, University of Nottingham, Nottingham, UK.
| |
Collapse
|
4
|
Lopes TR, Pereira HM, Silva BM. Perceived Exertion: Revisiting the History and Updating the Neurophysiology and the Practical Applications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114439. [PMID: 36361320 PMCID: PMC9658641 DOI: 10.3390/ijerph192114439] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 05/25/2023]
Abstract
The perceived exertion construct creation is a landmark in exercise physiology and sport science. Obtaining perceived exertion is relatively easy, but practitioners often neglect some critical methodological issues in its assessment. Furthermore, the perceived exertion definition, neurophysiological basis, and practical applications have evolved since the perceived exertion construct's inception. Therefore, we revisit the careful work devoted by Gunnar Borg with psychophysical methods to develop the perceived exertion construct, which resulted in the creation of two scales: the rating of perceived exertion (RPE) and the category-ratio 10 (CR10). We discuss a contemporary definition that considers perceived exertion as a conscious perception of how hard, heavy, and strenuous the exercise is, according to the sense of effort to command the limbs and the feeling of heavy breathing (respiratory effort). Thus, other exercise-evoked sensations would not hinder the reported perceived exertion. We then describe the neurophysiological mechanisms involved in the perceived exertion genesis during exercise, including the influence of the peripheral feedback from the skeletal muscles and the cardiorespiratory system (i.e., afferent feedback) and the influence of efferent copies from the motor command and respiratory drive (i.e., corollary discharges), as well as the interaction between them. We highlight essential details practitioners should consider when using the RPE and CR10 scales, such as the perceived exertion definition, the original scales utilization, and the descriptors anchoring process. Finally, we present how practitioners can use perceived exertion to assess cardiorespiratory fitness, individualize exercise intensity prescription, predict endurance exercise performance, and monitor athletes' responses to physical training.
Collapse
Affiliation(s)
- Thiago Ribeiro Lopes
- Laboratory of Exercise Physiology at Olympic Center of Training and Research, Department of Physiology, Federal University of São Paulo, São Paulo 04023-000, SP, Brazil
- São Paulo Association for Medicine Development, São Paulo 04037-003, SP, Brazil
| | - Hugo Maxwell Pereira
- Department of Health and Exercise Science, The University of Oklahoma, Norman, OK 73019, USA
| | - Bruno Moreira Silva
- Laboratory of Exercise Physiology at Olympic Center of Training and Research, Department of Physiology, Federal University of São Paulo, São Paulo 04023-000, SP, Brazil
| |
Collapse
|
5
|
Suviseshamuthu ES, Shenoy Handiru V, Allexandre D, Hoxha A, Saleh S, Yue GH. EEG-Based Spectral Analysis Showing Brainwave Changes Related to Modulating Progressive Fatigue During a Prolonged Intermittent Motor Task. Front Hum Neurosci 2022; 16:770053. [PMID: 35360287 PMCID: PMC8962200 DOI: 10.3389/fnhum.2022.770053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 02/10/2022] [Indexed: 12/03/2022] Open
Abstract
Repeatedly performing a submaximal motor task for a prolonged period of time leads to muscle fatigue comprising a central and peripheral component, which demands a gradually increasing effort. However, the brain contribution to the enhancement of effort to cope with progressing fatigue lacks a complete understanding. The intermittent motor tasks (IMTs) closely resemble many activities of daily living (ADL), thus remaining physiologically relevant to study fatigue. The scope of this study is therefore to investigate the EEG-based brain activation patterns in healthy subjects performing IMT until self-perceived exhaustion. Fourteen participants (median age 51.5 years; age range 26−72 years; 6 males) repeated elbow flexion contractions at 40% maximum voluntary contraction by following visual cues displayed on an oscilloscope screen until subjective exhaustion. Each contraction lasted ≈5 s with a 2-s rest between trials. The force, EEG, and surface EMG (from elbow joint muscles) data were simultaneously collected. After preprocessing, we selected a subset of trials at the beginning, middle, and end of the study session representing brain activities germane to mild, moderate, and severe fatigue conditions, respectively, to compare and contrast the changes in the EEG time-frequency (TF) characteristics across the conditions. The outcome of channel- and source-level TF analyses reveals that the theta, alpha, and beta power spectral densities vary in proportion to fatigue levels in cortical motor areas. We observed a statistically significant change in the band-specific spectral power in relation to the graded fatigue from both the steady- and post-contraction EEG data. The findings would enhance our understanding on the etiology and physiology of voluntary motor-action-related fatigue and provide pointers to counteract the perception of muscle weakness and lack of motor endurance associated with ADL. The study outcome would help rationalize why certain patients experience exacerbated fatigue while carrying out mundane tasks, evaluate how clinical conditions such as neurological disorders and cancer treatment alter neural mechanisms underlying fatigue in future studies, and develop therapeutic strategies for restoring the patients' ability to participate in ADL by mitigating the central and muscle fatigue.
