Fatigue in neurological disorders
Abstract
Chronic fatigue is a typical symptom of neurological diseases, and is most disabling in multiple sclerosis, postpoliomyelitis, poststroke, and in chronic fatigue syndrome. Disorders of neuromuscular junction transmission and metabolic diseases cause muscle fatigability, which is characterised by failure to sustain the force of muscle contraction (peripheral fatigue). Fatigue is also seen in diseases that affect the central, peripheral, and autonomic nervous systems (central fatigue). Enhanced perception of effort and limited endurance of sustained physical and mental activities are the main characteristics of central fatigue. Metabolic and structural lesions that disrupt the usual process of activation in pathways interconnecting the basal ganglia, thalamus, limbic system, and higher cortical centre are implicated in the pathophysiological process of central fatigue. A state of pre-existing relative hypocortisolaemia might sensitise the hypothalamic-pituitary-adrenal axis to development of persistent central fatigue after stress. The contributions of physiological, cognitive, and affective changes underlying fatigue are variable, and treatment is largely symptomatic and rehabilitative.
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- Authors
- Chaudhuri, A., & Behan, P. O.
- Affiliations
- University of Glasgow (GB)
- Corresponding author
- Chaudhuri, Abhijit
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2004-03
- Volume
- 363
- Issue
- 9413
- Pages
- 978-988
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2160660606
- Cited by
- 1,297
- References
- 6
- Citations by year
- 2026: 45 · 2025: 68 · 2024: 72 · 2023: 88 · 2022: 89 · 2021: 97 · 2020: 68 · 2019: 65 · 2018: 55 · 2017: 70 · 2016: 71 · 2015: 55 · 2014: 62 · 2013: 79 · 2012: 55
- FWCI
- 4.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Keywords
- chronic fatigue, central fatigue, peripheral fatigue, multiple sclerosis, post-stroke fatigue, chronic fatigue syndrome, neuromuscular junction disorders, muscle fatigue, hypothalamic-pituitary-adrenal axis, pathophysiology of fatigue, rehabilitation
- MeSH terms
- Fatigue, Humans, Nervous System Diseases
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