[Asthenia, mental fatigue and cognitive dysfunction].
Titova, N V, Bezdolny, Yu N, Katunina, E A · Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova · 2023 · DOI
Quick Summary
This article discusses asthenia, which is a condition characterized by extreme tiredness that affects daily functioning and productivity. The authors explain that it's important to distinguish between simple chronic tiredness and chronic fatigue syndrome (CFS), and that fatigue can affect both the body and the mind. The article reviews how the brain may be involved in causing fatigue and cognitive problems, and suggests that a combination treatment using specific medications may help patients with fatigue and thinking difficulties.
Why It Matters
Understanding the distinction between different types of fatigue and their neurobiological mechanisms is crucial for ME/CFS patients, as it may help clinicians identify the underlying causes of symptoms and select appropriate treatments. This review connects fatigue, cognitive impairment, and mental stress, which many ME/CFS patients experience simultaneously, offering a framework for understanding how these symptoms relate to each other.
Observed Findings
Asthenia is characterized by increased fatigue, impaired daily functioning, and decreased work productivity.
Fatigue in these conditions can manifest as physical fatigue and/or cognitive and mental fatigue.
There is a relationship between mental stress, fatigue, and cognitive impairment including subjective cognitive impairment (SCI) and mild cognitive impairment (MCI).
A distinction can be made between idiopathic chronic fatigue (primary/functional asthenia) and chronic fatigue syndrome in clinical practice.
Inferred Conclusions
Fatigue disorders involve distinct neuroanatomical and neurocognitive mechanisms that warrant targeted treatment approaches.
Combination therapy with piracetam and Ginkgo biloba with nicotinoyl-GABA has pathophysiologic rationale for treating asthenia accompanied by cognitive dysfunction.
Mental stress, fatigue, and cognitive impairment are interconnected phenomena that should be considered together in clinical management.
Remaining Questions
What is the comparative efficacy of the proposed combination therapy versus placebo or standard treatments in clinical trials?
Which specific neuroanatomical regions and neurocognitive pathways are most impaired in ME/CFS versus other forms of asthenia?
What This Study Does Not Prove
As an editorial review rather than a clinical trial, this article does not provide empirical evidence that the proposed combination therapy is effective in ME/CFS patients. The article presents theoretical rationale and existing knowledge rather than new data, so it does not establish the efficacy, safety, or appropriate dosing of the suggested treatment. The review does not prove that the proposed mechanisms are the primary drivers of fatigue in all CFS patients.