Collapse
Affiliation(s)
- Easter S. Suviseshamuthu
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
- Department of Physical Medicine and Rehabilitation, Rutgers Biomedical Health Sciences, Newark, NJ, United States
- *Correspondence: Easter S. Suviseshamuthu
| | - Vikram Shenoy Handiru
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
- Department of Physical Medicine and Rehabilitation, Rutgers Biomedical Health Sciences, Newark, NJ, United States
| | - Didier Allexandre
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
- Department of Physical Medicine and Rehabilitation, Rutgers Biomedical Health Sciences, Newark, NJ, United States
| | - Armand Hoxha
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
| | - Soha Saleh
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
- Department of Physical Medicine and Rehabilitation, Rutgers Biomedical Health Sciences, Newark, NJ, United States
| | - Guang H. Yue
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
- Department of Physical Medicine and Rehabilitation, Rutgers Biomedical Health Sciences, Newark, NJ, United States
| |
Collapse
|
6
|
Melo LT, Rodrigues A, Cabral EE, Tanaka T, Goligher EC, Brochard L, Reid WD. Prefrontal cortex activation during incremental inspiratory loading in healthy participants. Respir Physiol Neurobiol 2021; 296:103827. [PMID: 34808586 DOI: 10.1016/j.resp.2021.103827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 10/01/2021] [Accepted: 11/11/2021] [Indexed: 11/28/2022]
Abstract
We aimed to investigate whether changes in prefrontal cortex (PFC) oxyhemoglobin (O2Hb) and deoxyhemoglobin (HHb) associates with inspiratory muscle effort during inspiratory threshold loading (ITL) in healthy participants. Participants performed an incremental ITL. Breathing pattern, partial pressure of end-tidal CO2 (PETCO2), mouth pressure and O2Hb and HHb over the right dorsolateral PFC, sternocleidomastoid (SCM), and diaphragm/intercostals (Dia/IC) were monitored. Fourteen healthy participants (8 men; 29 ± 5 years) completed testing. Dyspnea was higher post- than pre-ITL (5 ± 1 vs. 0 ± 1, respectively; P<0.05). PFC O2Hb increased (P < 0.001) and HHb decreased (P = 0.001) at low loads but remained stable with increasing ITL intensities. PFC total hemoglobin increased at task failure compared to rest. SCM HHb increased throughout increasing intensities. SCM and Dia/IC total hemoglobin increased in the at task failure compared to rest. PETCO2 did not change (P = 0.528). PFC is activated early during the ITL but does not show central fatigue at task failure despite greater dyspnea and an imbalance of SCM oxygen demand and delivery.
Collapse
Affiliation(s)
- Luana T Melo
- Department of Physical Therapy, University of Toronto, Ontario, Canada; Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Antenor Rodrigues
- Department of Physical Therapy, University of Toronto, Ontario, Canada; Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
| | - Elis Emmanuelle Cabral
- Department of Physical Therapy, University of Toronto, Ontario, Canada; Performance Lab, Pneumocardiovascular and Respiratory Muscles (PneumoCardioVascular Lab/HUOL), Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Rio Grande do Norte, Brazil
| | - Takako Tanaka
- Department of Physical Therapy, University of Toronto, Ontario, Canada; Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ewan C Goligher
- Division of Respirology, Department of Medicine, University Health Network, Toronto, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; Department of Physiology, University of Toronto, Toronto, Canada
| | - Laurent Brochard
- Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada
| | - W Darlene Reid
- Department of Physical Therapy, University of Toronto, Ontario, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| |
Collapse
|
7
|
Silva Filho E, Moura S, Santos ADC, Brasileiro-Santos MDS, Albuquerque JAD. Transcranial direct current stimulation as a strategy to manage COVID-19 pain and fatigue. ACTA ACUST UNITED AC 2021; 67:26-28. [PMID: 34161475 DOI: 10.1590/1806-9282.67.01.20200671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/20/2020] [Indexed: 11/21/2022]
Abstract
The novel coronavirus disease (COVID-19) has infected millions of people worldwide and generated many sequels in the survivors, such as muscular pain and fatigue. These symptoms have been treated through pharmacological approaches; however, infected people keep presenting physical limitations. Besides, the COVID-19 damage to the central nervous system has also been related to the presence of some physical impairment, so strategies that focus on diverse brain areas should be encouraged. Transcranial Direct Current Stimulation (tDCS) is a non-pharmacological tool that could be associated with pharmacological treatments to improve the central nervous system function and decrease the exacerbation of the immune system response. tDCS targeting pain and fatigue-related areas could provide an increase in neuroplasticity and enhancements in physical functions. Moreover, it can be used in infirmaries and clinical centers to treat COVID-19 patients.
