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Frontier studies on fatigue, autonomic nerve dysfunction, and sleep-rhythm disorder

Dolphin

Senior Member
Messages
17,567
Free full text: http://link.springer.com/article/10.1007/s12576-015-0399-y

The Journal of Physiological Sciences

November 2015, Volume 65, Issue 6, pp 483–498


Frontier studies on fatigue, autonomic nerve dysfunction, and sleep-rhythm disorder
Open Access
Review

First Online:
29 September 2015
Received:
30 August 2015
Accepted:
01 September 2015
DOI: 10.1007/s12576-015-0399-y

Abstract

Fatigue is defined as a condition or phenomenon of decreased ability and efficiency of mental and/or physical activities, caused by excessive mental or physical activities, diseases, or syndromes.

It is often accompanied by a peculiar sense of discomfort, a desire to rest, and reduced motivation, referred to as fatigue sensation.

Acute fatigue is a normal condition or phenomenon that disappears after a period of rest; in contrast, chronic fatigue, lasting at least 6 months, does not disappear after ordinary rest.

Chronic fatigue impairs activities and contributes to various medical conditions, such as cardiovascular disease, epileptic seizures, and death.

In addition, many people complain of chronic fatigue.

For example, in Japan, more than one third of the general adult population complains of chronic fatigue.

It would thus be of great value to clarify the mechanisms underlying chronic fatigue and to develop efficient treatment methods to overcome it.

Here, we review data primarily from behavioral, electrophysiological, and neuroimaging experiments related to neural dysfunction as well as autonomic nervous system, sleep, and circadian rhythm disorders in fatigue.

These data provide new perspectives on the mechanisms underlying chronic fatigue and on overcoming it.

Keywords
Autonomic nervous system Central nervous system Circadian rhythm Fatigue Sleep
 

Dolphin

Senior Member
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17,567

barbc56

Senior Member
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3,657
It is often accompanied by a peculiar sense of discomfort, a desire to rest, and reduced motivation, referred to as fatigue sensation
.

Thank you for this. It describes exactly what I've feeling but have had difficulty explaining clearly this particular aspect of my fatigue clearly.I hadn't heard of the term fatigue sensation. I am seeing my doctor next week because these symptoms have dramatically increased over the last six months.

This will help!

Thanks for the article!
 
Messages
3,263
Just read the thing in full. The PEM test is kind of interesting.

I sound like a broken record, but again, I urge scepticism when it comes to "brain dysfunction" models of our illness. They suffer from many of the same problems as traditional psychological explanations.

The whole model is based on the premise that our fatigue arises entirely in the brain. The underlying reasoning is that "there's nothing wrong with the body, therefore it must be in the brain". Where have we heard that kind of faulty reasoning before?

This model also shares with its psychosomatic brethren an obsession with the symptom of fatigue, to the exclusion of all others. If you try to consider the full complement of symptoms that make up ME, brain dysfunction models start to look less and less impressive.
 
Last edited:

Snowdrop

Rebel without a biscuit
Messages
2,933
Not to mention also, the 'motivation' word I find problematic. As I had less and less energy to apply to my activities of daily living I found that physically I had motivational issues. Trouble getting up to get on with things --but my psychological motivation was not an issue.

One needs to be careful to distinguish lest some 'well meaning' but completely oblivious practitioner see this as a sign of fatigue= depression.
Way to easy to jump to that conclusion.
 

Justin30

Senior Member
Messages
1,065
My thing thats really got my mind going is that the disease process in ME that causes POTS Hypovolemia directly attributed to Ron David's theory of Mitochondrial dysfunction.

So can mitochondrial absorption issues from glycolosis and the citric acid cycle directly be corelated to the Autonomic dysfunction and neurological manifestations of ME?

I have read that Mito diseases main symptom is Encephalomylietis but is this whole POTS Autonomic Dysfunction and Brain Inflamation a separate beast or all in the same pot?

I wonder cause almost every ME patient I know has increased symptoms after exercion some more than others.

So by correcting the Mito problem do you correct the illness?

Or by dealing with the Autonomic Nervous system do you correct the illness.

Is it coming from the GUT, Brain or the Mitochondria?
 

A.B.

Senior Member
Messages
3,780
Is it coming from the GUT, Brain or the Mitochondria?

Naviaux writes:

CDR = cell danger response

When the CDR persists abnormally, whole body metabolism and the gut microbiome are disturbed, the collective performance of multiple organ systems is impaired, behavior is changed, and chronic disease results. Metabolic memory of past stress encounters is stored in the form of altered mitochondrial and cellular macromolecule content, resulting in an increase in functional reserve capacity through a process known as mitocellular hormesis. The systemic form of the CDR, and its magnified form, the purinergic life-threat response (PLTR), are under direct control by ancient pathways in the brain that are ultimately coordinated by centers in the brainstem. Chemosensory integration of whole body metabolism occurs in the brainstem and is a prerequisite for normal brain, motor, vestibular, sensory, social, and speech development.

http://www.sciencedirect.com/science/article/pii/S1567724913002390

CDR in ME/CFS is still hypothetical.
 

Justin30

Senior Member
Messages
1,065
Naviaux writes:

CDR = cell danger response

I remember reading the full article. I have a question though......

Cause I think it is valid.....this area of the brainstem do you think its permanently damaged, malfunctioning or toxified?

ME as originally presented by ramsay said neurological which is brain and brainstem. Thats how the WHO Classified ME as a neurological condition.

I am head is really buzzing with this stuff.
 

JamBob

Senior Member
Messages
191
Beware, this research is just about being a bit tired. This disorder apparently affects "more than a third" of Japanese people!

I'd be surprised if it didn't affect 80% of the population. The people work such long hours, the kids have to go to juku (night school) after they've been at school all day and study late into the night. I worked there for a while and all day long my colleagues would be complaining "しんどい しんどい" - "I'm tired, I'm tired". Chronic fatigue (not CFS/ME) could be the national disease.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
The underlying reasoning is that "there's nothing wrong with the body, therefore it must be in the brain".

This model also shares with its psychosomatic brethren an obsession with the symptom of fatigue, to the exclusion of all others.

I completely agree with these points. It seems far too many researchers are ignoring far too much of the evidence. Its the streetlight effect. They find it easy to research in specific areas, so ignore everywhere else.

I have started to say it more and more: fatigue is irrelevant. Its like ignoring cancer so you can research pain, with a goal to developing a better pain therapy to cure cancer. Its great for pain research, but it won't cure cancer.

PEM testing might be useful though. We need alternatives to the 2 day CPET.
 

Justin30

Senior Member
Messages
1,065
Yes I do and I think it is a necessary attack to prevent worse. The problem is the attack can be to strong.

If the attack is to strong than that would likely be damage then correct?

If this is the cases then damage to the brain and brainstem would got right nack to what they said early on an infectios trigger causes an Ecephalopathy or Encephalomylietis (both of these are the main symptoms in Mito diseases).

But only one mito disease has an infectious trigger and its an ecephopathy.
 
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3,263
I think aspects of the problem are in the brain. Whether its primary or secondary is still unproven. The brain is very vulnerable to immune and metabolic effects, for example. These systems are all loops that point back to each other. Where is the start of a circle?
I agree, @alex3619. The brain is involved in every sensation we feel, of course. But is the cause of our problems a dysfunction in our brain? Or is the brain responding completely normally to a malfunction involving some other body system?

The second is the simpler explanation, I feel, and the one more likely to be able to make contact with all the diversity of symptoms we experience.