Chronic Fatigue Syndrome: Limbic Encephalopathy in a Dysregulated Neuroimmune Network
Jay A. Goldstein in Chronic Fatigue Syndromes, 2020
Fatigue is a common symptom associated with many medical disorders which needs to be considered when evaluating a patient. Common causes of fatigue include viral, infectious or inflammatory syndromes, endocrine disorders, and autoimmune diseases. Heart failure, chronic lung diseases, anemia, malabsorption, hepatic and renal failure all may be associated with fatigue due to inadequate delivery of nutrients and oxygen to various organ systems. Almost any chronic illness can cause fatigue, and neoplastic disorders should always be considered. Adverse drug reactions and ingestion of alcohol, toxins, or illicit substances may also produce fatigue. Sleep disorders are commonly overlooked as is chronic sinusitis, a fatigue-producing condition that should respond to proper therapy.
Chronic Posttraumatic Stress
Rolland S. Parker in Concussive Brain Trauma, 2016
A syndrome descriptive of chronic job stress is “burnout” (i.e., emotional exhaustion, depersonalization, and reduced personal accomplishment) (Burke & Richardson, 1996) (see Allostasis and Stress and the following discussion). Stress in elderly caregivers was associated with poorer antibody response to influenza vaccine (Kiecolt-Glaser, cited by Vedhara & Wang, 2005). The initial stress response is temporarily beneficial, although antireproductive, antigrowth, catabolic, and immunosuppressive. Chronic stress may lead to a pathological syndromal state with psychiatric, neuroendocrine, cardiovascular, metabolic, and immune components (Chrousos, 1998). The amplitude of the release of pituitary hormones can be altered by prior stimulation that might have depleted a releasable pool of hormone (Molitch, 2001). The HPA becomes hyporesponsive, affecting stamina, health, and quality of life. Stress disrupts energy metabolism and caloric balance (Middleboe et al., 1992). A study compared two groups, mTBI and minor injury. Severe fatigue was associated with other symptoms (e.g., nausea and headache) (Stulemeijer et al., 2006a). Perhaps loss of stamina is related to the fact that catecholamines and cortisol shift.
Post-traumatic cognitive dysfunction
Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor in Essentials of Anesthesia for Neurotrauma, 2018
Fatigue and dizziness: Fatigue can be defined as a condition of decreased physical and mental efficiency. Despite being commonly identified as a sign or a symptom of a disease or side effect of a treatment, fatigue has been considered a subjective experience.34 Literature reveals mental fatigue induces a decline in executive function such as executive attention, sustained attention, goal-directed attention, alternating attention, divided attention, response inhibition, planning, and novelty processing.35 A significant proportion of people with brain injury (32%–73%) reportedly experience fatigue. Whereas fatigue resolves within days or weeks for most people with mild injuries, it can persist over many years after moderate to severe injuries and impact participation in numerous activities, including work, study, leisure, and social pursuits.36
Train drivers’ subjective perceptions of their abilities to perceive and control fatigue
Published in International Journal of Occupational Safety and Ergonomics, 2020
Yung-Hsiang Cheng, Hui-Ning Tian
Before we conducted the survey, we conferred with the senior train drivers and the safety manager to ascertain the appropriateness of the measurement items. A pilot study was also performed to modify the measurement items. Several prior studies discussed the causes of fatigue. Grandjean [65] described fatigue as a bucket of liquids filled with monotonous tasks, surroundings, intensity and length of work, psychological factors, illness and pain. The major causes of human fatigue include sleep quality, circadian rhythm and sleep disorders. Circumstantial factors, such as weather, temperature, type of work and workload, also directly lead to human fatigue [66]. Williamson et al. [13] summarized three major sources of fatigue, namely, sleep homeostasis factors, circadian influences and nature of task effects. Anxiety, mood states, personality and temperament may also influence driving fatigue [11]. Ji et al. [66] demonstrated that environmental factors, physical conditions and type of work significantly affect fatigue and that fatigue exhibits different manifestations that vary over time and uncertainties. Therefore, the scenario items used in this study were derived from previous relevant studies and through consultation with senior railway safety experts.
The development of the ‘Cancer Home-Life Intervention’: An occupational therapy-based intervention programme for people with advanced cancer living at home
Published in Scandinavian Journal of Occupational Therapy, 2021
Line Elisabeth Lindahl-Jacobsen, Karen la Cour, Lisa Gregersen Oestergaard, Marc Sampedro Pilegaard, Hanne Peoples, Åse Brandt
Findings from the scoping review were sparse. Only a few studies were identified: one of these, a pilot RCT, suggested that a telephone-based intervention lasting at most 120 min and with 1–6 contacts would be feasible, and would improve the quality of life for patients with breast cancer [22]. In another RCT, tailored to a cancer population with varying cancer diagnoses [19], the predominant intervention was prioritizing activities. The scoping review revealed that the following interventions would be relevant to incorporate in the ‘Cancer Home-Life Intervention’. Interventions that: promote adherence to activities and reduce social participation restrictions [22]; provide home modification and address functional decline by providing strategies to compensate for disparities between a patient’s ability and the environmental demands [23]; and target fatigue management [24]. In conclusion, data from the scoping review revealed that an intervention lasting at most 120 min and with 1–6 contacts was feasible, and that the intervention might address:Activities and social participation.Functional decline.Symptoms such as fatigue.Discrepancy between a person’s ability and the environmental demands.
The association between multiple prior concussions, cognitive test scores, and symptom reporting in youth rugby league players
Published in Brain Injury, 2020
Andrew J. Gardner, David R. Howell, Grant L. Iverson
Of the 78 participants, the age range was 14–18 years at the time of testing, and a majority (64%) reported having sustained at least one concussion in their lifetime (Table 1). There were no significant differences on the cognitive test scores based upon the number of self-reported lifetime concussions at the time of testing (Table 1). There were also no significant differences between groups for the total number of RPCSQ symptoms endorsed, although those who reported 0 prior concussions tended to report fewer total symptoms than the groups with 1–2 or ≥ 3 lifetime concussions; mean symptom score = 2.1 ± 2.7 vs. 4.0 ± 4.6 vs. 4.5 ± 4.8; χ2 = 3.35; p = .19 (Table 1). However, medium pairwise effect sizes were observed between those with zero prior concussions compared to those with 1–2 (Cohen’s d = 0.54) and three or more (d = 0.62) for the total number of symptoms endorsed (Table 1). The percentages of participants who endorsed individual symptoms stratified by concussion history are presented in Table 2. Endorsed symptoms were defined as a rating of 1 or greater. The most commonly reported symptoms were fatigue (41%), concentration difficulties (37%), headache (31%), taking longer to think (29%), restlessness (27%), frustration (26%), and irritability (24%). Those with a history of ≥ 3 prior concussions were more likely to endorse light sensitivity, and there was a trend for them to be more likely to endorse forgetfulness, irritability, restlessness, and feeling frustrated or impatient.
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