Collapse
Affiliation(s)
- Edson Silva Filho
- UniversidadeFederal da Paraíba, Departamento de Educação Física, Laboratório de Estudos do Treinamento Físico Aplicado ao Desempenho e a Saúde - João Pessoa (PB), Brasil.,UniversidadeFederal da Paraíba, Departamento de Educação Física - João Pessoa (PB), Brasil.,UniversidadeFederal da Paraíba, Escola de Medicina e Enfermagem de Nova Esperança - João Pessoa (PB), Brasil
| | - Stephanney Moura
- UniversidadeFederal da Paraíba, Departamento de Educação Física, Laboratório de Estudos do Treinamento Físico Aplicado ao Desempenho e a Saúde - João Pessoa (PB), Brasil
| | - Amilton da Cruz Santos
- UniversidadeFederal da Paraíba, Departamento de Educação Física, Laboratório de Estudos do Treinamento Físico Aplicado ao Desempenho e a Saúde - João Pessoa (PB), Brasil.,UniversidadeFederal da Paraíba, Departamento de Educação Física - João Pessoa (PB), Brasil
| | - Maria do Socorro Brasileiro-Santos
- UniversidadeFederal da Paraíba, Departamento de Educação Física, Laboratório de Estudos do Treinamento Físico Aplicado ao Desempenho e a Saúde - João Pessoa (PB), Brasil.,UniversidadeFederal da Paraíba, Departamento de Educação Física - João Pessoa (PB), Brasil
| | | |
Collapse
|
8
|
Monjo F, Zory R, Forestier N. Fatiguing Neuromuscular Electrical Stimulation Decreases the Sense of Effort During Subsequent Voluntary Contractions in Men. Neuroscience 2020; 446:113-123. [PMID: 32891703 DOI: 10.1016/j.neuroscience.2020.08.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/14/2022]
Abstract
As voluntary muscle fatigue increases, the perception of the effort required to produce a particular level of force also increases. This occurs because we produce greater neural outputs from the brain to compensate for the fatigue-induced loss of force. Muscle fatigue can also be generated following bouts of neuromuscular electrical stimulation (NMES), a technique widely used for rehabilitation and training purposes. Yet the effects of NMES-induced fatigue on the perception of effort have never been tested. In this study, we thus evaluated how electrically evoked fatigue would affect the sense of effort. For this purpose, we used two psychophysical tasks intended to assess effort perception: (i) a bilateral matching task in which subjects were asked to contract the elbow flexors of their reference and indicator arms with similar amounts of effort and (ii) a unilateral matching task in which they produced controlled levels of isometric force with their indicator arm and rated their perceived effort using the Borg CR10 scale. These tasks were performed before and after the biceps brachii of the indicator arm was submitted to a fatiguing NMES program that generated maximal force losses of 10-15%. Contrary to voluntary muscle fatigue, the sense of effort decreased post-NMES in both tasks despite increased neural outputs to the elbow flexors of the fatigued indicator arm. This shows that the relationship between motor command magnitude and effort perception was completely modified by NMES. It is proposed that NMES alters the sensory structures responsible for effort signal integration.
