![]() ![]() Physically effortful tasks with minimal cognitive demands or cognitively effortful tasks with minimal physical costs both induce a similar feeling of fatigue (Krupp et al., 1989). Strikingly, the same phenomenological experience of fatigue can occur when exerting effort into very different acts. cardiovascular) system (Boksem and Tops, 2008, Carroll et al., 2017, Chaudhuri and Behan, 2004, Fairclough and Mulder, 2011, Kurzban et al., 2013, Micklewright et al., 2017). It also putatively comes with a spectrum of internal changes within the body and neutrally, with marked changes to the autonomic (e.g. Similarly, people can experience state fatigue, that waxes and wanes during behaviours that require extended periods of cognitive control or motor output, typically impacting on the speed, accuracy or force of behaviours. One of the greatest impacts on behaviour is that it leads to persistent and pervasive reductions in daily activity. In the most severe cases, no amount of rest is able to ameliorate the feelings of exhaustion. Fatigue is classically thought to arise through effortful exertion and decline through rest. It is also present in a milder form in otherwise healthy people, with about 25% of people reporting themselves as being fatigued most of the time. Trait fatigue – a persistent feeling of exhaustion – is one of the most common symptoms across a broad range of neurological and psychiatric disorders and is the cause of as much as 10% of primary care appointments (Chaudhuri and Behan, 2004, Cullen et al., 2002, Demyttenaere et al., 2005, Skapinakis et al., 2003). This account provides a new framework for understanding the effects of fatigue during cognitively and physically demanding tasks as well as for understanding motivational impairments in health and disease. As a result, as levels of fatigue rise, the value of exerting effort into a task declines, leading to reductions in performance. Levels of fatigue arising from effortful behaviours impact on processing in systems that weigh up the costs and benefits of exerting effort. We put forward a neurocognitive framework for fatigue and its impact on motivation. Strikingly, this research has implicated systems in the brain, including the dorsal anterior cingulate cortex (dACC), anterior insula, and lateral prefrontal cortex, that in separate lines of research have been linked to motivating the exertion of effort, to persisting towards goals and to processing one's internal states. Here, we review recent neurophysiological and neuroimaging research that has begun to identify the neural mechanisms underlying changes in behaviour occurring due to fatigue. However, to date, theoretical accounts of fatigue have not fully characterised the neuroanatomical basis of cognitive and physical fatigue nor placed results within broader discussions of the functional properties of the systems implicated. During extended behaviours, fatigue increases over time, leading to decrements in performance in both cognitively and physically demanding tasks. Fatigue – a feeling of exhaustion arising from exertion – is a significant barrier to successful behaviour and one of the most prominent symptoms in primary care. ![]()
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