Fatigue and fatigability in neurologic illnesses: Proposal for a unified taxonomy
Open accessAbstract
Fatigue is commonly reported in many neurologic illnesses, including multiple sclerosis, Parkinson disease, myasthenia gravis, traumatic brain injury, and stroke. Fatigue contributes substantially to decrements in quality of life and disability in these illnesses. Despite the clear impact of fatigue as a disabling symptom, our understanding of fatigue pathophysiology is limited and current treatment options rarely lead to meaningful improvements in fatigue. Progress continues to be hampered by issues related to terminology and assessment. In this article, we propose a unified taxonomy and a novel assessment approach to addressing distinct aspects of fatigue and fatigability in clinical and research settings. This taxonomy is based on our current knowledge of the pathophysiology and phenomenology of fatigue and fatigability. Application of our approach indicates that the assessment and reporting of fatigue can be clarified and improved by utilizing this taxonomy and creating measures to address distinct aspects of fatigue and fatigability. We review the strengths and weaknesses of several common measures of fatigue and suggest, based on our model, that many research questions may be better addressed by using multiple measures. We also provide examples of how to apply and validate the taxonomy and suggest directions for future research.
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The clinical concept of fatigue is heterogeneous, comprising at least two dimensions: fatiguability of cognitive and motor processes and subjective perception of fatigue.
“The clinical concept of fatigue is a heterogeneous construct, comprising at least two dimensions (Kluger et al., 2013): fatiguability of cognitive and motor processes, and subjective perception of fatigue.”
From Allostatic Self-efficacy: A Metacognitive Theory of Dyshomeostasis-Induced Fatigue and Depression (2016) · cites this paper as Kluger et al., 2013
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- Authors
- Kluger, B. M., Krupp, L. B., & Enoka, R. M.
- Affiliations
- University of Colorado Boulder (US)
- Venue
- Neurology
- Published
- 2013-01-22
- Volume
- 80
- Issue
- 4
- Pages
- 409-416
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC3589241
- OpenAlex
- W2011810065
- Cited by
- 1,036
- References
- 63
- Citations by year
- 2026: 92 · 2025: 105 · 2024: 123 · 2023: 106 · 2022: 124 · 2021: 110 · 2020: 89 · 2019: 53 · 2018: 55 · 2017: 44 · 2016: 50 · 2015: 33 · 2014: 33 · 2013: 17
- FWCI
- 6.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (KL2TR001080)
- National Center for Research Resources (KL2RR025779)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- fatigue, fatigability, neurological disorders, multiple sclerosis, Parkinson's disease, myasthenia gravis, traumatic brain injury, stroke, fatigue analysis, pathophysiology of fatigue, disability, quality of life
- MeSH terms
- Chronic Disease, Fatigue, Humans, Nervous System Diseases, Neurology, Prevalence
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