Collapse
Affiliation(s)
| | | | - Nicolas Forestier
- Université Savoie Mont Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, Chambéry, France
| |
Collapse
|
9
|
Smith SGVS, Power GA, Bent LR. Foot sole cutaneous stimulation mitigates neuromuscular fatigue during a sustained plantar flexor isometric task. J Appl Physiol (1985) 2020; 129:325-334. [PMID: 32584665 DOI: 10.1152/japplphysiol.00157.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Neuromuscular fatigue impairs motor coordination, movement stability, and proprioception, which further decreases performance. A neuromechanical coupling exists between foot sole cutaneous mechanoreceptors and motoneurons of the lower limb, however, the contribution of skin sensory input on muscle fatigue remains unclear. The purpose of this study was to determine if the presence of cutaneous stimulation could mitigate the effect of fatigue of the plantar flexor muscles during a sustained isometric task at 30% maximal voluntary contraction (MVC). Participants (N = 16, age 24.1 ± 2.6 yr) underwent a 30% isometric plantar flexor fatiguing task in a seated position with hip, knee, and ankle angle at 80°, 100°, and 90°, respectively, with intermittent MVCs until task failure. Failure was defined as when the participant could no longer maintain 30% MVC for a minimum of two seconds. Throughout the protocol, electrical stimulation was applied to either the right heel, right metatarsals, or no stimulation. A subset of participants (N = 6) underwent an additional condition with electrical stimulation applied to the left arm. MVCs were also conducted intermittently throughout recovery for 30 min. Foot sole cutaneous stimulation mitigated fatigue, as demonstrated by an ~15% increased time to task failure (TTF) compared with the control condition. When normalized to TTF, MVC torque amplitude was not different at each time epoch, which indicated that each %MVC was maintained longer into the fatigue task during the heel and metatarsal stimulation conditions However, there was no significant effect of cutaneous stimulation on recovery. The results indicate that cutaneous stimulation may serve as a feasible means to mitigate fatigue.NEW & NOTEWORTHY Cutaneous coupling with lower limb motor neurons has long been known. We set out to establish whether this pathway could serve a purpose other than muscular modulation during standing and walking. We found that during a submaximal contraction of the plantar flexor muscles, the addition of intermittent cutaneous stimulation to the skin of the foot sole resulted in an increase in time to task failure by 15%, which was over a minute longer in duration. We conclude that skin stimulation may serve as a mechanism to mitigate fatigue.
Collapse
Affiliation(s)
- Simone G V S Smith
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Geoffrey A Power
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Leah R Bent
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| |
Collapse
|
10
|
Brownstein CG, Espeit L, Royer N, Lapole T, Millet GY. Fatigue-induced changes in short-interval intracortical inhibition and the silent period with stimulus intensities evoking maximal versus submaximal responses. J Appl Physiol (1985) 2020; 129:205-217. [PMID: 32584668 DOI: 10.1152/japplphysiol.00282.2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
During fatiguing exercise, previous studies have employed transcranial magnetic stimulation (TMS) paradigms eliciting either maximal or submaximal short-interval intracortical inhibition (SICI) and silent period (SP) durations. However, the effect of using either approach on the change in these variables with fatigue is unknown. This study examined the effects of using conditioning stimulus (CS, experiment A) and single-pulse TMS intensities (experiment B) that elicit maximal and submaximal SICI and SP duration (MaxSICI vs. SubmaxSICI in experiment A, MaxSP vs. SubmaxSP in experiment B) on the change in these measures with fatigue. In both experiments, participants performed a 10-min sustained isometric knee-extension contraction at a constant level of EMG, with measurements taken with maximal and submaximal intensities at baseline and every 2.5 min throughout the task. Immediately after the 10-min contraction (i.e., without recovery), responses were also measured at the same absolute force level as at baseline. In experiment A, no change in SICI was observed with either CS intensity throughout the EMG task (P > 0.05). However, an 18% decrease in SICI (i.e., less inhibition) was observed at the same absolute force only with the MaxSICI CS intensity (P < 0.01), with no change in SubmaxSICI (P = 0.72). In experiment B, the magnitude of increase in SP with fatigue was similar for both stimulus intensities (stimulus × time interaction: P = 0.44). These results suggest that CS intensities eliciting maximum SICI are more sensitive in detecting fatigue-induced reductions in SICI, whereas increases in SP are detectable with TMS intensities evoking maximal or submaximal SPs.NEW & NOTEWORTHY This study compared the change in silent period (SP) and short-interval intracortical inhibition (SICI) with conditioning stimulus and single-pulse transcranial magnetic stimulation (TMS) intensities (for SICI and SP, respectively) eliciting maximal and submaximal SICI and SP during fatiguing exercise. The results showed that changes in SICI were only detectable with intensities evoking maximal responses, with no difference between intensities for SP. These findings highlight the importance of maximizing SICI with appropriate intensities before measuring SICI during fatiguing exercise.
