Hanken Katrin, Eling Paul, Hildebrandt Helmut
Klinikum Bremen-Ost, Germany.
Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, the Netherlands.
Mult Scler. 2015 Apr;21(4):376-81. doi: 10.1177/1352458514549567. Epub 2014 Sep 25.
The compensatory approach of fatigue argues that it is a state caused by task load. The neuropsychiatric approach argues that fatigue is a trait (like depression), unrelated to environmental challenges. We propose that fatigue is an internal state that can be measured behaviorally only by applying specific cognitive tasks. PubMed was searched for articles concerning the relation between fatigue and cognitive performance or brain atrophy or functional MRI, distinguishing between the following cognitive domains: learning/memory, cognitive speed/selective attention, language, visuospatial processing, working memory, alerting/vigilance. Only tasks assessing alerting/vigilance are strongly related to fatigue. Areas with brain atrophy in fatigue patients overlap with brain regions activated in healthy controls performing alerting/vigilance tasks. Fatigue is not a compensatory state, nor a psychogenic trait. It is a feeling with behavioral effects that seems to be caused by brain atrophy or a neurochemical dysfunction of the alerting/vigilance system.
疲劳的补偿性观点认为，它是一种由任务负荷引起的状态。神经精神病学观点则认为，疲劳是一种特质（类似于抑郁），与环境挑战无关。我们提出，疲劳是一种内部状态，只能通过应用特定的认知任务来进行行为测量。在PubMed上搜索了有关疲劳与认知表现、脑萎缩或功能磁共振成像之间关系的文章，区分了以下认知领域：学习/记忆、认知速度/选择性注意、语言、视觉空间处理、工作记忆、警觉/警惕性。只有评估警觉/警惕性的任务与疲劳密切相关。疲劳患者出现脑萎缩的区域与健康对照在执行警觉/警惕性任务时激活的脑区重叠。疲劳既不是一种补偿性状态，也不是一种心理特质。它是一种具有行为影响的感觉，似乎是由脑萎缩或警觉/警惕系统的神经化学功能障碍引起的。