Collapse
Affiliation(s)
- Callum G Brownstein
- Inter-University Laboratory of Human Movement Science, Université Claude Bernard Lyon 1 and Université Jean Monnet-Saint-Etienne, EA 7424, Saint-Etienne, France
| | - Loïc Espeit
- Inter-University Laboratory of Human Movement Science, Université Claude Bernard Lyon 1 and Université Jean Monnet-Saint-Etienne, EA 7424, Saint-Etienne, France
| | - Nicolas Royer
- Inter-University Laboratory of Human Movement Science, Université Claude Bernard Lyon 1 and Université Jean Monnet-Saint-Etienne, EA 7424, Saint-Etienne, France
| | - Thomas Lapole
- Inter-University Laboratory of Human Movement Science, Université Claude Bernard Lyon 1 and Université Jean Monnet-Saint-Etienne, EA 7424, Saint-Etienne, France
| | - Guillaume Y Millet
- Inter-University Laboratory of Human Movement Science, Université Claude Bernard Lyon 1 and Université Jean Monnet-Saint-Etienne, EA 7424, Saint-Etienne, France
| |
Collapse
|
11
|
Bönstrup M, Iturrate I, Hebart MN, Censor N, Cohen LG. Mechanisms of offline motor learning at a microscale of seconds in large-scale crowdsourced data. NPJ SCIENCE OF LEARNING 2020; 5:7. [PMID: 32550003 PMCID: PMC7272649 DOI: 10.1038/s41539-020-0066-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 04/17/2020] [Indexed: 05/25/2023]
Abstract
Performance improvements during early human motor skill learning are suggested to be driven by short periods of rest during practice, at the scale of seconds. To reveal the unknown mechanisms behind these "micro-offline" gains, we leveraged the sampling power offered by online crowdsourcing (cumulative N over all experiments = 951). First, we replicated the original in-lab findings, demonstrating generalizability to subjects learning the task in their daily living environment (N = 389). Second, we show that offline improvements during rest are equivalent when significantly shortening practice period duration, thus confirming that they are not a result of recovery from performance fatigue (N = 118). Third, retroactive interference immediately after each practice period reduced the learning rate relative to interference after passage of time (N = 373), indicating stabilization of the motor memory at a microscale of several seconds. Finally, we show that random termination of practice periods did not impact offline gains, ruling out a contribution of predictive motor slowing (N = 71). Altogether, these results demonstrate that micro-offline gains indicate rapid, within-seconds consolidation accounting for early skill learning.
Collapse
Affiliation(s)
- Marlene Bönstrup
- Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20814 USA
| | - Iñaki Iturrate
- Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20814 USA
| | - Martin N. Hebart
- Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD 20814 USA
| | - Nitzan Censor
- School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, 69978 Tel Aviv, Israel
| | - Leonardo G. Cohen
- Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20814 USA
| |
Collapse
|
12
|
Cinelli KTM, Green LA, Kalmar JM. The Task at Hand: Fatigue-Associated Changes in Cortical Excitability during Writing. Brain Sci 2019; 9:brainsci9120353. [PMID: 31810290 PMCID: PMC6955716 DOI: 10.3390/brainsci9120353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/15/2019] [Accepted: 11/29/2019] [Indexed: 12/23/2022] Open
Abstract
Measures of corticospinal excitability (CSE) made via transcranial magnetic stimulation (TMS) depend on the task performed during stimulation. Our purpose was to determine whether fatigue-induced changes in CSE made during a conventional laboratory task (isometric finger abduction) reflect the changes measured during a natural motor task (writing). We assessed single-and paired-pulse motor evoked potentials (MEPs) recorded from the first dorsal interosseous (FDI) of 19 participants before and after a fatigue protocol (submaximal isometric contractions) on two randomized days. The fatigue protocol was identical on the two days, but the tasks used to assess CSE before and after fatigue differed. Specifically, MEPs were evoked during a writing task on one day and during isometric finger abduction to a low-level target that matched muscle activation during writing on the other day. There was greater variability in MEP amplitude (F (1,18) = 13.55, p < 0.01) during writing compared to abduction. When participants were divided into groups according to writing style (printers, n = 8; cursive writers, n = 8), a task x fatigue x style interaction was revealed for intracortical facilitation (F (1,14) = 9.90, p < 0.01), which increased by 28% after fatigue in printers but did not change in cursive writers nor during the abduction task. This study is the first to assess CSE during hand-writing. Our finding that fatigue-induced changes in intracortical facilitation depend on the motor task used during TMS, highlights the need to consider the task-dependent nature of CSE when applying results to movement outside of the laboratory.
Collapse
|
13
|
Zhou SS, Jiang JG. Anti-fatigue Effects of Active Ingredients from Traditional Chinese Medicine: A Review. Curr Med Chem 2019; 26:1833-1848. [DOI: 10.2174/0929867324666170414164607] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 02/24/2017] [Accepted: 04/17/2017] [Indexed: 01/17/2023]
Abstract
Background:
The application of traditional Chinese medicine (TCM) in the
treatment of fatigue has long been practiced in clinical and showed significant effects.
Objective:
This article summarizes the work done on the natural products from TCM that
are reported to have effects of treating fatigue, in the past two decades.
Method:
Research status, sources, models, efficacy and mechanisms of active ingredients
and their monomer in the treatment of fatigue are discussed.
Results:
Pharmacological research shows that active ingredients of polysaccharide can significantly
improve body’s resistance through promoting glycogen synthesis, reducing sports
metabolites and increasing hypoxia tolerance; Alkaloids have been proven to be effective in
promoting the reserving of various glucogen substances, improving exercise endurance and
speeding up the metabolism of body’s urea nitrogen in mice; With the increase of glycosides
amount, up goes the sport endurance, liver glycogen content and the ability of clear lactate
index in mice, indicating that saponin has clear, dose-dependent anti-fatigue effect; Polyphenols
have also functions of resisting fatigue, where they reduce free radicals accumulated
and thus slow down the rapid declination of exercise capacity when doing sports; There are
other active ingredients of TCM that have biological activities, like some proteins, anthraquinones,
terpenes, unsaturated fatty acid monomer compounds; And research has found
that tonic medicine can promote the elimination of fatigue and improve athletic ability.
Conclusion:
It is hoped that the data summarized in this review will be beneficial to the
screening of new nature-derived drugs with the ability of relieving and improving fatigue.
Collapse
Affiliation(s)
- Si-Si Zhou
- College of Food and Bioengineering, South China University of Technology, Guangzhou, 510640, China
| | - Jian-Guo Jiang
- College of Food and Bioengineering, South China University of Technology, Guangzhou, 510640, China
| |
Collapse
|
14
|
Nicoletti CG, Monteleone F, Marfia GA, Usiello A, Buttari F, Centonze D, Mori F. Oral D-Aspartate enhances synaptic plasticity reserve in progressive multiple sclerosis. Mult Scler 2019; 26:304-311. [DOI: 10.1177/1352458519828294] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Synaptic plasticity reserve correlates with clinical recovery after a relapse in relapsing–remitting forms of multiple sclerosis (MS) and is significantly compromised in patients with progressive forms of MS. These findings suggest that progression of disability in MS is linked to reduced synaptic plasticity reserve. D-Aspartate, an endogenous aminoacid approved for the use in humans as a dietary supplement, enhances synaptic plasticity in mice. Objective: To test whether D-Aspartate oral intake increases synaptic plasticity reserve in progressive MS patients. Methods: A total of 31 patients affected by a progressive form of MS received either single oral daily doses of D-Aspartate 2660 mg or placebo for 4 weeks. Synaptic plasticity reserve and trans-synaptic cortical excitability were measured through transcranial magnetic stimulation (TMS) protocols before and after D-Aspartate. Results: Both TMS-induced long-term potentiation (LTP), intracortical facilitation (ICF) and short-interval ICF increased after 2 and 4 weeks of D-Aspartate but not after placebo, suggesting an enhancement of synaptic plasticity reserve and increased trans-synaptic glutamatergic transmission. Conclusion: Daily oral D-Aspartate 2660 mg for 4 weeks enhances synaptic plasticity reserve in patients with progressive MS, opening the path to further studies assessing its clinical effects on disability progression.
Collapse
Affiliation(s)
- Carolina G Nicoletti
- Multiple Sclerosis Clinical & Research Center, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Fabrizia Monteleone
- Multiple Sclerosis Clinical & Research Center, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Girolama A Marfia
- Multiple Sclerosis Clinical & Research Center, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Alessandro Usiello
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, The Second University of Naples, Caserta, Italy/ Laboratory of Behavioral Neuroscience, CEINGE —Biotecnologie Avanzate, Naples, Italy
| | | | - Diego Centonze
- Multiple Sclerosis Clinical & Research Center, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy/ Unit of Neurology, IRCCS Neuromed, Pozzilli, Italy
| | - Francesco Mori
- Multiple Sclerosis Clinical & Research Center, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy/ Unit of Neurology, IRCCS Neuromed, Pozzilli, Italy
| |
Collapse
|
15
|
Ramage AE, Tate DF, New AB, Lewis JD, Robin DA. Effort and Fatigue-Related Functional Connectivity in Mild Traumatic Brain Injury. Front Neurol 2019; 9:1165. [PMID: 30713519 PMCID: PMC6345685 DOI: 10.3389/fneur.2018.01165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 12/17/2018] [Indexed: 11/23/2022] Open
Abstract
Mental fatigue in healthy individuals is typically observed under conditions of high cognitive demand, particularly when effort is required to perform a task for a long period of time-thus the concepts of fatigue and effort are closely related. In brain injured individuals, mental fatigue can be a persistent and debilitating symptom. Presence of fatigue after brain injury is prognostic for return to work/school and engagement in activities of daily life. As such, it should be a high priority for treatment in this population, but because there is little understanding of its behavioral and neural underpinnings, the target for such treatment is unknown. Here, the neural underpinnings of fatigue and effort are investigated in active duty military service members with mild traumatic brain injury (mTBI) and demographically-matched orthopedic controls. Participants performed a Constant Effort task for which they were to hold a pre-defined effort level constant for long durations during fMRI scanning. The task allowed for investigation of the neural systems underlying fatigue and their relationship with sense of effort. While brain activation associated with effort and fatigue did not differentiate the mTBI and controls, functional connectivity amongst active brain regions did. The mTBI group demonstrated immediate hyper-connectivity that increased with effort level but diminished quickly when there was a need to maintain effort. Controls, in contrast, demonstrated a similar pattern of hyper-connectivity, but only when maintaining effort over time. Connectivity, particularly between the left anterior insula, rostral anterior cingulate cortex, and right-sided inferior frontal regions, correlated with effort-level and state fatigue in mTBI participants. These connections also correlated with effort level in the Control group, but only the connection between the left insula and superior medial frontal gyrus correlated with fatigue, suggesting a differing pattern of connectivity. These findings align, in part, with the dopamine imbalance, and neural efficiency hypotheses that pose key roles for medial frontal connections with insular or striatal regions in motivating or optimizing performance. Sense of effort and fatigue are closely related. As people fatigue, sense of effort increases systematically. The data propose a complex link between sense of effort, fatigue, and mTBI that is centered in what may be an inefficient neural system due to brain trauma that warrants further investigation.
Collapse
Affiliation(s)
- Amy E. Ramage
- Department of Communication Sciences and the Interdisciplinary Program in Neuroscience and Behavior, University of New Hampshire, Durham, NH, United States
| | - David F. Tate
- Missouri Institute of Mental Health, University of Missouri-St. Louis, Berkeley, MO, United States
| | - Anneliese B. New
- TIRR Memorial Hermann, Department of Neuropsychology, Houston, TX, United States
| | - Jeffrey D. Lewis
- Department of Neurology, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences School of Medicine, Bethesda, MD, United States
| | - Donald A. Robin
- Department of Communication Sciences and the Interdisciplinary Program in Neuroscience and Behavior, University of New Hampshire, Durham, NH, United States
| |
Collapse
|
16
|
Kalmar JM. On task: Considerations and future directions for studies of corticospinal excitability in exercise neuroscience and related disciplines. Appl Physiol Nutr Metab 2018; 43:1113-1121. [DOI: 10.1139/apnm-2018-0123] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Over the last few decades, transcranial magnetic stimulation (TMS) has emerged as a conventional laboratory technique in human neurophysiological research. Exercise neuroscientists have used TMS to study central nervous system contributions to fatigue, training, and performance in health, injury, and disease. In such studies, corticospinal excitability is often assessed at rest or during simple isometric tasks with the implication that the results may be extrapolated to more functional and complex movement outside of the laboratory. However, the neural mechanisms that influence corticospinal excitability are both state- and task-dependent. Furthermore, there are many sites of modulation along the pathway from the motor cortex to the muscle; a fact that is somewhat obscured by the all-encompassing and poorly defined term “corticospinal excitability”. Therefore, the tasks we use to assess corticospinal excitability and the conclusions that we draw from such a global measure of the motor pathway must be taken into consideration. The overall objective of this review is to highlight the task-dependent nature of corticospinal excitability and the tools used to assess modulation at cortical and spinal sites of modulation. By weighing the advantages and constraints of conventional approaches to studying corticospinal excitability, and considering some new and novel approaches, we will continue to advance our understanding of the neural control of movement during exercise.
Collapse
Affiliation(s)
- Jayne M. Kalmar
- Wilfrid Laurier University, Department of Kinesiology and Physical Education, Waterloo, ON N2L 3C5, Canada
- Wilfrid Laurier University, Department of Kinesiology and Physical Education, Waterloo, ON N2L 3C5, Canada
| |
Collapse
|
17
|
Pattyn N, Van Cutsem J, Dessy E, Mairesse O. Bridging Exercise Science, Cognitive Psychology, and Medical Practice: Is "Cognitive Fatigue" a Remake of "The Emperor's New Clothes"? Front Psychol 2018; 9:1246. [PMID: 30250436 PMCID: PMC6139359 DOI: 10.3389/fpsyg.2018.01246] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/28/2018] [Indexed: 12/30/2022] Open
Abstract
Fatigue is such a multifaceted construct it has sprouted specific research fields and experts in domains as different as exercise physiology, cognitive psychology, human factors and engineering, and medical practice. It lacks a consensus definition: it is an experimental concept, a symptom, a risk, a cause (e.g., of performance decrement) and a consequence (e.g., of sleep deprivation). This fragmentation of knowledge leads to slower dissemination of novel insights, and thus to a poorer research. Indeed, what may seem as a novel result in one field, may very well be old news in another, hence leading to this "innovation" being a scientific equivalent to the emperor's new clothes. The current paper aims to describe the common denominator in the different areas of expertise where fatigue is investigated. Indeed, rather than focusing on the differences in semantics and conceptualization, we hope that identifying common concepts may be inductive of easier multidisciplinary research. Considering the vastness of fatigue research in all areas identified as relevant-cognitive science, exercise physiology, and medical practice, this analysis has not the ambition to be an exhaustive review in all domains. We have reviewed the fatigue concepts and research in these areas and report the ones that are used to describe the proposed common model to be further investigated. The most promising common feature to cognitive science, exercise physiology and clinical practice is the notion of "perceived effort." This allows to account for interindividual differences, as well as for the situational variations in fatigue. It is applicable to both mental and physical constructs. It integrates motivational and emotional dimensions. It overcomes current polemics in various research fields, and it does not draw on any semantic ambiguity. We thus suggest a new model of fatigue and performance, whether this performance is mental or physical; and whether it is in a clinical range or relates to optimal functioning.
Collapse
Affiliation(s)
- Nathalie Pattyn
- VIPER Research Unit, Royal Military Academy, Brussels, Belgium
- Department of Experimental and Applied Psychology, Vrije Universiteit Brussel, Brussels, Belgium
- Human Physiology Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jeroen Van Cutsem
- Human Physiology Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Endurance Research Group, University of Kent, Chatham, United Kingdom
| | - Emilie Dessy
- VIPER Research Unit, Royal Military Academy, Brussels, Belgium
- Department of Experimental and Applied Psychology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Olivier Mairesse
- VIPER Research Unit, Royal Military Academy, Brussels, Belgium
- Department of Experimental and Applied Psychology, Vrije Universiteit Brussel, Brussels, Belgium
- Sleep Unit, CHU Brugmann, Brussels, Belgium
| |
Collapse
|
18
|
Van Cutsem J, Marcora S, De Pauw K, Bailey S, Meeusen R, Roelands B. The Effects of Mental Fatigue on Physical Performance: A Systematic Review. Sports Med 2018; 47:1569-1588. [PMID: 28044281 DOI: 10.1007/s40279-016-0672-0] [Citation(s) in RCA: 353] [Impact Index Per Article: 58.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Mental fatigue is a psychobiological state caused by prolonged periods of demanding cognitive activity. It has recently been suggested that mental fatigue can affect physical performance. OBJECTIVE Our objective was to evaluate the literature on impairment of physical performance due to mental fatigue and to create an overview of the potential factors underlying this effect. METHODS Two electronic databases, PubMed and Web of Science (until 28 April 2016), were searched for studies designed to test whether mental fatigue influenced performance of a physical task or influenced physiological and/or perceptual responses during the physical task. Studies using short (<30 min) self-regulatory depletion tasks were excluded from the review. RESULTS A total of 11 articles were included, of which six were of strong and five of moderate quality. The general finding was a decline in endurance performance (decreased time to exhaustion and self-selected power output/velocity or increased completion time) associated with a higher than normal perceived exertion. Physiological variables traditionally associated with endurance performance (heart rate, blood lactate, oxygen uptake, cardiac output, maximal aerobic capacity) were unaffected by mental fatigue. Maximal strength, power, and anaerobic work were not affected by mental fatigue. CONCLUSION The duration and intensity of the physical task appear to be important factors in the decrease in physical performance due to mental fatigue. The most important factor responsible for the negative impact of mental fatigue on endurance performance is a higher perceived exertion.
Collapse
Affiliation(s)
- Jeroen Van Cutsem
- Human Physiology Research Group, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.,Endurance research group, School of Sport and Exercise SciencesUniversity of Kent at Medway, Chatham Maritime, Kent, ME4 4Ag, UK
| | - Samuele Marcora
- Endurance research group, School of Sport and Exercise SciencesUniversity of Kent at Medway, Chatham Maritime, Kent, ME4 4Ag, UK
| | - Kevin De Pauw
- Human Physiology Research Group, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - Stephen Bailey
- Department of Physical Therapy Education, Elon University, Elon, NC, 27244, USA
| | - Romain Meeusen
- Human Physiology Research Group, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.,School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Queensland, Australia
| | - Bart Roelands
- Human Physiology Research Group, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium. .,Fund for Scientific Research Flanders (FWO), Brussels, Belgium.
| |
Collapse
|